Prevention is better than cure: how to protect yourself against STBBIs

For DépistaFest, Prelib is teaming up with Club Sexu to provide an update on STBBI prevention methods.

Every year, more than 40,000 Quebecers are diagnosed with the disease.sexually transmitted and blood-borne infections (STBBI)1. Fortunately, most of them are easily treatable... when detected. If left untreated, complications can develop that can have significant health consequences.

The best way to protect yourself from STBBIs is to combine several strategies (presented below) according to your needs: get tested regularly, use protective methods during sexual activity and drug use, PrEP and PEP, vaccination and discuss sexual health and testing with your partner(s).

Regular screening

Whatever your sexual practices and protection methods, regular screening is the only way to make sure you haven't contracted an STI. Taking care of yourself and your partners will make the pleasure last!

Screening is recommended if you recognize yourself in any of these situations:

  • you wish to undergo routine STBBI screening;
  • you are in a stable relationship and wish to stop using condoms;
  • you have doubts about past or present partners;
  • you may have had contact with blood.

Depending on your practices, we recommend regular screening between one and four times a year. Our services include a non-judgmental medical questionnaire assessing the appropriate tests for your practices, and a telephone consultation with a professional to discuss the frequency best suited to your situation.

Barrier protection methods

Barrier methods, as their name suggests, are designed to create a wall during sexual contact to block the transmission of STIs. They are effective in reducing risk, but not to 100 %, because in practice, many things can happen: from dipping to the use of the wrong lubricant, to certain STIs whose lesions extend beyond the protected zone, such as syphilis, HPV and herpes simplex virus (HSV). The best thing to do is to combine the use of barrier methods AND get tested regularly AND have a good chat with your partner(s). It's just a little more work and a lot more fun.

Moreover, barrier protection methods can be found in pharmacies in some cases, or ordered online and in specialist stores.

Condoms (internal and external)

The outer condom covers the penis, while the inner condom is inserted directly into the anus or vagina. To be effective, the condom must be used according to the following recommendations:

  • make sure it hasn't expired;
  • do not tear packaging with teeth or scissors;
  • put on the condom before any sexual contact, including oral sex for the external condom;
  • use only water- or silicone-based lubricants to prevent damage;
  • change the condom for each partner and each new orifice entered;
  • do not use more than one at a time, as friction between two condoms may damage them and cause tears.do not use more than one at a time, as friction between two condoms may damage them and cause tears.

The sex dam

Also known as dental dams or latex squares, sex dams act as a barrier between the mouth and the vulva or anus. As with a condom, it's important to follow the precautions for use to ensure optimal protection (its effectiveness rate is similar to that of a condom). Here's a quick guide to how to turn a condom into a dental dam:

The latex glove and the latex finger

Working on the same principle as the condom, the latex glove or finger is worn over the hand or fingers when stimulating the anus or vagina with the fingers.
Be sure to remove your rings and take care not to pierce the glove/finger with your fingernails.

PrEP and PPE

PrEP

PrEP (or pre-exposure prophylaxis) is like contraception, but designed to prevent HIV. Taken in tablet form, it is intended primarily for people at high risk of contracting HIV:

  • men who have sex with men;
  • trans women;
  • people of the plurality of genders;
  • HIV-negative people who have sexual relations with one or more HIV-positive people.

There are two types of PrEP: continuous (to be taken every day) and on-demand (two tablets between 2 and 24 hours before high-risk sex, then one tablet 24 and 48 hours afterwards).

Despite its effectiveness in preventing HIV transmission, PrEP does not protect against other STIs. It must be used in combination with a barrier method such as condoms and regular screening.

The cost of PrEP may vary depending on your insurance coverage. Contact us for more information.

The PPE

PEP (post-exposure prophylaxis) is your morning-after pill for HIV: an emergency prevention tool to be used AFTER potential exposure to HIV. It should be taken as soon as possible, within 72 hours of a suspected exposure, and for 28 consecutive days. When taken in time, PEP blocks replication of the virus in the system to prevent permanent infection.

The key to obtaining PEP is to act quickly: get an appointment for a medical consultation at a clinic specializing in sexual health, or in a hospital emergency room. Some pharmacies can also provide PEP while you're waiting for an appointment. To be directed to the appropriate resource, you can call the Info-Santé hotline at 811.

The cost of PPE may vary depending on your insurance coverage. Contact us for more information.

Vaccination

Infections with hepatitis A and B viruses, and the human papillomavirus (HPV), can be prevented by vaccination. These vaccines are available in Canada, and may be free for certain people eligible for the Québec vaccination program.

To find out about your eligibility and the cost of vaccines, consult your healthcare professional.

Harm reduction during drug use

If you use drugs by injection or inhalation, you can reduce your risk of contracting an STI by following certain strategies:

  • Use sterile consumption equipment (straws, needles, pipes, filters, etc.) and do not share them with others;
  • Have regular screening tests;
  • Find out about the drugs you use and their effects, to avoid an overdose or a bad trip;
  • Bring naloxone with you if applicable.

Sterile consumables are available from several resources.

If you practice chemsex or Party and Play (PnP), other strategies need to be considered in addition, as the use of psychoactive substances can alter our judgment about risks and our limits, putting us at risk of unknowingly damaging the mucous membrane of the anus and creating a gateway for STIs, including HIV. Here are a few tips for a safe session:

  • Bring sufficient protection for your practices: condoms, fingers or latex gloves;
  • Use a LOT of lubricant (water-based or silicone);
  • Make sure you've taken your PrEP doses if applicable;
  • If you don't use PrEP or physical protection, use other risk-reduction strategies such as PEP (see PEP section above);
  • Discuss PnP with your doctor if you're comfortable.

Talk to your partners

In addition to the protection methods suggested above, it's a good idea to communicate with your partners to find out about their sexual health status, such as their most recent screening, any STIs they may have and any treatments they're taking. You can also negotiate protection strategies to be implemented in your sexual activities or those with your other partners, to reduce the risk of transmission.

Open communication goes a long way towards limiting risk by maximizing the implementation of strategies that fit your shared situation, and helping you make informed decisions.

*Notifiable diseases (MADO) are intoxications, infections or illnesses diagnosed by a physician or confirmed in a laboratory, which must be reported to public health authorities in order to monitor the health of the population and plan intervention strategies accordingly. To find out more about MADOs, visit the Ministry of Health and Social Services.

1National Public Health Program - Reach, screen and detect, treat Integrate STBBI prevention into regional public health action plans, 2017.

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