Safer Sex & STD Prevention for Gay & Bi Men

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Specific Sexual Behavior and Safety

Kissing
STD risks include:

• Anogenital warts (HPV)
• Genital herpes
• Gonorrhea
• Hepatitis A
• Molluscum (Molluscum contagiosum; viral infection that causes pimple-like bumps)
• Syphilis

Viruses and bacteria can be transmitted through kissing. Red, fleshy, waxy-looking, and puss-filled lesions present around the mouth may indicate an STD. Partners should avoid kissing any part of the body, unless the bumps are known to be noncontagious.

Licking
STD risks include:

• Gonorrhea
• Parasites

If the tongue contacts the mouth, urethra (opening of penis), or anus, there is a risk for infections associated with oral sex, oral to anal sex, and kissing. If these areas are not licked, there is no risk. A dental dam (a small, flat latex sheet) or ordinary (nonmicrowavable) plastic wrap can reduce the risk for exposure during oral to anal or oral to genital licking.

Frottage (genital-to-genital rubbing)
STD risks include:

• Anogenital warts (HPV)
• Crabs
• Genital herpes
• Scabies

If frottage is done while wearing clothes, there is no risk for spreading or contracting the viruses, but there is a risk for crabs and scabies. HSV and HPV may be transmitted through direct contact.

Mutual masturbation (masturbating a partner)
STD risks include:

• Hepatitis B and C
• HIV
• Syphilis

STDs can be transmitted while masturbating a partner if semen enters a wound on the hand. It is advisable to keep semen away from open skin. The skin of the hands and fingers should be examined before masturbating a partner, particularly if the partner is a new acquaintance.

Oral sex (penis in mouth) without a condom, inserter or receiver, with or without ejaculation
STD risks include:

• Chlamydia
• Genital herpes
• Genital warts
• Gonorrhea
• Hepatits B and C
• HIV
• Molluscum
• Syphilis

Oral sex can expose a person to HIV. These STDs are transmittable in the fluid that exits the penis just before, or in cases of near, ejaculation. If STDs are suspected, or if the health status of a partner is unknown and a latex condom is not available, it is advisable to withdraw the penis before ejaculation. This can significantly reduce the spread of disease.

Care should be taken to keep the skin and gums of the mouth intact and free from bleeding. It is helpful to avoid behaviors such as eating crispy foods, like chips, and hot foods, like melted cheese, which can wound the inside of the mouth. Partners are advised to postpone oral sex for several minutes following brushing or flossing, as both can irritate the gums.

If a lesion, open wound, or pus is found on the penis or opening (meatus), it may be better to keep it out of the mouth. The inability to achieve an erection may also be a sign of STD. If this occurs in a partner who feels ill, it may be best to avoid oral sex. Avoiding genital herpes, genital warts, and molluscum is harder because the lesions can be difficult to see. For example, molluscum often affects the pubic area and may be hidden beneath hair. Oral contact with these lesions, whether they are visible or not, can lead to infection.

Oral sex (penis in mouth) with a condom, inserter or receiver, with or without ejaculation
STD risks include:

• Genital herpes
• Genital warts
• Molluscum

Proper use of a latex condom that does not break eliminates the risk of STD transmission as long as the base of the penis and pubic area are avoided. It is important to avoid dental work while using a condom, as rough edges on fillings and braces can tear the latex.

Oral-anal sex, oral or anal role, without a dental dam
STD risks include:

• Anogenital warts
• Chlamydia
• Genital herpes
• Gonorrhea
• Hepatitis A, B, and C
• HIV
• Molluscum
• Parasitic infections
• Syphilis

If possible, the anus should be examined for signs of STDs and for injury. These signs include lesions, sores, bumps, tears, redness, blood, and irritation. It is advisable to avoid licking an anus that bears any of these signs. Open skin increases the chance for transmitting STDs. All but HIV and hepatitis B and C can be contracted from skin that is intact. The skin of a healthy anus is pink, intact, and lesion free.

The STDs most commonly associated with oral-anal sex are hepatitis A and parasitic infections. Men who have sex with men are advised to get a hepatitis A vaccination, which consists of two shots given 6 to 12 months apart. Parasitic infections are treated with oral antibiotics. The best preventive practice is to wash the anal region thoroughly before oral-anal sex.

Oral-anal sex, oral or anal role, with a dental dam
If a dental dam is used properly during oral-anal sex, there is no risk for contracting STDs. A dental dam is a piece of plastic or latex that is laid over the anus prior to oral-anal contact. It creates a barrier that prevents the spread of STDs. Applying a small amount of water-based lubricant to the anus before placing the dental dam on it enhances pleasure. Ordinary plastic wrap can be used as a dental dam as long as it is not the microwavable kind, which is porous. Dental dams are available in most stores that carry condoms.

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