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Sexual Health

**We are worth the effort! Taking Care of Ourselves is not only about ensuring our longevity in the workplace, but it is also about feeling able and confident about switching careers if that time comes.**

*The following information can be found in the St. James Infirmary Occupational Health and Safety Guide

  • Use condoms every time you have sex.
  •  Wash hands with soap and water before engaging in any sexual  activity and after the disposal of condoms and dams, or handling of sex toys with another person’s body fluids.
  • Condoms, dams and gloves should never be reused.
  • Sex toys should be covered with a new condom for each partner or when switching receptive holes (like switching from anal to vaginal, or anal to oral).
  •  The condom should be removed from the toy and discarded after each use and the equipment cleaned and disinfected.
  •  Use dental dams or plastic wrap for both oral-vaginal and oral-anal activity.
  •  Use latex gloves (ideally, elbow length) and lots of lube for fisting.
  •  If condoms or barriers are not available or an option, use lots of lube to provide a barrier.
  • Where more than one worker is providing services to a client
    • necessary to ensure that vibrators, dildos and so on are not used by one person and then another without being cleaned, disinfected and/or having a new condom put on first.
    • Ideally each worker should have his or her own toys and equipment, which are not used by other workers.
    • In addition, each worker may choose to use a condom of a different color in order to identify who has used the dildo last.
    • Latex or rubber sex toys may be cleaned using antibacterial soap and water.
    • Plastic battery operated sex toys should not be soaked in water—use antibacterial wipes to clean.
    • Sex Workers: try to always bring your own toys, latex gloves, lube and condoms on outcalls. If you have an in-call, have plenty of these items stored on site.

Condom breakage is most likely to occur for the following reasons:

  • The condom has passed its expiration date or has been stored incorrectly. Please store in a dry, cool and dark area.
  • The condom is torn or damaged by a fingernail or jewelry during application or use.
  •  Insufficient lubricant has been used—particularly in anal sex or just before menstruation when the vagina can be drier than usual. Lubricant should be reapplied on the outside of the condom as needed.
  • Oil-based lubricant has been used. Only water-based lubricant should be used with latex condoms and dams.
  •  If the sexual act is of particularly long duration or with repeated sex acts throughout the day.

Condom slippage may occur:

  • If the insertive partner does not have the condom rolled on all the way to the base of the penis.
  • If the insertive partner fails to hold on to the end of the condom at the base of the penis while withdrawing.
  • If the insertive partner’s penis is only semi erect or flaccid.
  • If the insertive partner’s penis is small and/or thin, or flared.
  • During sexual acts of particularly long duration.
  • If the insertive partner has climaxed (cum) and continues to penetrate without changing the condom. Note: Customers have been known to do this. If this happens, and penetration continues, both his cum and the condom can get lodged pretty far up the vagina or anus, so be mindful. 20 21

To avoid condom breakage and slippage the sex-worker should:

  • Apply a small amount of lube to the tip of the penis prior to rolling the condom on—it will feel better for the client and prevent breakage. It also can expedite orgasm.
  •  Make sure that the condom has been put on properly—squeeze the tip of the condom while unrolling it onto an erect penis or dildo, completely down to the base.
  • Before starting a service ensure that a variety of sizes and types of condoms and water-based lubricant are close at hand.
  •  Regularly (every 5-10 minutes) check that the condom is still on, or that the insertive partner has not cum into the condom (re-lubrication is a good excuse to use to stop the service and check the condom).
  • Watch your back! If performing “doggie-style” regularly reach around and manually feel that the condom is still on his penis.
  • Become familiar with what a condom breaking and a broken condom feels like—possibly by discussing it with other workers who have experienced it.
  • Alert the employer and other workers to any client who attempts to break or remove a condom during a service.

In the event of a condom breaking or slippage, regardless of whether the male has ejaculated, there is the potential for the exchange of body fluids in either direction between the two partners. If the worker or client realizes the condom broke or slipped, the worker should ensure the following steps are carried out:

Condom breakage during vaginal or anal sex:

  • Stop the service immediately; the insertive partner should withdraw. He should then urinate to clear the urethra and wash the genital area thoroughly, particularly under the foreskin if present.
  • The receptive partner should remove excess semen from the vagina by squatting and squeezing it out using vaginal muscle exertion. Fingers can be used to scoop out any remaining excess semen. However, care must be taken to avoid scratching the lining of the vagina with fingernails or jewelry. Remove excess semen from the anus by sitting down on the toilet and bearing down. Fingers should not be used in the anus.
  • The Morning After pill, or other emergency contraception can be used to prevent pregnancy if necessary. Having extra doses on-hand is helpful. If not, seek care at a clinic or emergency room.
  • Medication is available if you think you have been exposed to HIV or other STIs. Seek care at a clinic or emergency room ASAP. For an HIV exposure, antiretrovirals (anti-HIV meds, or PEP) are typically given for a month, but must be started no later than 72 hours after exposure. For an STI exposure many drugs can be prescribed for quick treatment.

Condom breakage during oral sex:

  • The receptive partner should spit out any semen and rinse their mouth with a chlorhexidine-based mouthwash, a diluted tea-tree oil mixture, or Betadine.
  • They should not brush or floss their teeth or eat for at least an hour afterwards.
  • The insertive partner should urinate and wash their penis thoroughly particularly under the foreskin.

Trick Sex

“Trick sex” is having intercourse between the thighs, under the armpits or in a cupped hand held in the genital area. If a worker has shaved or waxed his/her body or public hair, s/he needs to be careful of cuts and scrapes. Any cuts, abrasions, rashes or grazes should be covered to prevent possible contact with body fluids. If a condom breaks or slips during trick sex, the insertive partner should wash the genital area thoroughly. Trick oral sex shows are when two female Sex Workers pretend to give each other oral sex. This can reduce your exposure to STIs. Most customers will not notice the difference, but some will. When doing doubles and providing a “show,” be sure to ask your co-worker if you believe the customer will not notice the difference.

The Dick Check

If you have the option, it is good practice to check your client’s genitals for signs of infection or crabs. This is not a 100% guarantee that you won’t catch something, but it can reduce your chances. Under ample light, run your fingers through the pubic hair and look for open soars, rashes or crabs at the base of each hair (crabs can look like freckles at first glance, but if you look closely, you will see a distinctive crab form.). Look up and down the entire shaft of the penis and the testicles for any signs of infections (see the description below on symptoms of STIs). If the client is uncircumcised, pull back the foreskin. Milk the shaft of the penis for a precum drip. Place the drip between your index finger and thumb and check to make sure the drip is clear, tacky and somewhat odorless; not cloudy and smelly. If you think he has an STI, it is best to refuse the client.

A Good Way to Clean the Vagina

Unless prescribed by a doctor, don’t douche with anything. (Douching is the process of rinsing out the vagina or anus with either plain water or a variety of store products, vinegar, baking soda and many other preparations.) The vagina does a great job of cleaning itself naturally with normal secretions (fluids). Recent studies show that women who douche seem to get more PID (infection of uterus, tubes, ovaries) or BV (Bacterial Vaginosis) infections.

Feminine hygiene sprays, powders and wipes are not necessary and can be harmful. Mild unscented soaps and warm water are the best cleaners for the outside lips of your vagina. Don’t use very hot water or antibacterial/deodorant soap. Vaginal tissue is very sensitive. Remember, your vagina is amazing so treat it with love and kindness.

A Good way to Clean the anus

Washing the anal region before and after anal sex reduces the amount of bacteria that can be transmitted from partner to partner. Plain water enemas can be used to clean the anus for sex, but overuse can destroy the normal, healthy balance of bacteria in the lower intestine.

Spermicides

Spermicidal foams and creams are designed to prevent pregnancy by destroying the sperm with which they come in contact. Nonoxynol-9 is a major ingredient in many spermicides. There is now evidence that frequent use of nonoxynol-9 may lead to genital irritation, vaginal and cervical ulcers, recurring yeast infections and increased risk of acquiring HIV or STIs. Sex Workers should not use nonoxynol-9 for HIV/STI prevention. If other spermicides are used, you should monitor to ascertain whether any irritation is occurring.