Knowledge Base and Recommendations

The Most Important Safer Sex Principles are:

- Use barrier precautions for vaginal and rectal intercourse, but withdraw prior to climax and ejaculate out of partner - The only absolutely Safe Sex is abstinence from any behavior which exposes another person to bodily fluids.  Touching and dry "kissing" carry no risk of infection.

- Penile/rectal and penile/vaginal transmission accounts for the largest number of sex-related HIV infections.  Most sexual transmissions occur in persons who engage in receptive rectal or vaginal intercourse without barrier precautions

- Despite the effective barrier which latex condoms represent, penile-rectal and penile/vaginal transmissions do occur, most likely do to product failure.

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- Penile/rectal intercourse is not confined to male homosexuals but is practiced with substantial frequency by heterosexual couples. - women must be educated in ways to decrease their risk of infection by anal as well as vaginal routes. - Penile-rectal and penile-vaginal transmissions also occur more frequenly in the setting of concurrent rectal or vaginal irritation, infection or disease. - Persons should refrain from rectal or vaginal intercourse in the setting of concurrent rectal or vaginal irritation or disease.

- A higher rate of tampon use was noted among infected wives and compared with uninfected wives of HIV infected hemophiliacs.  Tampon use, especially "super absorbent" tampon use, has been shown to result in dryness, desquamation and other cellular abnormalities which may increase the likelihood of infection. - the generous use of a water-based lubricant is recommended for all occassions of vaginal intercourse. - persons should refrain from vaginal intercourse in the setting of vaginal dryness or irritations. - alternative methods of absorption (e.g. sanitary napkins) should be tried if tampon-related vaginal irritation or dryness occur.