With the advent of HIV/AIDS and the need to practice safe sex, many people are abstaining from penetrative sex and those who do so use a barrier method of contraception such as a condom in order to reduce the risk of sexually transmitted diseases and unwanted pregnancies. However, in recent times the attention of the public is being drawn to the fact that it is not enough for you to say you are practising safe sex simply because there has been no penetrative sex. The American College of Obstetricians and Gynaecologists have issued an opinion in the September 2008 edition of the journal Obstetrics & Gynaecology about the health risks associated with noncoital (non-penetrative) sexual activity. In an article entitled "Non coital sexual activity may not be safe sex" by Penny Murata, the dangers of mutual masturbation, oral sex, and anal sex are discussed. While it is acknowledged that these behaviours carry little or no risk of pregnancy, they point out that women engaging in these noncoital behaviours may be at risk of acquiring sexually transmitted diseases." This is because most individuals engaging in oral sex are unlikely to use barrier methods of protection. However, sexually transmitted diseases (STDs) may be spread through saliva, blood, vaginal secretions, semen, and faecal matter, especially in the presence of pre-existing infections, open sores, or other lesions. Research has shown that those who practice anal sex are five times more likely to have HIV transmitted to them from an infected partner compared to those who practice vaginal sex with an infected partner. Herpes simplex virus (HSV-l) is usually associated with oral lesions and HSV-2 with genital lesions. However, both types can infect oral, anal, and genital sites. Human papillomavirus (HPV) is a highly prevalent, sexually transmitted virus that can cause anogenital and oral cancers as well as benign genital warts. Hepatitis B virus is commonly spread through noncoital sexual activities and the virus can be found in semen, saliva, and faeces. Hepatitis A is transmitted through faecal contamination of the oral cavity and is more common in men practising oral-anal contact. Syphilis, gonorrhoea, and Chlamydia are sexually transmitted diseases caused by bacteria which can be contracted even when there has been no penetrative sex and it has been recommended that all sexually active women 25 years or younger should be screened annually for Chlamydia, and all sexually active adolescents should be screened for gonorrhoea. It has been suggested that due to the fact that many people especially the youth are switching to oral sex to avoid pregnancy, there is the need for the youth to be educated on the implications for their health. The authors advise medical practitioners to communicate better with the youth about sexual activities other than penile-vaginal intercourse and that they should enquire about specific noncoital sexual activities and counsel patients to their dangers. There is the need for the public to be better educated regarding the potential health risks of noncoital sexual activities and the importance of risk reduction and the need to use barrier methods of protection consistently and correctly as well as restricting the number of sexual partners. Other suggested strategies to the youth include abstinence, mutual monogamy, engaging in relatively safer behaviours, and STD testing before initiating sexual activity with a new partner. Whenever sexual abstinence is mentioned, it creates a lot of problems because many people have a very narrow definition of what constitutes sex. Next week we will sample some views of the youth of what constitutes sexual abstinence. Source: The Mirror