Safer Sex: How To Diminish Risks For Men Having Sex With Men (MSM)?

It is commonly acknowledged that men who have sex with men (MSM) are in a particularly high risk of transmitting sexually transmitted infections (STIs), and this for good reasons that we are going to develop in this article, along with other information relating to safe sexual practices. Indeed, safe sex does not just mean using a condom. Let’s explain further.

What Is Safe Sex?

Within the gay community, we speak a lot about safe sex. By this, many people think it just mean using a condom and making sure its partner doesn’t have HIV. But safe sex goes much further than that. The same way that general health includes mental health as well as physical health, safe sex includes good physical practices as much as a certain sexual well-being such as a good relationship communication, without which sexual performances can deteriorate.

In a few words, « safe sex » includes:

• Using protections such as lube and condoms to avoid HIV/STIs infection risks,
• Knowing your boundaries,
• Learning to communicate properly about sexual practices and strategies,
• Feel good about any aspect of sex we allow to ourselves.

STIs & HIV

Still, STIs and HIV are the most important concerns when speaking about safe sex, that is true. The main known STIs concerning MSM are:

• Hepatitis: amongst other types, hepatitis B is the most likely to be transmitted sexually.
• Chancroid: a bacterial STI that causes painful ulcers or sores in the genital region.
• Trichomoniasis: one of the most curable STI (with antibiotics).
• Human Papillomavirus (HPV) and Genital Warts: the most common STD worldwide (at least 50% of sexually active people will get it at some time in their lives).
• Herpes: quite common although not curable, it still can be controlled by certain meds.
• Gonorrhea: the most common STI in the US, it can lead to infertility.
• Chlamidiae: very common as well, it is the number one cause of preventable infertility in the U.S.
• Syphilis: can be cured easily with antibiotics if caught early.
• Scabies: these parasites infect the skin and can be passed just through skin-to-skin contact of any kind, sexual or not.
• Pubic “Crab” Lice: parasites that can cause itching, blue spots and sores in the infected area.
• Pelvic Inflammatory Disease (PID): it is caused by bacteria, which often stem from another STD such as Chlamydia or gonorrhea.
• Mucopurulent Cervicitis (MPC): it is caused by other STDs such as Chlamydia or gonorrhea and may be treatable with antibiotics.
• Molluscum Contagiosum: it is caused by a virus and will usually go away on its own within a year even without treatment.
• Lymphogranuloma Venereum (LGV): it is fairly uncommon and is most often spread through unprotected anal sex.

And of course, the Human Immunodeficiency Virus (HIV), the virus that causes Acquired Immune Deficiency Syndrome (AIDS), which is transmitted by blood and body fluids. Although AIDS has been an important plague for decades, it is now quite controllable (but still not yet curable), and many people manage their lives quite well despite being infected with the disease.

Knowing your Boundaries

As we said, another aspect of safe sex and no less important than using protections to avoid STIs, is our sexual well-being. Sexual well-being includes knowing our boundaries regarding sexual performances and constantly improving our good communication regarding sexual practices and strategies, to ourselves first and then to our partner(s).

Knowing your boundaries is important as it sets your limits above which you are more likely to not feel well anymore about your practices. Not feeling well about a sexual act can lead to stress and extra tension, which can further lead to unnecessary pain and other risks. For example, if you are not totally ready to practice anal sex, you might be too tense for it to go well. It could hurt you more than normal and lead to unnecessary bleeding. And who says bleeding says extra infection risks.

Sexual Performances & Communication In Relationships

Every aspect of sex being linked to another, if you don’t know your boundaries well enough, you won’t feel perfectly at ease during the act. This could cause bad sexual performances, leading to a devaluation of your sexual self-esteem, leading to worse performances, and so on. For this reason, it is important to know exactly what you are ready to do, what you are ready to experience, and what you do not want to practice at all. And above all…

You need to be able to speak about it with your partner(s)! Knowing your boundaries without being able to communicate them will not be much helpful. Again, a good communication will help to feel more confident, more relaxed during the acts and reduce risks. You need to be able to say what you have already done, what you would like to do for the first time (meaning that your partner must be even more careful when realizing the performance), and what you do not want to do (yet). Note that speaking about sexual practices can seem a difficult step at first, but once done a first time with someone, it gets easier afterwards. Even with different people, speaking about sex can be practices and get natural with time. You just have to practice it.

Can I Still Have Sex If I Am HIV-positive?

Another aspect of a good sexual communication is to be able to tell your partner(s) if you are infected by HIV and/or STI(s). Many people think that if you’re sexually infected, you cannot have sex anymore. This is completely untrue. You can totally have sex with someone if you’re sexually infected, as long as you to tell him (them) clearly about your condition. Then, if he (they) still agree(s) to have sex with you (of course, you must accept « no » as an answer!), you will then have to decide together about all necessary measures to take in order to make sure your partner(s) won’t get infected himself (themselves).

About Anal Sex

One thing you must absolutely know about anal sex is that it is one of the most risky sex acts for HIV transmission, and this because it often creates bleeding. Even small bleeding increase considerably the infection risks. For this reason, make sure to use condoms and a lot of lubricant. Lube is what will help you to perform the act without bleeding. Also, try to go carefully at the beginning of the act, going further to more extreme practices later on, once the anus is properly dilated.

About The Use Of Poppers

Many gay men practicing MSM think highly of poppers as they are known to help dilate the anus. However, they can also strongly inhibit decision-making and increase sexual risks. We do not recommend using this kind of substances if you are not in total peace with your boundaries and if you do not have a perfect communication about your sexual goals. However, if everything is totally settled with your partner(s) and that you decide together to use it to help to practice MSM without risks (especially for a first anal experience), it can be helpful. Just make sure you are both totally OK with all what is going to happen during the whole act.

About Mouth Sex

About mouth sex, few people are aware that they can protect themselves. Indeed, you have the possibility to use dental dams in order to reduce risks. Of course, it is not the sexiest accessory, but it will highly lower your chances of small mouth bleeding and infections transfer. If you don’t have dental dams with you, you can just cut a condom to distort its use into a mouth protection.