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Practical guidelines and advice on HIV & STD prevention within SM play

Συζήτηση στο φόρουμ 'Σαδομαζοχισμός' που ξεκίνησε από το μέλος lara, στις 7 Σεπτεμβρίου 2006.

  1. lara

    lara Αυτοδεσποζόμενη Contributor

    Safer SM
    Education Project
    (A Part of the Talking Sex Project)

    NOTICE:
    This document was the work of many dedicated volunteers. They deserve to be properly recognised, so you are free to use it on the condition that you print, post, or otherwise distribute the document in its entirety and without changes. This notice should remain attached at the top of the document when you do so. Requests to excerpt portions of the text should be made to SaferSM@SaferSM.org or to the mailing address at the bottom of this document. Thanks.
    Please tell us (preferably by e-mail) if you use this document for your local organizations, newsletters, seminars, web sites, or whatever. We'd like to know that it's useful to you. Also, if you find errors, please tell us about those, too.

    © 1996-2000, The AIDS Committee of Toronto.

    --------------------------------------------------------------------------------

    Practical guidelines and advice on HIV & STD prevention within SM play


    If sexually explicit information about sadomasochism might offend you,
    this pamphlet is not for you.


    HIV Transmission

    HIV (the virus that can lead to AIDS) can be avoided. HIV is passed from one person to another when infected


    blood
    semen (cum) or
    vaginal secretions (cunt juice)

    goes from one person’s body into another, and then makes its way into the bloodstream. HIV can also be passed in breast milk.

    On the outside of the body, unless you have cuts and scrapes, you don’t have to worry about


    saliva (spit)
    perspiration (sweat) or
    urine (piss) or fæces (shit)

    STDs increase the risk of HIV infection. This knowledge is particularly important for women, who may have an STD and not know it. Always remember to use common sense. Ensure first-aid items are readily to hand. By remembering these basics, you can make any kind of sex safer.


    SM Risk Reduction


    Most SM (also known as BDSM: Bondage and Discipline; Dominance and Submission; and Sadism and Masochism) activities have always been low-risk for getting HIV (Human Immuno-deficiency Virus). Responsible SM has always been about practising safety.

    Getting a sexually transmitted disease (STD), like HIV, can be prevented. But there are other possible dangers with SM. For more information on how to avoid these, read material like On The Safe Edge: A Manual for SM Play by Trevor Jacques, et al; Lesbian SM Safety Manual by Pat Califia; SM101 by Jay Wiseman; or Screw The Roses, Send Me The Thorns by Molly Devon and Philip Miller.

    Generalized information on HIV and STDs is available from most community health centres, doctors’ offices/clinics, hospices, or community AIDS organizations.


    SM Etiquette


    Use the etiquette of SM. It’s really just a matter of respecting the person(s) with whom you’re playing. You should agree upon a safety word and what you want to do in a scene before you start the scene. A safety word (or motion) is used by any partner to stop the scene immediately, no questions asked. There is no shame in using the safety word. It’s there for both of you. You should respect it and your partner’s limits and feelings at all times.

    Always consider your partner(s). Discuss interests, pleasures, perceived needs, etc.. If you are unsure of a certain sexual or SM activity, then hold off until you’re familiar with the safety aspects of it. Find out as much as possible beforehand, so you can you make a decision about how and/or when to proceed.

    If you are HIV+, think about how infection with STDs--or re-infection with HIV--could affect your immune system. Bow out when necessary. For example, don’t deep throat a sore throat. By being interested in your health and practicing safer sex, you are doing a lot to help stop the transmission of HIV and other STDs.

    Always ask before using someone else’s toy. They may not want you to use it, or it may be broken.

    By practising the guidelines mentioned in this pamphlet, you will be making your contribution to the community of safer SM players.



    Lubricants



    Lubricants (lube) can be lots of fun, whether used for play or insertion. Flavoured brands can be used externally or for oral sex. Other ingredients in lubricants, like nonoxynol-9, can irritate the vagina and bowel and should not be used internally.

    If you’re going to insert something into someone, you should only use a water-based unscented brand--like K-Y®, Lubafax®, Muco®, Astroglide®, or Wet®. Never use oil-based lube (like Crisco® or Vaseline&reg ; it weakens latex condoms and gloves, making them more likely to break. Too little lube will cause friction, which can break the condom.

    Also, during a scene, you shouldn’t take lube from a large container. Either buy small portions and throw the packets away afterwards or put enough lube for this play time into something disposable (like a paper cup or plate). Some brands come in pump jars. This makes sure that nobody’s ‘dirty’ hand, penis, or whatever can get into your personal supply of lube.


    Your Rectum



    The rectum (ass) is delicate, and you should take care of it. Sticking things up your rectum-- whether it’s a finger, cock, dildo, fist, or anything else--can tear the lining of the rectum. Even extremely tiny tears can open up the body and be places where HIV and other STDs can get in.

    Fucking without protection is a high-risk activity, since a penis ejaculates semen (cums). A penis also has a pee hole in the end, which can let viruses in. Always use a latex condom, and use it properly.

    To put on a condom: first make sure the penis is erect. If it’s uncircumcised, pull back the foreskin before putting on the condom. Squeeze the air out of the tip. If the condom is round-ended and doesn’t have a tip, squeeze the air out and leave 1cm free at the tip of the penis.

    Lubricate the outside of the condom really well with a water-based lube (like K-Y®, Lubafax®, Muco®, Astroglide®, or Wet&reg , because too little lube causes friction, which can break a condom. Never use oil-based lube (like Crisco® or Vaseline&reg ; it weakens condoms. Pull out soon after you cum, grabbing the base of the penis to make sure the condom doesn’t slip off. To be extra careful, you can start fucking with a condom, and then pull out before you cum--you can then cum on the chest, thighs, hands, or whatever.

    If you finger a rectum, be careful not to finger it if you have a cut or sore on your finger, or if you have sharp/long nails. You should also use a latex glove when fingering. As for dildos, make sure they’ve been cleaned before they go up your rectum (see the section on cleaning toys).


    Your Vagina


    Successful play with your vagina (cunt) depends on paying attention to detail, because a great variation of sensation occurs over very small areas. Unprotected penis/vagina sex is a high-risk activity. Please see the section on Your Rectum for how to put on a condom.

    It’s easy to bruise, cut, or tear your vagina, so you should take care to protect it whenever anything goes into it. The inner parts of the vagina are mucous membranes, so a good rule is to make sure that your play is less aggressive here. Anything inserted into the vagina should be properly washed and have no sharp edges.

    Your vagina can be damaged in other ways, too--you can: bruise or scrape the cervix, which is located about 10cm (about a finger length) inside the vagina (the cervix feels like the tip of your nose. Its exact position varies from woman to woman); tear the skin between the vagina and the rectum; bruise the tissue between the pubic bones; or cut and scrape around the pee-hole. All of these can open up your body to HIV--or other STDs--making vaginal intercourse without a condom a high risk activity.

    A good rule is that too much lubricant is not enough. If you don’t use enough, you may cause tears and rips, or a mechanically induced vaginitis.

    Vaginal play depends on moving slowly to generate fairly symmetrical sensations, and remembering that the border between pleasure and pain here is razor thin. So get to know the size and shape of your partner’s vagina, and remember that it changes shape depending on where she is in her menstrual cycle and how excited she gets.


    Enemas


    Most people into fisting, fucking, or dildos feel it is very important to have a clean rectum and vagina. Douching or enemas before any ass play wash away the surface mucous that’s there to protect you. Incomplete douching can leave fecal matter in the rectum that is likely to cause abrasion, which can make one more vulnerable to infection. For both these reasons, it is important to use lots of lubricant.

    Never share your douche bag or the nozzles of shower douches. Clean them each time you use them (see the section on cleaning toys). Douching or enemas should not be used after sex, because they don’t necessarily wash things away--they can also push infected semen, blood, or fæces further into the body. Infections and bacteria douched up into a woman’s uterus and fallopian tubes can cause Pelvic Inflammatory Disease (PID)--which could lead to infertility, or worse.


    Toys


    When you were growing up, your mother probably told you to share your toys. Well, for sex toys, forget it! Anything that goes into a person’s rectum and/or vagina could transmit HIV or other STDs, if it’s shared and not properly cleaned. Any toy that draws blood can also be a risk.

    If you’re a bottom, the best idea would be to have your own toys and get your top to use them on you. If you’re a top, ask your bottom what toys he or she owns. Or, if having sex with various bottoms, you should assign and mark each toy for use with one bottom only.

    For example, if you spank someone with a sturdy wire brush, you’re going to draw blood. So, tape the bottom’s name onto the back of the brush--maybe even tape the brush to the bottom’s leg--but don’t use it on anyone else. The same applies to dildos, butt plugs, etc..


    Restraints & Bondage


    While restraint is not likely to cause a risk of disease transmission, it is often used with other SM play. Any material that can wrap around or encase the body should be of a flexible material. Never make any restraint too tight, especially around the neck or joints (wrists, ankles, elbows, knees, etc.). Likewise, never leave anyone who is inescapably bound alone, and be sure to have good emergency equipment nearby.

    Good 7mm diameter soft cotton or nylon rope is the most versatile for play. When you tie off your ropes, try to keep the knots between limbs and objects you use. This will reduce the chances of pressure points on the body. For the same reason, it’s a good idea to avoid twisting the rope or crossing it where it touches the body. Any time you pass a rope around limbs, you should wrap it around at least three times. This will spread the load and help minimize the risk of nerve damage. Tie the ends off with a reef-knot (also known as a square knot). Since the reef-knot is likely to be the only knot you’ll need as a beginner, it’s worth the time to learn it properly. More complicated knots can come later. To check that any rope bondage is not too tight, you should be able to pass one nger between the rope and the skin.

    A flat position is better for long periods of restraint. If using adhesive tape (e.g. duct or insulating tape), do not apply it directly to the skin, since it may not only rip off hair when it is removed; skin may come off with it, too. If using ‘non-breathing’ materials such as duct tape or Saran Wrap, be careful of the room temperature. If it is too hot, the bottom will sweat a lot and overheat (in a prolonged scene of a few hours). If the scene lasts several hours, mild dehydration may occur, so the bottom should be required to drink fluids to avoid this. For long scenes, you should allow for the bottom to urinate.

    For secure bondage, there is no substitute for steel, but improperly used it can cause problems. Most cheap swing-through cuffs with a single locks and ones with lever-operated set-locks can tighten accidentally, and they can be easily broken or forced open. So, for safety, buy good ones with double locks. To avoid nerve damage, do not swing handcuffs onto the wrist nor suspend a person from metal restraints. Put them on carefully and ensure that nothing is pulling against them. Lock metal restraints immediately you put them on, so that they do not tighten and cause damage. Cuffs attached in front can be a dangerous weapon, so always put cuffs behind the back. Keep extra keys handyóNothing can ruin play quicker than trying to remove restraints and finding that you can’t find the keys.


    Pinching



    You can pinch, lightly slap, and rub the skin, including the nipples. Provided that there is no broken skin involved, there’s no risk of transmitting HIV or other STDs when playing this way (if the skin is broken, follow the advice in the Piercing section). Breast milk can contain HIV, so there is some risk of transmission if the nipple is lactating (many men produce milk, too). If you have a history of cystic breasts or abnormal mammograms, keep to light play on your breast and nipples.

    Clothes pegs, nipple clamps, and ropes can be used to put tight pressure on the skin. Tight pinching this way should only be left on for ten to fifteen minutes to avoid circulation problems. If skin goes blue, immediately take off the pressure.


    Temperature

    Playing with changes in temperature can be great fun. You can only transmit disease this way if there are cracks in the skin, open blisters, or charring caused by high temperature, so stop at reddening the skin.

    Cigars and cigarettes should not be allowed to drop ash on the heated area, since the ash may burn the skin and stick to it. This can cause infection later, as the wound heals. For hot wax play, choose cheap, white parafin candles, because they burn at a low temperature. Do not use coloured, scented, or beeswax candles, which burn at a higher temperature.

    In any kind of play, after the skin is warm, ice can be a very effective way to cause intense sensations and prolong your play. You can also put your toys into the freezer, to use when they’re cold.


    Sucking, Blowing, & Licking

    Fellatio (blow job, sucking cock) is considered a low risk sexual activity for HIV transmission. If, however, you have just flossed or cleaned your teeth, or if you have just been to the dentist, getting cum or pre-cum in your mouth is riskier. Even an irritated throat can increase your risk, so, in this case, it’s best to use an unlubed condom when you suck cock.

    Cunnilingus (cunt-licking) has similar risks, so, if you are concerned about the risk associated with this activity, you should use a dental dam (from your local medical supply store) as protection. (If you can’t find dental dams, use non-microwavable plastic food wrap.) An unlubricated condom can be cut to produce a flat latex barrier that can be used in the same way.

    If the genitals have any sore, any sign of an STD, or if they look like the skin has been broken, condoms or dental dams are required for play.


    Cleaning Toys


    You’ll need these things to clean your toys:

    soap and hot water
    one part household bleach to nine parts water
    10% hydrogen peroxide solution



    What if you’re using a toy on someone and you don’t mean to draw blood--but you do? You don’t have to throw away your toy. Wash it with soap and hot water, let it soak for 20 minutes in the bleach solution, rinse it in hot, clean water, and then let it dry thoroughly (preferably overnight) before using it again. The same goes for douche nozzles.

    Leather toys are a bit different: To clean a leather toy (like a whip, flogger, or leather dildo), first wash the tips or ends with a strong foaming cleaner using a hard bristle brush to get at nooks & crannies in the leather; then spray the tips or ends well with hydrogen peroxide, wipe away the excess with clean towels, & let them air dry for at least a few hours (preferably overnight) before using them. Cleaning dries out the leather very quickly, so your toy should be treated with an acceptable leather conditioner immediately after it has dried, or it will become brittle and crack.

    It’s a lot easier to clean a dildo after playing if you put a condom on it before you use it. If you are a top, you can probably think of lots of ways to make your bottom put the condom on the dildo.

    It may sound complicated, but it isn’t really; just make sure any toy with cum, blood, or fæces on it, or anything that’s been in someone’s rectum or vagina is properly cleaned. Make sure you get any bleach or soap off the toy by flushing it with clean water. Remember, unclean shared toys can transmit STDs--which can affect your whole immune system.



    Watersports


    Both urine and fæces are fine on the outside of the body. Urine in your mouth is a negligible-risk activity for getting HIV, but with an infected bladder there is a high risk of catching other STDs. If you take fæces in your mouth, there is also the possibility of catching other STDs or parasites. Never brush your teeth or tongue just before playing, wait at least 3 to 4 hours, and never play when you have cold sores, cankers, or cuts in your mouth.

    If there are any cuts on the outside of the skin, don’t urinate (piss) or defecate (shit) near the cut(s). Remember that a pimple (zit) is also a cut.


    Fisting

    Fists are big things. They can create more serious tears in the rectum or vagina than most sexual activities. If you get fisted, you’re going to have to treat your rectum and/or vagina very, very carefully.

    Immediately after you’ve been fisted, never let anything else (a penis, dirty dildo, or a finger with semen, fæces, or blood on it) into your rectum or vagina that might be carrying HIV or other STDs. Always hold true to this.

    If you are going to fist, wear latex gloves. They protect both of you. Surgical gloves are the best. They usually go part of the way up the arm and are good for most fistings. If you are going to be fisting deeply, use a calving glove. You can buy them at veterinarian supply stores. Calving gloves can bunch up, though, and the wrinkles can cut the lining of the rectum or vagina. To avoid this, cut the finger and thumb sections off the calving glove to leave the glove covering the palm of your hand, including the base of your thumb. Then put a surgical glove over the calving glove.

    Don’t fist if your fingernails are long. Cut them and smooth them down with an emery board, since they can tear the fisting glove or the bottom’s rectum or vagina. If you have an open wound or hangnails on your hand(s), don’t fist with that hand, even with the precaution of gloves. Be sure the glove stays well lubed while you’re using it (see the section on lubricants). When pulling out (as with condoms), make sure to grab the open end of the glove so that it doesn’t slip off.

    Some people aren’t built to be fisted, or they can take a long time to work up to a whole hand. Also, pushing too hard or fast can cause damage. So, take your time and enjoy yourself.

    Rimming

    Rimming--licking someone’s rectal opening (ass hole)--is negligible-risk for becoming infected with HIV, but high risk for the transmission of other STDs (like herpes, anal warts, and hepatitis A), as well as parasites. If you want to rim, use a condom cut lengthwise to form a sheet of latex, or use a latex barrier like a dental dam (more difficult to find). Never brush your teeth or tongue just before your sexual play, wait at least 3 to 4 hours.

    Rimming can be very enjoyable for your partner but always take precautions to ensure your own safety--avoid leaving yourself open to STDs.


    Piercing, Shaving, etc.


    If you want to have a permanent piercing, make sure the rings or bars are sterile. Have it done by or learn from a professional piercer. If you can’t, you might be able to find a doctor or nurse to do the piercing in a sterile way. Make sure the bars or rings are sterile by using an autoclave, or by properly soaking them in bleach and then rinsing them in water before they’re inserted. Make sure only new sterile needles are used and then only on one person. Make the person into whom the needles were stuck put the caps back on the needles, so that you don’t accidentally prick yourself with a dirty needle.

    If a temporary piercing is part of a scene, make sure you use sterile, disposable needles. Use them once--only once--on one person. Then dispose of them safely. (See the section on cleaning needles, and disposing of needles under Drugs and Alcohol).

    As for branding, heat-branding is safe because of the high temperatures involved (heat kills HIV). Knife-branding should only be done with a knife that’s been soaked in bleach for twenty minutes and then rinsed with water. Better yet, you can use a sterile scalpel with a disposable blade (scalpels can be bought at medical supply stores). Use it once, then dispose of it safely. (See the section on disposing of needles under Drugs and Alcohol).

    For piercing, branding, or shaving, any drops of blood should be wiped away with sterile cotton balls. Soak the cotton ball in rubbing alcohol. You can also buy pre-soaked separately wrapped cotton balls called ‘alcohol preps’ or ‘alcohol rub.’ After use, put them in a plastic bag, tie up the bag, and put it in the garbage.

    When starting a piercing, branding, or shaving scene, the area of the skin should first be wiped with rubbing alcohol, ‘alcohol preps,’ ‘Hibitane®,’ or ‘staphene’ to remove any fine dirt trapped by the skin’s oil.

    Whipping


    If there’s no break in the skin during whipping or flogging, then there’s no problem at all. Depending on the material that the whip, quirt, or cat-o’-nine-tails is made of and the way it is used, it can draw blood if the skin is broken.

    During a flogging or whipping scene, wipe up the blood the same way you would for piercing or branding, and always clean your flogger/whips (see the section on cleaning toys).

    When in a more public forum, you should avoid breaking the skin, as blood can be flicked from the flogger/whip during the return of the stroke.


    Drugs & alcohol


    If you’re into SM (BDSM), you have to keep your wits about you. Mind-altering drugs like tranquilizers, uppers, or hallucinogens are not recommended. If you use them, you’ll be more likely to make mistakes. Alcohol can have the same effect. Too much drugs or alcohol leads to unsafe activities.

    As for ‘poppers,’ they make your blood vessels bigger. This may increase your risk of infection with HIV when you get fucked. Poppers are also hard on your heart and immune system.

    If you use injection drugs, a very easy way to pass on HIV is by sharing your needles, syringes, or cookers. Use your own works and never share them unless they are properly cleaned in bleach and water.

    To clean your needle and syringe properly:

    Fill the syringe completely with sterile water, shake it, and squirt it out;
    Fill the syringe with full-strength bleach and squirt a little out. Leave the rest in for 30 seconds, then squirt it out;
    Repeat step 2;
    Fill the syringe with sterile water, shake it, and squirt it out;
    Repeat step 4 twice more.
    Bleach and sterile water can be obtained from your local needle exchange.

    To dispose of your needle and syringe properly:

    Once a needle or scalpel is used, make sure the cap is put back on gently and the whole thing is placed in a ‘sharps’ container (see your local needle exchange or pharmacy), or a strong, narrow-necked plastic container (with its lid on), before disposal, so no-one handling your garbage gets pricked or cut.


    Electricity


    Electrical equipment (like the ‘Relax-A-Cisor’ machine or ‘Violet Wand’) probably won’t break skin, so there’s not much risk of getting HIV from it. If it does break skin, wipe up any blood with disposable, sterile cotton balls soaked in hydrogen peroxide, and cover the broken skin with a Band-Aid®. Since flexible, sticky electrical contacts pick up dirt from the skin, use them on one person only. If you get bodily fluids on them, throw them away and get new ones. There is no way to clean them.

    Only use electric charges below the belly button--you don’t want the electric charge to affect the heart or the brain’s own electric system.


    About This Pamphlet


    We developed this pamphlet with the help of experts in the field of education, as well as people experienced in safe, sane, and consensual SM (also known as BDSM: Bondage and Discipline; Dominance and Submission; and Sadism and Masochism). For maximum effect, we have used frank language specifically aimed at the target audience; not to shock, but to speak to them in their own words.

    Educational research indicates that this direct, non-judgemental presentation, using slang equivalents of the correct terms, ensures effective use of pamplets like this. We have also used photographs and design to help maintain the reader’s interest throughout the text.


    For copies of the illustrated, four-colour version of this document, please contact the AIDS Committee of Toronto (address below) or send an e-mail message to SaferSM@SaferSM.org.
    This brochure was funded exclusively by the SM community in Toronto.

    Thank you to these supporters:

    Alternate Sources, The Barracks, Northbound Leather, National Leather Association--Toronto, Spearhead Toronto, Dan Bowers, Glenn Fraser, Trevor Jacques, Duncan MacLachlan, Dr. Dale McCarthy, Rachael Melzack, Steve Munro, Dennis O’Connor, Sniffer, David Stein, Jay Wagner, and the many generous donations from participants at the Safer SM Education Project seminars.

    Special thanks to John Maxwell and Mike Willan at A.C.T.

    AIDS Committee of Toronto, Safer SM Education Project

    URL: http://SaferSM.org