BC BDSM

Safer Kink – How do we apply what we know about STI’s and safer sex to BDSM?

A good place to begin is by thinking about and understanding how body fluid transmission of diseases happens.

Being aware of the routes of transmission, the ability of a pathogen/virus to survive in what environments, etc, can help you weigh levels of risk and find ways to minimize risk and make safer play choices.

The first thing to understand is that in order for a disease to be transmitted through body fluid contact a sufficient amount of active virus, in a body fluid, from an infected person, has to contact the mucus membrane or broken skin, of another person.

So what does that mean?

Potentially infectious body fluids include: blood, plasma, semen, breast milk, sweat, vaginal fluids, saliva, urine and feces.

Mucus membranes include: eyes, nose, mouth, rectum, urethra, or vagina.

Infectious body fluids can transmit disease by three methods; direct contact, indirect contact, and airborne transmission:

1) Direct contact occurs when you contact body fluids directly, such as during sexual acts. This form of fluid exchange is usually obvious to the participants.

2) Indirect contact occurs when you contact items that have been contacted by body fluids. In cases, such as a pool of blood or urine on the floor, the possibility of contact and risk is obviously high. In cases such as with equipment, furniture, walls and floors, you really have no way to know for sure if the item in question has been in contact with body fluids, or if it has been cleaned properly. The same goes for toys that are not under your direct control and have ever been used on anyone else. This type of risk is more difficult to quantify.

3) Airborne transmission occurs when you inhale airborne particles of body fluids, such as particles of blood that have flown off of a flogger or whip. As with indirect contact, this type of risk is difficult to quantify.

Assessing the level of risk of body fluid transmission of diseases:

How much of a risk are you taking by using toys and equipment that have been used by someone else is based on several factors:

1) Presence of a pathogen: the person whose body fluids you have contacted must have must harbour the pathogenic organism, whether or not disease symptoms have developed. Short of frequent blood tests, there is no way to know and assess the risk.

2) Amount of pathogen: The aeration of minute specks of vapourized fluid caused by a whip cracking poses a risk; a drop of blood will contain a higher concentration of pathogens and a corresponding increase in risk.

3) Vulnerability to the pathogen: There is no effective vaccine for AIDS, therefore you are not immune and are vulnerable to at least one disease. If you have been vaccinated against a disease you are considered immune for the most part to that pathogen.

4) Point of entry: infected fluid must contact mucus membrane or broken skin in order to enter your body.

5) Length of exposure time and cumulative exposure levels: Prompt cleaning and attention to wounds can lessen the risk. Repeated exposure increases the risk.

Some viruses, like HIV, do not live long outside the human body and once the body fluid has dried, it is no longer pathogenic. Other viruses, like Hepatitis A, can live outside the body for months. How long will any given virus live on your leather flogger? On a silicone toy? On a wet towel? That will depend on all kinds of things, the heartiness of the strain of virus, how much body fluid there is, how friendly the environment is to the virus, etc. There is the life of the virus that science has determined in the lab, but that doesn’t tell you how long it will live on your favourite toy.

Body Fluid transmission risks of specific viruses

HIV

Body fluids that HIV can be found in – blood, semen, vaginal secretions, breast milk, saliva, tears – the amount found in saliva and tears is a much lower concentration than in other body fluids.

HIV is generally felt to not be transmittable environmentally. There have been no known cases of someone contracting HIV from contact with an environmental surface. HIV does not live long outside of the human body, once a body fluid has dried, the virus will be dead. HIV is sensitive to the hostile environment outside of the body and dies quickly from contact with chemicals and cleaners. Transmission from objects, like needles, usually occurs via blood that is contained in a closed environment (like a needle where it is protected).

Toys are considered to be safe from transmitting HIV if they have been washed in soap and hot water or a commercial toy cleaner and then soaked for 20 minutes in 10% bleach solution (1 part household bleach to 10 parts water, bleach that comes from a bottle that has been opened more than a month ago has started losing effectiveness). After you have soaked the toy for 20 minutes then rinse it in hot, clean water and then let it dry thoroughly before using it again.If you’re using insert-ables on more than one person, bagging it with a condom is always a good way to reduce risk.

Hepatitis

Hepatitis A, HAV, is transmitted through oral ingestion of fecal matter, and not through other body fluid contact, this is the strain of hepatitis that can live outside the body for a number of months. If it hasn’t been contaminated by fecal matter you cannot get HAV from it. If it doesn’t go in your mouth, you cannot get HAV from it. HAV is killed by heating to 185 degrees F (85 degrees C ) for one minute. Newer dishwashers will do this, or you can put items in a pot of water on the stove with a thermometer.

Hepatitis B and C, HBV and HCV, are transmitted through blood and body fluids to mucus membranes or broken skin. HBV has been known to live outside the body up to 10 days. HVC has been known to live outside the body for up to 4 days.

There are vaccinations available for HAV and HBV, but not for HCV.

Quaternary disinfectants are recommended for cleaning environmental surfaces. This type of disinfectant carries a positive charge. The bacteria, viruses and fungi you are trying to remove carry a negative charge. When you clean a surface using a quaternary disinfectant, the cells of the bacteria, viruses and fungi change from a negative to positive charge, which if used according to the products instructions will kill them. Quaternary, also referred to as Quats, are  odourless, non-staining and non-corrosive to metals. They are fairly non-toxic if used in diluted concentrations.  They can be acquired at janitorial, medical or restaurant supply stores.  If you cannot access quat cleaners 10% bleach solutions or anti-viral cleansers are recommended for cleaning environmental surfaces. (Bleach must be fresh, after a bottle of bleach has been opened the bleach inside will over time lose it’s ability to dis-infect).

Having this information about the level of risk, and what causes risk allows us to take take precautions to minimize risk.

How to reduce the risk of body fluid transmission of diseases

1) In the case of direct contact:

a) Use barriers to prevent body fluids from transferring between people. Barriers should be condoms, gloves, or dental dams. Use approved medical grade barriers that do not allow disease to pass.

2) In the case of indirect contact:

a) Stay well back from areas where piercings, knife play, blood sports, water play, flogging, whipping, or caning are taking place.

b) Do not play with porous surfaced toys or furniture without a barrier in use on someone with broken skin.

c) Use barriers, such as condoms to cover toys or implements that will come into contact with body fluids to keep them free of fluids, and disposable drop sheets on surfaces.

d) Treat all liquids on surfaces as potentially infectious. Discard barriers and if a disposable barrier hasn’t been used and body fluid does contaminate a surface you need to do your best to kill potential pathogens.

e) Clean up right away, the shorter the exposure time the less risk there is. You want to clean up body fluid contamination as soon as you notice it. Wash yourself and toys after contact. Hand washing, showering, washing genitals, use soap and water when washing, and wash all items that have come in contact with body fluids with some form of disinfectant.

f) When cleaning play stations or other surfaces there are good tips to keep in mind. Spray the clean towel and wipe down the surface rather than spraying the surface directly and then towelling. The force of the spray may propel contaminants from the surface into the air if you spray it directly, turning it into an airborne source of pathogen.

g) Use disposable towels or sterilize reusable towels for cleaning. Once a towel surface has gone over an area once, discard it and use a fresh piece of paper towel, don’t smear germs around, wipe an area with a saturated cloth, use a new cloth for a new area. I prefer disposable paper towel for this purpose. If you want to use cloth, you need to ensure the cloth is also treated properly between uses to prevent spread of germs from a contaminated cloth.

h) Use a cleaning product that is going to be more likely to kill the virus when washing toys and surfaces. Soap and water is good, 10% bleach solution is better. Bleach is a good disinfectant, it’s inexpensive and easy to get a hold of, so it’s often the cleaner of choice for many people. Most people use between a 10%-25% concentration of bleach in water. When using chlorine bleach be aware it will lose it’s effectiveness after 30 days of the bottle being opened. If the bottle was opened more than 30 days ago, it is not going to be an adequate disinfectant. If you are using bleach as a primary method of disease prevention, I recommend marking an expiry date on your bleach bottles after opening them. Only use bleach in well ventilated areas. Bleach produces toxic gas when mixed with certain other cleaners, particularly acid bases like ammonia or vinegar, never mix bleach with any other cleansers or products. Some people follow up cleaning with bleach with water to remove bleach residue, or isopropyl alcohol. Some people recommend specific anti-viral cleansers such as ClinASept, madacide, nonoxynol-9 cleanser, betadine (does stain). I buy a specialty disinfectant cleanser from a janitorial supply that is termed ‘hospital-grade’. Hospital grade disinfectants are anti-viral, anti-bacterial, and anti-fungal, the bottle gives recommendations for dilution for different uses. There are many such cleaners available and you can search local medical supply, restaurant supply, janitorial supply or on-line for hospital grade disinfectant cleaning products. Always read the entire product label and follow dilution instructions explicitly to ensure that the safest, most effective concentration is applied.

i) To achieve effective disinfection requires that surfaces be saturated thoroughly with the disinfectant. A disinfectant should remain on the surface for the appropriate contact time, which varies with the product, always read the label. Afterwards, areas should be rinsed thoroughly and allowed to dry. As a general rule the longer the exposure to the hostile chemical environment the more likely it will have killed all the virus, usually soaking an item for 20 minutes is going to do the trick. Once you’ve cleaned a contaminated surface, letting it dry thoroughly is a good added precaution, viruses thrive in moist conditions.

j) Quarantine of items, if you are unsure if a toy is safe, retiring it from use for a while will reduce risk as well. The longer a virus has been outside the body the less likely it is to have survived.

What is an acceptable level of risk?

I talk about risk reduction rather than prevention, because you can never state that something is 100% risk free. Barriers do not universally prevent the spread of infection, cleaning well does not prevent the spread of infection, what these methods do is reduce risk of infection. Even with sterilization, as soon as the process is finished and the item exposed to air, it is no longer sterile.

What is an acceptable level of risk for you is a question only you can answer.

If you are using a toy made of a material you do not want to or can not sterilize, that should affect the risks you take in using it; you choose the level of precaution you want to take.

Unless you have personally cleaned a toy or piece of equipment and know whom it has been used on, there is no way to safely and accurately assess the risk involved.

The chance of infection by indirect contact with infected fluids is lessened by proper cleaning and sterilization of toys constructed of non-porous materials such as those made of glass or steel; however, there is no way to ensure an absolute zero risk when a toy is used on more than one person.

With porous materials, such as wood, plastics, leather, fabric, hair and rope; complete sterilization is impossible. Once exposed to body fluids from one person, toys and equipment made from porous materials can not be cleaned or sterilized sufficiently to ensure an absolute zero risk if used on a second person.

You can’t break skin on one person with a wood or leather toy and then clean it sufficiently to ensure that there is an absolute zero risk involved with breaking skin on a second person.

A piercing or branding that has not healed, pimples, minute scratches, scrapes or pinpricks are all in effect, broken skin. Fluid exposure and transfer can still occur even if skin is broken only slightly, and toys can come in contact with infected fluids even if they do not seem to have drawn blood or broken the skin. Any abrasion, scratch, or pimple qualifies as broken skin contact, and body fluid contact.

Be aware of the risks and take precautions to minimize them.

Make responsible choices to minimize risks where ever you can.

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Katt

- Originally written in 2005, updated ongoing with new information, last update 2008. Please check your local sexual health resources for the most recent information on STI’s. My recommendation is a yearly screening of STI’s for brand new paperwork to woo potential playmates with, when you’re there getting tested for wee buggies is to ask if there’s any changes over the last year in terms of sexual health and STI information.  Keep yourself informed direct from the professionals. Get tested and be armed with knowledge.