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What is safe sex and what are sexually transmissible infections (STIs)? The types of STIs including HIV, herpes, gonorrhoea, chlamydia, warts, lice, hepatitis B and syphilis are discussed along with symptoms and treatments. Knowing how to protect yourself and practise safer sex is important to protecting your health and wellbeing and your fertility.

Topics on this page

What is safer sex?

Safer sex is sex where semen, vaginal secretions or blood are not exchanged between partners. The exchange of these body fluids can occur with the following sexual activities:

  • Vaginal sex
  • Anal sex
  • Oral sex
  • Oral anal contact
  • Fingers or objects in the vagina or anus (if they have these fluids on them)

Unprotected sex with your regular partner will only be safe as long as both partners are only having sex with each other, and you have both had an STI check-up.

Withdrawal (pulling out before ejaculation) is not safe sex because sexual fluids can be released before ejaculation (known as pre-ejaculatory fluid).

Couple holding hands

Sexually transmissible infections (STIs)

An STI is an infection spread from one person to another during unprotected sex. STIs include the following:

Herpes or genital herpes

What is transmitted

Virus: Herpes simplex virus (HSV1 or HSV2)

Some of the symptoms

Causes recurrent blisters and painful ulcers around the mouth or genitals.

Usual treatment

No cure is available for the virus, but the virus can be controlled with medication. Simple analgesics (such as paracetamol or ibuprofen) can help to reduce pain and discomfort.

Gonorrhoea

What is transmitted

Bacteria: Neisseria gonorrhoeae

Some of the symptoms

Sometimes there are no symptoms in women. Symptoms include increased vaginal discharge and stinging/burning with urination and pain during sex.

Usual treatment

Antibiotics (injected into the buttock).

Genital warts

What is transmitted

Virus: Human Papillomavirus (HPV)

Some of the symptoms

The warts (lumps) may not be visible on the skin of the genitals.

Usual treatment

Visible warts can be treated with dry ice or creams/paints.

Pubic lice

What is transmitted

Ectoparasite: Pthirus pubis

Some of the symptoms

An infestation of lice in pubic hair.

Usual treatment

Creams/lotions containing permethrin.

Chlamydia

What is transmitted

Bacterium: Chlamydia trachomatis

Some of the symptoms

Most women have no symptoms. Symptoms can include change in vaginal discharge, pain during sex, bleeding between periods or after sex and burning/stinging with urination.

Usual treatment

Oral antibiotics

Syphilis

What is transmitted

Bacterium: Treponema pallidum

Some of the symptoms

Painless ulcers then later a rash and swollen glands.

Usual treatment

Penicillin (injected into the buttock)

Trichomoniasis

What is transmitted

Protozoa: Trichomonas vaginalis

Some of the symptoms

Yellowy/green vaginal discharge with itching of the labia and burning/stinging with urination.

Usual treatment

Oral antibiotics

Hepatitis B

What is transmitted

Virus: Hepatitis B virus, which infects the liver.

Some of the symptoms

Mild flu-like symptoms unless severe, then jaundice (yellowing of the eyes and skin) with brown urine and pale stools.

Usual treatment

Virus may clear but liver damage can be caused. Antiviral tablets can be used to control the virus.

Human Immunodeficiency Virus (HIV)

What is transmitted

Virus: HIV – the virus that causes AIDS

Some of the symptoms

Often no symptoms until the immune system is not able to protect the body, and infections such as unusual pneumonias occur.

Usual treatment

No cure is available for the virus, but the virus can be controlled with medication.

STIs don't discriminate

Anyone can catch an STI, whatever their sexual orientation. You are at risk of an STI whether it's the first time you have unprotected sex or the 100th time.

You cannot tell if a sexual partner has an STI. A strong and healthy person may still be infected. Some people may not even know they are infected. You risk getting an STI from any partner who has had, or is having, unsafe sex with another person.

If either you or your partner has an STI, you need to practise safer sex to minimise the risk of becoming infected.

Condom on bed sheets

Safer sex practices

Practise safer sex by avoiding contact with your partner's body fluids to reduce your risk of STIs.

Condoms are an effective barrier against most STIs. This includes HIV as well. Some STIs, such as herpes, genital warts and pubic lice, may still be spread even if a condom is used. They are spread by skin-to-skin contact.

Oral sex is not the answer to avoiding STIs as herpes, gonorrhoea and chlamydia can all be transmitted through unprotected oral sex.

Use dental dams if you are having oral sex with other women. Dental dams are small sheets of latex rubber that act as a shield between the vagina and the mouth.

Practising safer sex is important at any time including during your period.

STIs & cervical cancer

Cervical cancer is caused by a common STI, the human papillomavirus (HPV). HPV is very common in women aged 20-30 and can be sexually transmitted. Four out of five women will be exposed to the virus at some time in their lifetime.

The virus infects the surface cells of the genital area including the cervix, vagina, vulva and anus and can also cause visible warts. Vaccination against the virus is now available to prevent most cases of cervical cancer.

There are different types of HPV and there are two types of cervical cancer vaccines – Gardasil and Cervarix – to protect against these. For more information on cervical cancer and vaccination to prevent cervical cancer see our webpages on cervical cancer.

Safer sex & baby boomer generation

Being born before we knew about HIV and other STIs such as chlamydia, many older women starting new relationships for the first time in many years may not know about applying safer sex rules.

Between 2004-2010, the rates of chlamydia doubled in Australian women aged between 40-64, with infection rates among women in their early 40s rising 42% between 2009-2010.[1]

Many women say they find it awkward to raise the subject with their partner and are nervous about how to negotiate condom usage, particularly as avoiding pregnancy is no longer an issue after menopause.

While the benefits of condoms in preventing STIs are obvious, some older couples face difficulties because of physical changes. Postmenopausal women may experience dryness and thinning of the vaginal wall, which may cause discomfort when using some types of condoms. There are a number of lubricants available to help overcome this problem. If older women are partnering with older men, there may be concerns about using a condom because of erectile dysfunction. The man needs to have a discussion with his doctor about the options available to assist him. Having a sexual health check-up is an important part of this discussion. This can be as simple as a blood test and a urine test.

Condoms

Condoms are one of the best protections. There are a wide variety of condom types available including ultra-thin types that have limited impact on sensitivity.

To make condom use easier:

  • discuss their use in advance
  • keep them in a convenient location such as in the bedside drawer
  • if you haven't used one before, or for a while, practise before you need it
  • talk to your sexual health doctor or nurse if you are not sure how to use them

Lubrication

If inadequate lubrication causes discomfort, Jean Hailes gynaecologist Dr Elizabeth Farrell recommends:

  • spending longer on foreplay and arousal
  • using a water-based lubricant such as k-y jelly or sylk
  • talking to your doctor about topical treatments to improve vaginal dryness

Things to remember

  • Have a check-up for STIs before having sex with a new partner
  • Use condoms
  • Use dams for oral sex
  • Talk to partners about sexual health
  • Limit the number of sexual partners to reduce your risk

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at December 2013.

References

  • 1
    Data from National Notifiable Diseases Surveillance System
Last updated: 22 March 2020 | Last reviewed: 02 December 2013

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