ZAPoly Discussion Topic : Safer Sex agreements 

Safer Sex agreements : what to consider when drawing them up

Polyamory is a form of responsible non-monogamy: Polyamorists practise honesty, communication and consent, all of which go into formulating safer sex agreements. Safer sex practices are a nonnegotiable part of responsible non-monogamy. Safer sex agreements about safer sex practices are part of the broader topic of relationship agreements, they're sufficiently important and complex enough to warrant their own topic. Many people think that using condoms makes them safe. But while condoms are an integral part of safer sex practices, especially if you're going to be having sex with more than 1 person, there's more to consider:

  1. What happens if the condom breaks?
  2. What happens if you're not using the condom properly?
  3. What happens if the person you're having sex with has a SexuallyTransmittedInfection (STI) against which condoms are not 100% effective? For example, condoms are only 70% effective against HPV - a common virus that can cause warts and cancer.
  4. Is it okay to have sex --- even with condoms --- with someone with a potentially lethal STI like HIV?
  5. What if the person you're with doesn't know they have a STI? Many STIs have no symptoms. And some symptoms people don’t often realise imply a STI risk (cold sores are a symptom of HSV1 → can be transmitted to genitals via oral sex; abnormal pap smears could be from HPV)
  6. What happens if you contract an STI from Bob, your new boyfriend, and pass it on to Alice, your long-term girlfriend?
  7. What happens if there's an unplanned pregnancy? Unplanned pregnancies in poly situations are massive drama.
  8. What happens if Bob's wife starts having sex with a new partner who hasn't been tested for STIs?
  9. What damage do any of the preceding situations do to your existing relationships?

Ideally, you should think through all these issues in advance --- before they happen. Contingency planning is not only a very good idea, it's responsible. Every person has different comfort levels regarding sexual activity and risk.. What might be an acceptable risk for one person is unthinkable to another person. It's necessary to determine if the people you're in relationships with have compatible comfort levels with yours. And before you can determine if your comfort levels are compatible, you need to make sure you're talking about the same things. For instance:

  1. What is considered 'sex'? What is 'making out'? No, really. This is a serious question. Unknowingly using different definitions can lead to much strife.
  2. What is `safer sex'?
  3. What relationship structures are you open to? (closed or open ones?)

You have to educate yourself about STIs and how easy or difficult it is to catch them. You need to think seriously about procreating and how a kid would fit into your life. Once you have this information, you can start drawing up your safer agreements.

A lot of the information available about STI's is written from the viewpoint of a monogamous relationship. For instance, it's usually implicitly assumed that the reason why Alice is being tested for STIs is because she wants to be diagnosed and/or cured. Using STI tests as part of a safer sex agreement is a bit of a foreign concept.

The next assumption is that the safest thing to do is to only have 1 sex partner. Obviously, that's not what polyamorists do. However, polyamorous people can be safer.

Poly people can be safer via
- some form of negotiated agreement on latex barrier use (condoms and dental dams and gloves),
- regular STI testing and
- behaviour modification (example - no sex before testing, or engaging in only certain kinds of lower risk sexual activities).

Some people have verbal agreements. Some people write them down. Some people have simple agreements. Some people have very complex ones. Some people start out with a very simple safer sex agreement with their primary, but when they come across situations they hadn't catered for (for instance, moving away from relatively static closed relationship configurations to relatively open and dynamic relationship configurations) their agreement may become more complex.

The following are a list of things to consider and discuss in detail:
  1. birth control

  2. whether STI testing is necessary

  3. whether latex (or equivalent non-latex e.g nitrile or polyisoprene in the case of latex allergies/sensitivities) barriers are necessary in all situations/acts, or only certain situations/acts, and what kind of barriers, e.g., Condoms, dental dams, gloves.

  4. regularity of scheduled testing in

    1. polyfidelitous (polyfi) situation
    2. non polyfi situations
  5. definition of polyfi and non polyfi situations

  6. specific list of tests (to avoid having an argument about what constitutes a 'full' set of tests)

  7. list of vaccinations (hepatitis B, HPV -  Human Papillomavirus[Gardasil/Cervarix])

  8. handling of test results

  9. incidents that prompt non-scheduled testing (e.g., risky incidents and new partners in sex network)

  10. definition of risky incidents

  11. definition of unacceptable risky behaviours

  12. who pays for STI tests

  13. notification procedure for infectious/contagious diseases in network

  14. list of notifiable infectious/contagious diseases, e.g., STIs, abnormal pap smears, thrush, bladder/bacteria infections, cold and flu, fevers, cold sores, etc.

  15. timing of above notification

  16. actions to be taken upon above notification

  17. definition of safety levels

  18. lists of acceptable and non-acceptable types of activities in each safety level

  19. procedure for moving from one safety level to another (safer and less safe)

  20. procedure for condom break

  21. procedure for accidental pregnancy

  22. procedure for introducing new partners

  23. procedure for fluid exposure (break in skin and contact with body fluids)

  24. modifications of procedures/behaviours with planned pregnancy

  25. specific details of HPV strategy (it is not currently possible to easily test men for HPV although that may change when the new high risk strain hpv urine test becomes available in South Africa)

  26. specific details of deadly disease strategy (there are 1041 new HIV infections a day in SA)

  27. recommended minimum tests for sex network partners and minimum information to be shared

  28. what the scope of your agreement is, e.g., Your own boundaries, an agreement with your immediate partner(s), an agreement with everyone in your extended network etc.

Example opinions on STI testing

'I think that in a closed sex network, having tests all-round when someone new joins the network (and the new person possibly 6 months after that if their last new sexual contact was prior to 6 months before) is probably sufficient. I think all women should have a minimum of a yearly pap smear test regardless. In an open sex network, everyone should be tested for STIs every 6 months.'

 'Condoms first of all and don't sleep with someone until you both go for aids tests, and trust them not to sleep with someone they aren't sure about '

'I get tested once a year, regardless'

'I just assume that everyone has STIs and act accordingly'

Example Deadly disease strategies

'I will not endanger the lives of the people I love by entering into a new sexual relationship with someone who has a transmissible deadly disease and I expect that of my partners as well.'

Example HPV strategies

'I will not have sex with anyone who is currently having abnormal pap smears, or in sexual contact directly or by proxy with someone else who is until there is medical proof that the issues have been resolved.'

'I will be vaccinated against HPV (gardasil/cervarix) and I will be tested for known high risk HPV strains as part of my yearly STI testing . I will have a minimum of yearly pap smear tests unless I am advised against it due to medical complications. I will not be involved in a sexual network where female members do not have yearly pap smear tests.'

'I practice what I call HPV boundaries, which effectively eliminates genital-to-genital contact (at least one of us always keeps our clothes below the waist on), and for stricter observances, I can remove oral-to-genital contact, hand-to-genital contact and toy-to-genital contact. '

Resources

Safer Sex Howto

Ethical Non-monogamy Specific

Sexual Health Info

-- South African Polyamory http://www.polyamory.co.za

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