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Infection Transmission

How Infections Get Passed Along

Not all STIs/STDs are transmitted the same way. Here are the basics about how infections can be passed through intimate play.



Infection transmission

Infection transmission

• gonorrhea
• syphilis


• pubic lice
• scabies

Lots of other infections, from the flu to mononucleosis, can also be transmitted during intimate play.

Unprotected vaginal and anal contacts carry the highest risks for the most dangerous STIs/STDs.

Lower-risk play includes

• masturbation
• mutual masturbation
• erotic massage
• body rubbing
• kissing
• deep kissing
• vaginal intercourse with a latex or female condom
• anal intercourse with a latex or female condom

If You Are a Woman…

In general, a woman’s risk of infection is higher than a man’s. The vagina and rectum are more easily infected than male organ. A woman’s chance of being infected by a man with HIV is twice as great as a man’s chance of being infected by a woman with HIV.

Women generally have fewer symptoms than men. You are less likely to know if you are infected. Lots of damage can be done — even if you have no symptoms.

Many women develop pelvic inflammatory disease (PID) because they don’t know they are infected with chlamydia or gonorrhea. PID increases the risk of sterility and ectopic pregnancy, especially if untreated.

If You Are a Man…

STIs/STDs do not only affect women. You can also have an infection and not know it. And if an infection is left untreated, it can cause damage.

For example, chlamydia can spread from the urethra to the testicles and cause sterility.
If untreated, chlamydia infections in the testicles can cause reactive arthritis, which can lead to permanent disability.

When You Have a Checkup…

Don’t assume you’re getting tested for STIs/STDs. You need to ask your clinician to do it. Otherwise, it probably won’t happen.
“Everybody is different. Everyone has to decide what risks they are prepared to take — then decide what to do.” — a 26-year-old African-American woman


Intimate relations can be very satisfying without intercourse. There are a lot more than penetration. It’s about exploring the many ways you can turn your partner on. It’s exploring the many ways that you can be turned on.

Don’t be shy about your pleasure. Partners who explore safer contacts may discover new excitements. They can be clear about how and where they like to be caressed. They help each other enjoy even more.

For many years, women and men were taught that “good relations” only meant having an orgasm during vaginal intercourse. Nothing could be less true. Most women don’t have orgasms from vaginal stimulation.
Most women have them when the clitoris is stimulated. Men also enjoy play — even if they’re shy about letting their partners know.


Kissing — Many people explore different ways of kissing. They may also explore kissing different body parts.

Masturbation — Many people enjoy masturbating — touching their own organs for pleasure. Partners can masturbate alone or together.

Erotic Massage— Many couples touch and rub each other’s organs with their hands, bodies, or mouths.

Body-to-body Rubbing/Frottage — Many couples rub their bodies together for pleasure and orgasm.

Fantasy — Couples can read or watch stories or pictures together. It can also be exciting to share fantasies. People do it in person, on the phone or Internet, or through e-mail.

Toys — Vibrators, and other toys can be used to explore and caress the body. Condoms need to be used if partners share the same toy. Follow the cleaning instructions that come with toys.


Condoms are the best protection when enjoying sexual intercourse. Condoms help make pleasure last longer by preventing premature ejaculation.

Latex and female condoms reduce the risk of

vaginitis caused by trichomoniasis
• chlamydia
• syphilis
• gonorrhea

Latex and female condoms may offer more limited protection against

bacterial vaginosis
• herpes

But do not use latex and female condoms together.

The Female Condom

• stays in place even if a guy loses his erection
• has an external ring that may stimulate the clitoris
• can be used for anal sex
• can be used by people who are allergic to latex

Follow the instructions on the package insert to learn how to use condoms.

(Written by Jon Knowles, Revised by Jennifer Johnsen, MPH)

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