LGBTQ+ Safe Sex Guide

By Ciara Barrett

A press release published by HIV Ireland in December confirmed that positive cases in Ireland have more than doubled since 2021. HIV is a heavily stigmatised sexually transmitted infection initially seen in gay and bisexual men, and this increase in positive tests shows that we’re still lacking information and education surrounding safe sex for the LGBTQ+ community. As of 2022, the Department of Education had only initiated the process of fully implementing comprehensive sexual education in Ireland, including an LGBTQ+ inclusive curriculum. As the current curriculum focuses solely on heterosexual relationships, there are several issues left unaddressed. These include HIV testing and methods to avoid contracting HIV and other STIs, as well as information on HIV as a whole. The most important thing to remember is that HIV is not always transmissible. If a HIV positive person is up to date on their medication and has an undetectable viral load, the infection cannot be transmitted. Regardless, it’s still important to take steps to prevent the spread of any other infection. 

The most commonly taught method for avoiding STIs is the use of condoms. However, due to the structure of sexual education in Ireland, condoms are first and foremost marketed as a method of contraception. This marketing lends itself to the idea that men do not need them if they are having sex with other cisgender men, as there is no possibility of pregnancy becoming a factor. This is dangerous, as it is still highly possible to contract an STI. Condoms are the most prominent method of avoiding STIs, and although they can be expensive, they can be accessed for free from theUCC Students Union Welfare Office on Main Campus (up to three a day). The full price breakdown is available from the UCCSU website under Our Services. When using condoms, always remember to use a water-based or silicone lube, as oil based lubes can break down latex and increase the risk of the condom breaking.

While condoms should always be the first form of STI prevention used, it’s important to remember that they’re only 95% effective at preventing infection. While these are good odds, there are other steps that can be taken to prevent HIV infection. The primary medication used to treat possible infection is a 28 day course of antibiotics known as post-exposure phylaxis, or PeP. The course must be started within 72 hours of possible infection. PeP is free in Ireland, and available from sexual health clinics across the country. There are several clinics in Cork City where people can access PeP, as well as clinics in Mallow and Bantry. A full list of clinics across the country is available on sexualwellbeing.ie. While UCC Student Health does not carry the antibiotic, they have rapid STI testing available. However, HIV specifically is less likely to show up in a rapid urine test than it is in a blood test. Blood tests are available from the Student Health sexual health clinic weekly on Friday mornings. Similarly, pre-exposure phylaxis, or PrEP can be taken by HIV negative before sex as a preventative measure. This is also freely available from the HSE. 

While the groups most cited in the conversation around contracting HIV are sexually active gay and bisexual men, anyone who is sexually active is at risk of infection regardless of gender. HIV can also be spread through the blood, such as accidentally ingesting the blood of someone who is infected. Regular STI testing is important, and the HSE offers free at-home testing kits for HIV, chlamydia, gonorrhoea, syphilis, hepatitis B, and hepatitis C. Always test yourself between sexual partners, and ensure that the people you’re having sex with do the same. 

Although condoms are the best method of STI prevention, external condoms are not always an option. For people with vaginas, another option is internal condoms. These are less publicised than typical external condoms, and are more difficult to access. Unfortunately, there is no quality standard on internal condoms as there is with external condoms, due perhaps to the heteronormativity of sexual education and research. Another downside of these is that not all trans women who have gotten affirmation surgery as their use is dependent on the depth of the vagina. While there is not as much research on internal condoms as on external condoms, they are thought to be just as effective in preventing orally transmitted STIs. Internal condoms are most readily available online or from some sex shops, although not all carry them. 

There are some instances where information on avoiding infection gets a bit confusing. For example, for oral sex or anything using your hands, you should never brush your teeth beforehand, but you should always wash your hands. Our hands are everywhere, all the time, and they are one of the easiest parts of the body to contract an infection from. On the other hand, brushing your teeth puts you at risk of developing microscopic tears or cuts on your gums and tongue, putting you and your partner at a higher risk of infection. If you feel like you should do something, use mouthwash before sex, and brush your teeth afterwards.

While this applies to everyone, it is especially important for lesbians, bisexual women, non-binary people who were assigned female at birth, and trans men. Always wash your sex toys after every use, regardless of whether you have multiple partners or not. Most strap-on dildos as well as other sex toys are made of silicone, and as they are generally wet after use, there’s a much higher likelihood of hair or dust sticking to them. Even though silicone is the most popular, there are a variety of materials toys can be made from and therefore a variety of ways each material needs to be properly cleaned after use. Make sure you know exactly what everything you have is made from, and research properly how to clean, disinfect, and store your toys.

When discussing safe sex for the LGBTQ+ community, pregnancy is also an important factor to consider. The main thing to consider is if anyone involved is at risk of getting pregnant. Trans men on testosterone who have not undergone gender affirmation surgery can get pregnant, although the risk is greatly decreased. You should always act under the assumption that pregnancy is a risk unless explicitly told otherwise by a healthcare professional. 

Aside from STIs and pregnancy, there are other parts of having safe and fun sex. One of the most important of these is lube. Lube makes everything more comfortable and more enjoyable, and should especially be used during penetrative anal sex. Using lube prevents friction and tearing inside the anus, both of which are extremely uncomfortable. Similarly, it is important that if you’re using any toys that they absolutely must have a flared base. No base, no trace. If the toys you’re using do not have a flared base, there is a risk of them accidentally getting lodged up there which would make for a very awkward A&E visit.

With physical safety considered, it is also important to look after your mental health. Don’t allow anyone to put you in a situation you’re not comfortable with, and always ensure that your partner is comfortable. Always ask for consent for various sex acts and implement a safeword to make sure that everyone involved can safely and comfortably stop what they’re doing if things get a bit too much. If sex is making you feel uncomfortable, dysphoric, or ashamed among other things, talk to your partner or a professional about it. Sex should be both safe and fun for everyone involved. If you do find yourself in a position where you need to talk to a professional, seek out queer and trans inclusive specialists. The website Psychology Today is a great resource to locate therapists and psychologists, as queer and trans inclusive users of the website have this criteria listed on their profiles. Looking after your health while having sex is as much about keeping well mentally as it is about staying safe physically. Queer sex can be scary for some people as it is not as widely discussed as heteronormative sex, and access to information on it is just as important to your health as anything else.