Frequently asked questions about protection and safer sex

Whether you are in a committed relationship or having a one-night stand, protecting yourself from HIV and other sexually transmitted infections (STIs) should be on your mind. Because even though you might be thinking, »This does not affect me. This is something other people get.«, the fact is that one million people worldwide are infected with an STIs every day – regardless of their sexual orientation and gender, whether they live in Germany or anywhere else in the world, whether they are young or old.

Every person has their own ideas about what sex should be like. Vaginal, anal or oral, from the front or from behind, with or without sex toys... Some people have fun all their lives doing the same thing during sex, other people like variety and try out new things.

Many people know that condoms protect you against HIV during vaginal and anal sex and reduce the risk of infection with other STIs. But sex involves more than the penis penetrating the vagina or the anus. And safer sex can be practised in many ways. There are other ways to protect yourself when engaging in some sexual practices. So: Inform yourself, for example with the Safer-Sex-Check from LIEBESLEBEN.

Choosing the right condoms is often a matter of personal taste. For example, do you like condoms with nubs or ribs? Should the condom be vegan or fair trade? And are colour or taste important to you?

But there is one thing that must be right: the condom must fit you! It's the size that's important, or the width, to be precise: if a condom is too tight, it will tear easily. If it is too wide, it slips off the penis easily and can get stuck in the vagina or anus. Only a condom that fits properly can provide optimal protection. And you can feel it, too! Because if the condom fits well, you can unroll it easily and you hardly feel it during sex. The motto here is: try it out!

To find the right condom, you should pay attention to its width. Width is generally mentioned on the outside of the packaging. The following sizes are common:

•     Narrow condoms: around 47 or 49 mm
•     Medium-sized condoms: around 52 or 53 mm
•     Wide condoms: around 55 or 57 mm

And by the way: with the condometer from LIEBESLEBEN you can easily find out your ideal width.

Condoms are very reliable. However, a condom can tear or rip. For example, if you use a greasy lubricant or if the condom was damaged when opening the packaging or during unrolling.  As soon as you notice the condom is broken, you should pull out the penis and rinse it with plenty of water. It is also important that you urinate as soon as possible to flush out the urethra. However, colonic or vaginal irrigation is not recommended. That's because this can cause injuries that may even increase the risk of infection.

If you have had a condom mishap, you can get help and advice from your doctor or your local counselling centre.

More than 90 percent of new HIV infections in Germany are sexually transmitted. HIV primarily affects men who (also) have sex with men, people who come from countries with a high HIV prevalence and, to a lesser extent, people who use drugs and have no access to clean syringes. According to estimates, just under 20 percent of infections are through heterosexual contact, i.e., sex between a man and a woman. HIV transmission from mother to child now only occurs in a very small number of cases in Germany.

Some people who have contracted HIV have the following symptoms a few days or few weeks after infection:

•     Fever
•     Flu-like symptoms (muscle and limb pain, general feeling of being unwell)
•     Obvious rash on the body (patchy redness caused by fever)
•     Diarrhoea
•     Swollen lymph nodes in several parts of the body

However, none of these symptoms alone indicates HIV! And not everyone gets these symptoms. Many people who have contracted HIV don't notice anything at first. In fact, in almost half of all newly diagnosed HIV infections, people have been infected for several years. This means that you can't assume that you would know that you have HIV. And you can't tell if your partner has HIV either.

There are a lot of reasons why your partner might not tell you about their HIV infection. For example, they may not know enough about the routes of infection and therefore be unable to properly assess risks. Your partner may simply not know that they are HIV-positive. And maybe your partner is also afraid of your reaction and does not want you to pull away. That's why you can't always rely on what your partner tells you. And fortunately, there is no legal obligation in Germany to tell anyone that you are HIV positive – each person can decide for themselves who to tell about their HIV infection.

If you are in a relationship and you want to stop using condoms, both of you should take an HIV test first and agree on whether you will also have sex with other people or not. And the most important protection is still the condom for anonymous sexual encounters or one-night stands.

You can contract HIV if infected body fluids get onto open wounds or mucous membranes. Because HIV is present in many bodily fluids involved in sex – semen, vaginal fluid, the fluid from the intestinal mucosa, and (menstrual) blood – infection primarily occurs during unprotected sex.

However, HIV is a difficult virus to transmit compared with other pathogens. Transmission only occurs if enough of the HIV virus enters the body via the mucous membranes or open wounds. If you have dinner with someone who is HIV positive, share a flat, share the same bathroom and toilet, work together, sit next to on a bus or you go to the pub with them – in all these situations you cannot contract HIV. The following are examples of no-risk activities:

•     In everyday life
•     Being coughed or sneezed on
•     Insect bites
•     Kissing – including with tongues
•     Close skin and body contact, including cuddling and petting

Also Mosquitoes and other insects cannot transmit the HIV virus from one person to another.

Safer sex protects you from HIV and lowers your risk of contracting other sexually transmitted infections (STIs). Condoms are very important because they can prevent potentially infectious body fluids (semen, vaginal fluid, anal secretions and blood) from entering the body during sex. Condoms are not only practical and inexpensive, they are also very reliable and provide optimal protection against HIV when used correctly.

There now are other ways to prevent an HIV infection: treatment as prevention and so-called pre-exposure prophylaxis, or PrEP for short. Both may also be appropriate in very specific situations to prevent infection with HIV, but not with other sexually transmitted infections (STIs).  

Sexually transmitted infections (STIs) are like others infectious diseases. And just as anyone can get the flu or the common cold, anyone can contract bacteria, viruses or parasites that cause an STI. During sex, these germs are sometimes transmitted very easily.

There are more than 30 different STIs worldwide, including:

•     Chlamydia
•     Syphilis
•     HPV
•     Gonorrhoea
•     HIV and AIDS
•     Herpes
•     Hepatitis A
•     Hepatitis B
•     Hepatitis C
•     Trichomonads
•     Scabies
•     Pubic Lice (Crabs)

Some of them are unpleasant, but mostly harmless. Others can even be life-threatening. However, if an STI is discovered early, it can usually be treated.

Infection with an STI can occur during a wide range of sexual activities, but especially during unprotected vaginal and anal sex; sometimes it can be transmitted orally. There are different ways for bacteria, viruses or parasites to enter the body. This includes contact with infectious body fluids, such as semen, vaginal fluid, the fluid from the intestinal mucosa and (menstrual) blood. But infection can also occur through contact with mucous membranes in the vagina, penis, anus or mouth, as well as through contact with skin lesions, such as herpes blisters, genital warts and syphilis ulcers. It is also possible to get infected indirectly, such as when you share sex toys. This is called smear infection.

There are also diseases that are often not transmitted during sex, even though many people think they are. Fungal infections in particular, such as the yeast infection candidiasis, are usually not passed on during sexual activity; they are caused by hormonal changes, stress and even some medications.

Safer sex protects you from HIV and lowers your risk of contracting other STIs. Condoms are very important, because they can prevent direct contact during sex with infectious body fluids, infectious mucous membranes and also contagious skin areas. Contagious skin lesions, especially herpes blisters, genital warts or syphilis sores, should not be touched. You can also get vaccinated against some STIs: hepatitis A, hepatitis B and HPV.

If you notice signs of an STI, don't put off going to the doctor for too long. Because STIs are easily treatable and can often be completely cured, especially if they are detected early. It also prevents you from passing them on to other people.

Several signs may indicate that you have contracted an STIs. If you know your body well, you are more likely to notice changes. You should pay particular attention to the following:

•     Unusual discharge from the vagina, penis or anus, as well as bleeding between periods 
•     Itching, rash and redness of the skin 
•     Pain and burning when peeing 
•     Skin changes and weeping skin areas, especially blisters, warts and ulcers
•     Yellowing of the skin and conjunctiva 
•     Pain during sex 
•     Flu-like symptoms 
•     Loss of appetite, vomiting, diarrhoea

Unfortunately, the signs of an STI are not always clear. Sometimes you don't have any symptoms at all. And with some STIs, the symptoms disappear after a while, but the pathogens may stay in the body and damage your health. That's why only a doctor can tell you for sure if you have an STI or not.