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Safer Sex Issues
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Safe sex and STDs are a very real concern for everyone, but especially for those who have multiple sexual partners. When people engage in monogamous relationships, it is assumed that there are no other sexual partners. With high statistics of people admitting to have cheated at least once in their lives, this means that even in monogamous relationships, we are all at risk for sexually transmitted diseases and infections. Even without cheating, many people are actually "serial monogomists", meaning they have several partners over a lifetime, and many STDs can lie dormant for years. In fact, the latest research shows that HPV is so easily transmitted, that it is showing up in 9 year old girls who have not had sexual contact and HSV (herpes) can be transmitted from an infected parent giving their child a kiss while shedding the virus around their mouth. So even monogamy with only one partner ever is not safe from STDs because some infections can be transmitted through non-sexual contact. When people have open and honest sexual relationships, theoretically the people involved at least know what they are risking. It is up to each individual to determine what their risk level is and to set the limits they are willing to take.
First we will start with what the various STDs are with a chart taken directly from Smoocherie, who is not in the medical profession, but has done an enormous amount of research and put together a very clear and concise page on STD issues within the context of poly relationships.
| STD (Link to CDC) |
Description | Rate of Infection | Condom Effectiveness |
| Unintended Pregnancy | While not a "disease", an unintended pregnancy is a major issue to deal with | ~50% of pregnancies are unintended. | 98% |
| Bacterial Vaginosis | Overgrowth of 'bad' bacteria in the vagina, causing discharge, odor, pain, itching or burning. Treated with antibiotics. | Most common vaginal infection (exact number not known) | Unknown |
| Trichomoniasis | Parasite infection that can cause painful urination, discharge and pain during intercourse. Highly treatable with metronidazole. | 7.4 million new infections a year | High |
| HPV | Human Papillomavirus - Responsible for both genital warts and cervical cancer. Can often require physical removal of tissue to correct. | 6.2 million NEW infections a year
20 million active infections 80% of the population affected at some point in life. |
70% |
| HSV 1 & 2- Herpes/Cold Sores | Viral infection that causes painful blisters and ulcers that can re-occur over a lifetime. Can occur on either the genitals, rectum, mouth or eyes and can be interchangeable. Anti-viral medications can shorten outbreaks, but there is no cure. | 1 out of 5 adults has had a genital HSV infection. | Little (sores can occur outside of protected area) |
| Chlamydia | Bacterial infection that can cause infertility in women before she even knows she has an infection. Burning sensations in penis for men. Usually easily treated with antibiotics if caught. | 2.8 million new infections a year | High |
| Gonorrhea | Bacterial infection that usually has few symptoms. Can cause PID and infertility if left untreated. Can spread to blood and joints too. Antibiotic treatments may be able to treat it, but there are drug resistant strains. | 700,000 new infections a year. | High |
| Hepatitis A/B/C/D/E | Class of viruses that can attack the liver, causing severe and often untreatable damage. There are vaccines for some strains that are the best protection. | 73,000 new infections of Hep B a year | Unknown |
| HIV | Viral infection that causes AIDS. There are treatments that prolong life, but no cure. | 42,000 new infections a year | 98% |
| Syphilis | Bacterial infection that causes 3 stages - sores, skin rash and internal organ damage. Easy to cure in early stages with antibiotics - critical to be diagnosed in first year. | 32,000 new infections a year (and seems to be increasing) | Little (sores can occur outside of protected area) |
Sex is risky. But so is life in general. Everyone needs to determine what level of risk they are willing to take for themselves. But in open relationships, you can't be concerned only with yourself. When you have multiple intimate relationships, you have created a circle of people who love you and put their trust in you. The decisions you make affect everyone else. Remember the Poly Formula & Network Chart? That is a lot of people that you need to be responsible for.
You need to first decide what your level of acceptable risk is. Then, discuss with your partners and everyone in your group what level of acceptable risk and responsibility you are all willing to take for each other. How will new partners be introduced? How often will testing be done? Do you share your sexual history as part of your risk assessment? Do you discuss with potential partners to make sure everyone has the same definitions for "risk level" and that they have the same level of understanding as you for STDs?
It's tempting to just trust that the person you love will tell you all the information you need to know and has your best interests at heart. And that person might indeed believe he is telling you what you need to know and has your best interests at heart. But it is a fact that everyone has their own ideas about "what someone needs to know" and what someone's "best interests" are. When dealing with multiple sexual partners, the consequences are too high to simply rely on trust that your partners have the same definitions you do. This does not mean to imply that your partners are maliciously keeping secrets from you. This is a very realistic acknowledgment that we all come from different backgrounds and have our own assumptions and definitions about relationships. Clearly discussing your safe-sex requirements is merely one aspect of the "open and honest communication" that is so important in polyamorous relationships ... in any relationship for that matter!
To that effect, I strongly recommend everyone keep a written list of sexual history, STD test dates, medical records, etc. And yes, I do mean literally, a written list (hand or typed or computer file) that you exchange for a written list with your potential partner(s). Again, this is not to imply your partners are lying. This is to provide a visual aid for clear communication, to make sure that you both have the same level of understanding of what each person means. I am a strong proponent of taking notes into a serious discussion to make sure you cover all the details you want to cover without accidentally forgetting something or leaving it out. I also advocate taking notes of the discussion, to ask for clarification later or to help remind you to make sure your assumptions and definitions are known and understood. For an excellent guide to the kinds of information you may want to ask of your potential partners, download The Sexual Health & History Disclosure form developed by Serolynne and edited by me for a more user-friendly format (you will need Adobe Acrobat to view this file). Yes, we actually fill it out and ask our partners to fill it out too. Mine is quite complicated and I will talk more about it in How I "Do" Poly.
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