Yeah, OK, pun intended. Couldn’t help it.

Sexual health — and particularly safer sex skills — are key considerations in any relationship or connections that involve sexual contact. This is true even for monogamous relationships (because most of them are only ostensibly, not actually, monogamous) as well as for nonmonogamous relationships and more casual encounters. And fluid bonding (having barrier-free sex) can significantly increase most serious STI risks — if you don’t handle it consciously at all times.

Fluid bonding is not something that anyone should embark upon cavalierly or by default, not even monogamous people — not if they care about their own health and that of their partners.

I’M WRITING A BOOK about non-standard approaches to relationships — and that includes managing sexual health risks.
Want to help? Take this survey to share your views and experiences of relationships that aren’t on society’s standard relationship escalato(NOTE: I originally published this article on Jan. 15, 2013. But since then, in response to questions and comments from readers and others, I’ve expanded it significantly — especially with information and links about non-vaginal sex and STI testing.)

No joke: This month the U.S. Centers for Disease Control issued a warning about the increasing incidence of antibiotic-resistant gonorrhea in the U.S. And yes, this is one of many STIs that can be transmitted via any contact with mucous membranes, even orally.

Also, even though it’s easier for women to catch an STI from a man, women are less likely than men to exhibit or recognize STI symptoms. And anyone with an asymptomatic STI can easily transmit it unknowingly, because they don’t know they have it.

Don’t worry, I’m not paranoid about STIs. Some STIs do carry some potentially serious consequences — but in the bigger health picture, they’re not the biggest thing to worry about. Other risks, like heart disease and accidents, are far more prevalent and serious. Often STI risks get overemphasized because of the insidiousness of sex negativity in our culture. So it pays to be appropriately educated, aware, and proactive when it comes to sexual health.

People often assume, and expert sources often claim, that having multiple partners increases your risk of sexually transmitted infections (STIs). This can be true, depending on circumstances. But sexual health is not solely a numbers game. In the bigger picture, having good safer sex skills (including communication skills), and practicing them consistently is the best way to substantially decrease STI risks and manage all sexual health concerns.

That’s right: Always being prepared for safer sex, using those supplies and skills easily in the heat of the moment, and regular testing and talking are far more reliable ways to ensure sexual health than two fluid-bonded partners who simply trust each other to be 100% sexually exclusive with each other but otherwise don’t talk or do much about safer sex — or who consider safer sex second-rate or a hassle.

Looking at the flip side, this means: Failing to take responsibility to learn about sexual health risk factors, failing to adopt a good variety of proven safer sex techniques (which is about more than men wearing condoms correctly), and especially failing to communicate clearly, completely and promptly about them with everyone involved will almost certainly vastly increase your health risks for yourself, your partners, and their partners.

How I handle safer sex in my relationships

I thoroughly enjoy safer sex, with condoms and other techniques as appropriate. Unbarriered penetrative sex does not greatly increase my physical pleasure or emotional satisfaction, nor does it denote anything special about my relationships. I’ve found my relationships are simpler, safer and less drama-prone when I’m consistent with all partners about safer sex. Discussing sexual likes, desires, and health is an important (and fun!) part of that process. Also, when I don’t feel I need to surveil or micromanage my partners’ (and their partners’) sex lives, that helps us all relax– and thus have better sex.

Consequently I usually choose to use condoms for vaginal and anal intercourse (the activities that would represent the greatest risk to me). I communicate with partners to evaluate other risks/circumstances and adapt as needed.

In rare cases I may opt to have unbarriered sex occasionally or regularly with a specific partner — but only if we’ve been using condoms for a while, and I’m satisfied that their STI status/testing, behavior, and character warrant this level of trust. And also if we agree up front that returning to using condoms would not be viewed as downgrading our emotional intimacy or sexual connection. Partners who require no condoms in order to feel emotionally close to me, or to enjoy sex at all, are not sexually compatible with me.

My partners understand that if I choose to engage in unbarriered intercourse with them, they should not feel entitled to it going forward. It’s something I reserve the right to refuse at any time, and that should not be a problem. My partners understand that if I feel they’re pressuring or manipulating me into compromising my risk tolerance, our sexual relationship would end immediately.

Testing and talking

Getting regular STI testing (and being willing/able to discuss your testing and exposure status) is, of course, an important part of taking responsibility for your sexual health — certainly for people who have multiple sexual partners, but even for monogamous people.

Trusting a partner to be sexually exclusive to you and honest about that is fine if that’s what you want to do — but getting yourself tested at least annually so you know your own status for certain is basic common sense. IMHO, any partner who’d feel betrayed or offended by you wanting to ascertain your own health status has some significant growing up to do.

Here’s how I handle testing: I get tested every six months for HIV, gonorrhea, and chlamydia (including, when warranted by my recent sexual activity, oral tests for the last two, which you usually have to request and pay extra for, but urine samples or vaginal swabs usually won’t reveal oral infections). Plus, once per year I get tested for syphillis as well as hepatitis C. (I’ve been vaccinated for hepatitis B. Here’s CDC info on hepatitis.) I take STI testing windows (based on typical incubation periods) into account for the timing of my tests. That helps me make decisions about possible new STI risks I might consider in the month or so prior to my test.

If I have chosen to engage in unbarriered sex with a partner, I increase my testing period to every three months during that time.

I request my test results on paper, scan them, and save them as PDF files on my phone so I can show them to any partner who really wants to see them. (In fact, one really hot guy actually asked to see my results, and was impressed that I could show him immediately. The sex we had later that night was equally impressive!)

It pays to shop around for STI testing, since options and costs can vary widely. Call your insurance company (or check your policy carefully) to see what kind of testing they cover, and how often. I’m self-employed, and I’ve purchased individual health insurance — but my insurance only covers annual HIV and hepatitis C testing.

I’ve found that if you admit you’ve had any recent STI exposure risk (such as a new partner), insurance companies may decline to cover STI testing as preventative medicine — which only encourages people to be dishonest with their doctor. Some insurance companies will cover preventative STI testing only for women and not men. All of this annoys me enormously given how expensive health insurance is in the U.S., and since free HIV tests are fairly easy to get in many places.

Be wary of testing services that don’t post any price information online — they may be good and reliable, but they can be surprisingly costly.

In my town there’s both a Planned Parenthood and a few low-cost health clinics. I’m on their e-mail lists, which is where they often announce specials — they tend to offer pretty good testing deals at certain times. It’s generally best to get tested by your own doctor or at a local clinic where you can speak to health professionals. But if this isn’t an easy or affordable option in your location, you might consider using services that take samples at a local lab and call you with results. Just get specifics about their prices and packages, and whether they take insurance, before you use their services.

Regarding genital herpes and HPV — personally I handle those STI risks through communication, since barriers don’t offer much protection against them. Also, I don’t freak out about HSV and HPV. Most sexually active people have at least been exposed to them, so avoiding them is nearly impossible to do, or to ascertain. More importantly, the consequences of HSV and HPV are annoying but not life threatening (except for possible cervical cancer, and I do get a pap smear annually). Most people with healthy immune systems tend to clear these infections.

So, from what I’ve learned, here’s my position on HPV and HSV: If you seriously want to avoid exposure to those particular common STIs, you basically have to refrain from having sex that involves skin-to-skin contact with other people. And not just around outbreaks — while viral shedding is strongest before and during outbreaks, it can happen at other times, too. Personally, I’d rather be having sex, despite this risk. But I do inform my partners about my perspective on this matter, so they can make their own choices.

(Of course, if you or any of your partners have a compromised immune system, or are pregnant, HSV and HPV outbreaks present higher risks. I’m generally healthy and do not have or want kids — factors that definitely steer my personal sexual health risk tolerances.)

When I have the safer sex talk with new or ongoing partners (yes, it’s something you do need to keep checking in about, because things can change even with longtime partners), I do ask if they’ve experienced genital HSV or HPV outbreaks, and when the most recent one was. We can then choose what kind of sex to have on that occasion in order to minimize possible transmission risks.

Still, it’s always possible that some people may not honestly disclose their HSV/HPV status or history, since those relatively minor STIs are socially stigmatized due to widespread sex negativity and general ignorance. Also, some people simply are not self-aware enough to recognize when they’ve had (or are about to have) outbreaks — the symptoms can be subtle.

What if a condom breaks or falls off? Yes, that happens. I’ve been fortunate that the handful (maybe 4 or 5) of time this has happened to me in my life, either my partner or I have noticed it in the moment and immediately stopped to apply a fresh condom. This is crucial to me since I use condoms not just to prevent STI transmission, but as my primary contraception method, since I’m not on hormonal birth control.

If a condom fails, my STI exposure risks — as well as my partner’s — would increase. Which is why I prefer to talk about STI status and testing in advance of having sex. That way I know what to get tested for, and how soon to get tested, in case of condom failure.

So yes, there are always some risks with all sexual contact. Decide for yourself how to handle them. Generally, you’ll have more and better sex if you opt for information and skills (both for safer sex, and in terms of the variety of sexual activities you’re good at and enjoy) than if you resort to paranoia out of ignorance.

Why I generally require condoms

To my knowledge, I’ve been fortunate to never contract an STI other than a bladder infection. (Technically that was sexually triggered rather than transmitted, but still it sucked.) But I have been involved in situations where failure to discuss safer sex and sexual health clearly and promptly, or to consistently follow safer sex agreements, led to relationship disasters. Huge-blow ups, with lots of angry words exchanged, deeply hurt feelings, profound regret, and eventually bad breakups. All of this was probably very preventable.

Plus over many years I’ve seen many people I know (poly and mono) as well as countless online forum discussion threads (like this one) end up in huge drama-ridden relationship crises because they didn’t really consider fluid bonding clearly before they started doing it — and especially before they set it up as a huge, powerful symbol of all kinds of emotionally fraught issues.

Consequently, I’ve personally come to the decision that unbarriered sex is vastly overrated, and often unduly tokenized as an emotionally laden symbol of relationship depth, rank or commitment. I’m not saying unbarriered sex isn’t fun or intimate — but so is safer sex, with far fewer tradeoffs and risks.

Seriously: If you think about it, learn and experiment — it’s almost always possible to find ways to enjoy sex and feel emotionally close to a partner in ways that do not involve riskier forms of fluid exchange.

Personally, I greatly enjoy safer sex. It doesn’t diminish my physical or emotional experience in the slightest. In fact, it enhances my pleasure because I feel more respected, relaxed and certain. I don’t have nagging worries in the back of my mind about whether my partner or his other partners have been fully honest. (Because — lets face it — if people are going to lie about anything, they will lie about sex. Especially to the people they claim to love and trust, or to someone they’re trying to get into bed for the first time. People are most likely to lie when they feel like they’ve got a lot to lose, including their self respect or the respect or approval of others.)

Also I don’t feel the need to ask my partners and metamours a ton of invasive, awkward questions about the details of their sexual health and activity.

There’s also a hidden bonus to safer sex: Partners who are accomplished at safer sex skills and communication tend to be more skilled in everything about sex! Yes, they’re much better lovers! Not the least because they don’t believe great sex is all about having a hard cock or a thunderous, obvious orgasm. They tend to be inquisitive, experimental, aware and fully absorbed in the pleasure of the entire experience. Lovers skilled in safer sex tend to view every partner and experience as unique. They’re generally really into learning what turns you on, specifically. They’re not following some script; they’re equipped to improvise.

The men I choose to have more than one sexual encounter with are open to a variety of options to achieve climax and otherwise enjoy sex. I always consider an initial sexual encounter a “test drive” for this skill set, which makes for some especially interesting first encounters!

What about people who don’t enjoy sex with condoms? I’m primarily straight, and so only have sex with men. But I’m quite comfortable with using a female condom, and most men don’t seem to have a problem with it once they try it (a great option where fluctuating erections can be an issue).

I have known a couple of women who greatly dislike using barriers during sex — an issue more often cited by men. Everyone’s sexual tastes and needs are unique. But before anyone, regardless of genitalia, opts for fluid bonding, I’d hope they’d first explore their full range of options and products — preferably with advice from a trained sex educator or sex-positive medical professional. This kind of research and experimentation can be a lot of fun.

Safer sex is not about completely eliminating all risk

Rather, safer sex about understanding, communicating and negotiation sexual health risks and managing them within your chosen tolerance for risk. Personally, I’m willing to consciously assume some moderate sexual health risks — because I practice good sexual health communication and regular STI testing.

For instance, I am aware that pre-seminal fluid can pose some sexual health and pregnancy risks, and that not using a condom increases the chances for internal transmission of HPV and HSV. That’s why I offer unbarriered vaginal intercourse only rarely — and the partners with whom I’ve chosen to share it understand that it’s my exception, not my norm.

Everyone has their own risk tolerance. For me, fellatio (blow jobs) are usually, but not always, within my risk tolerance with established male partners who have demonstrated good sexual health communication and skills, have current STI tests, and generally use good judgment. When I offer fellatio, it may or may not involve male climax in my mouth, at my discretion. But that’s my choice to make, since most of the risk in that situation would be mine. I don’t have sex with men who aren’t OK with that.

For anal intercourse involving a penis, I do require a condom and lube 100% of the time — as well as applying a fresh condom if we switch to a different activity. For manual stimulation I personally don’t require gloves — but I do expect that we’ll both wash our hands before having sex, or if we’re taking a break between activities. Hygiene 101.

Other people might make different choices, of course. Risk tolerances are highly individual decisions. For the record, I’m quite comfortable with and skilled at giving and receiving oral sex with barriers. I’m straight, so I probably wouldn’t be performing oral sex on a woman — but I’m fine if a partner wants to use barriers to perform oral sex on me. I’ve done this, and it’s fun! The sensations are different, but not negatively so.

Mostly avoiding unbarriered sex is one of my key personal relationship standards — rules that I apply to myself. They affect my choices of which intimate or sexual relationships I choose to enter and continue, and how I will conduct myself in relationships. But ultimately this is a choice I’m making for myself. While it affects my lovers (or would-be lovers) I’m not imposing it them unilaterally. I am willing to negotiate safer sex practices with partners — and I prefer to do that by taking very few risks at first and gradually expanding as warranted over time. People who aren’t comfortable with doing and talking about safer sex simply aren’t compatible with me as sexual partners.

My reason for generally avoiding barrier-free sex is not solely about preserving my own sexual health, although that is important to me. It’s also about minimizing drama, regret, betrayal, and ill will. My relationships, casual and committed, are much happier and easier without fluid bonding. And the sex I have is still great!

The hidden trouble with fluid bonding

In my experience, the big relationship pitfall around fluid bonding is not whether people practice safer sex well or consistently adhere to agreements. Rather, it’s that people often fail to communicate clearly and promptly about safer sex and sexual health. Especially if fluid bonding is an important symbol in your relationship(s).

Whenever you “tokenize” an activity to stand in for an emotionally fraught issue, usually that’s done in part to avoid the need for frank, awkward, and potentially emotionally risky direct discussion of that issue. Avoiding talking about important stuff tends to cause more problems than it solves.

Fluid bonding is often used as a stand-in symbol for many charged and thorny issues: emotional investment, life commitment, relationship status or hierarchy, etc. In my experience, most people who do fluid bonding rarely do so solely for sensual pleasure, procreation or based on rationally considered health risks. Especially where a relationship hierarchy is involved, fluid bonding is commonly used as a symbol of territory or “rank.” And in poly relationships, violation of safer sex agreements where only some partners are “allowed” to be fluid bonded is one of the most prevalent forms of “cheating” and sources of strife.

In fact, since I originally published this article, I was stunned by how common it is that people (even people with lots of poly/open relationship experience) don’t discuss the choice to begin, or continue, being fluid-bonded sex partners very clearly, thoroughly — or at all. It’s often something that lovers just “start doing” at some point. And then, when fluid bonding started presenting complications, they tend to keep doing it rather than return to safer sex practices with that partner.

While that may seem surprising, it’s important to remember that fluid bonding is a common socially recognized marker of relationship status or progress in the world of “standard” (ostensibly) monogamous relationships. Since people often feel they can’t backtrack from fluid bonding temporarily or permanently without damaging or sacrificing their relationship, it’s a part of society’s standard relationship escalator model. Alternative relationships often retain a lot of social norms and presumptions — which is why couple privilege is such a thorny issue in the poly/open community.

Since I decided to take fluid bonding off the table (except in rare cases). I feel freer to say what’s going on for me, voice my questions, insist upon clear answers, listen openly to what partners and metamours say, and flexibly negotiate options and solutions when issues arrive. It gets easier to separate out conversations about safer sex from conversations about emotional investment, commitment, etc.

Keep in mind, as a solo polyamorist I personally don’t have (and am not seeking) a primary partner of my own. Also, I don’t engage in other people’s relationship hierarchies. I’m quite happy with solo polyamory as a way of life. But I understand that people who do have a primary partner or spouse often consider fluid bonding an important (even essential) part of their sexual connection.

Like any personal sexual choice, the choice to engage in fluid bonding — and even hold it up as a much-more-than-physical symbol in your relationship — is totally valid. That is, as long as this choice is arrived at consciously, based on solid information, and discussed clearly (not just presumed).

If fluid bonding is important to you, or if you’re already doing it (or are considering it), I’d ask you to consider:

• What does fluid bonding really mean to you and your partner(s)?
• Why do you want it? Why do your partners want it? Does it carry any symbolism or meaning beyond the physical aspects of sex? Do you simply prefer the sensations of unprotected sex?
• What are your plans or agreements for regular STI testing? (Even if you’re completely monogamous, this is still a common-sense measure, at least during your annual physical.)
• How would you handle it if anyone in your fluid-bonded relationship or network developed an STI or had unprotected sex with someone new? And if they didn’t tell you about this before resuming unprotected sex with you? Do you have a way to make a safe space for such uncomfortable revelations?
• If it was a wiser choice to do without fluid bonding (even with a spouse or long-term committed partner), how might you do that without viewing your connection as diminished?

If you can’t answer these questions clearly — or if you can’t safely have this discussion with your partner(s) — I’d suggest you might want to hold off on fluid bonding altogether. You’re probably not really ready for it, the way it works in the real world (not in romantic novels or movies where all this hot sex happens but no one ever seems to open a condom packet).

Doesn’t monogamy keep your sex “safe?”

If you think fluid bonding is complicated for poly/open people, consider the plight of monogamous people — over half of whom aren’t really that monogamous.

Over a decade ago, when I first told my physician that my then-husband and I were opening our relationship, she asked me about safer sex and gave me some very practical, nonjudgmental advice. (Yeah, I love my doctor.) But she also observed that the most heartbreaking instances of STIs and unintended pregnancy she’d witnessed happened when someone in an ostensibly monogamous couple cheated.

My doctor said that often, the cheating partner had never developed sufficient skills or comfort with safer sex techniques, and so wouldn’t bother with safer sex in the heat of the moment with a new partner. In fact, often they’d use drugs or alcohol in order to lower their inhibitions or maintain plausible deniability — to tell themselves or others that they “didn’t know what they were doing,” or it was “a mistake,” or they “couldn’t help themselves.”

Even worse, people in monogamous relationships often avoid carrying condoms or other safer sex supplies — since then it would be harder to believe or claim that having sex with someone else was some kind of accident. And afterward it would look “suspicious” to suddenly want to start using barriers or refrain from sex with their monogamous partner. So they’d just pretend it never happened, hoping for the best. (Some recent research backs up her observation.)

Then, when an STI or unintended pregnancy surfaced, or even if the monogamous partner learned that they’d been exposed to new risks without their consent or knowledge, all hell would break loose — resulting in much heartache and sometimes ruined families and lives.

When people reflexively claim that traditional monogamy is inherently simpler or safer than polyamory or open relationships, I think about fluid bonding first. Monogamy only seems relatively simpler because most of the time you can get away without discussing things that non-monogamous people cannot really afford to avoid discussing. However, when issues or conflicts arise that relate to sex with or attraction to others — as they often do — monogamous people often are at a relative disadvantage to find ways to cope with these issues that don’t involve stifling feelings, lying, putting themselves or others at risk, breaking up or living with resentment.

What is your experience with safer sex and fluid bonding? What agreements or standards do you have about it for yourself or in your relationships? Please comment below.