Due to the wide range of practices, the possibilities for the transmission of sexually transmitted diseases in BDSM are particularly numerous. The problem: even in the BDSM scene, sexually transmitted diseases and infections are not a topic that is casually discussed at the regulars’ table. People often like to talk shop about all practices, but rarely provide enough information.
Yet one in four adults in Germany already has or has had a sexually transmitted disease, as STIs and STDs are colloquially known. That doesn’t just sound like a lot, it is. However, as many do not even know that they could have such a disease, the number of unreported cases is most likely even higher.
What exactly are STDs and STIs?
Not every disease that can be transmitted during sexual intercourse is also an STI. Nevertheless, the word is used for any type of infection or disease that is sexually transmitted or occurs in the genital area. Doctors make a distinction between “sexually transmitted disease” and “infection”. In English, “sexually transmitted disease”, or STD for short, and “sexually transmitted infection”, or STI for short.
Not all infections lead to a disease and not every disease starts with an infection. Sexually transmitted diseases, however, are usually preceded by an infection. The most common are fungal infections of the genitals, HPV or genital warts and genital herpes. Other STIs include the following diseases: Syphilis, gonorrhea, soft chancre (ulcus molle) and a certain form of chlamydial infection (lymphogranuloma venereum).
You can protect yourself and other people from most sexually transmitted infections through safer sex. Physical barriers such as condoms, latex, femidoms, gloves or lick cloths are considered fairly safe. If diseases are detected and treated early, the chances of recovery are generally good.
What are the possibilities of a transmission?
It is important to know the various transmission routes for STIs and STDs in order to consider whether there is a potential for infection during BDSM acts.
Contact with infectious bodily fluids
Most STIs are transmitted via bodily fluids. These include:
- Semen
- Vaginal fluid
- rectal secretions (fluid film of the intestinal mucosa)
- Blood and menstrual blood
- Saliva
- Breast milk
The pathogens contained in such fluids can enter the body via damaged skin or mucous membranes. Sometimes even tiny amounts and unnoticed irritation are sufficient.
Contact with affected mucous membranes and skin lesions
The mucous membranes secrete and absorb fluids. They are often the regions affected by infections. These include:
- Vaginal mucosa
- Foreskin
- urethral opening
- Intestinal mucosa
- Oral mucosa
- Mucous membrane of the eye
- Nasal mucosa
STIs often cause skin changes such as weeping patches of skin, especially blisters, warts or ulcers. Contact with these can very easily lead to transmission.
Smear infection
This refers to transmission that occurs through contact with a contaminated surface. The pathogen can enter the system via mucous membranes or injuries. This occurs, for example, from person to person via oral sex, but also when fluids come into contact with your own hands or genitals. Transmission via objects and surfaces is also possible.
Transmission not only through sex or intimacy
The most common transmission of STIs and STDs occurs during sexual activity. However, transmission through drug use is usually also included at this point. This is because syringes, cutlery, tubes, swabs or other accessories are associated with this.
While drugs are less present in the BDSM scene, there are many practices in which utensils are used. For example, STDs and STIs can be transmitted through unclean toys. This also includes impact tools, Wartenberg wheels and ropes if they come into contact with mucous membranes.
Especially in medical play, which from the outside look like a high standard of hygiene, paradoxically, people play with many sources of danger. These types of games often involve inserting something into the body, injuring the skin or playing with bodily fluids, which increases the potential for infection.
However, STIs can also be passed on via close physical contact, bedding, towels or clothing. These are most commonly the more harmless infections, such as crabs or scabies.
Transmission during kissing?
Only a few STIs are transmitted through kissing. Often only small amounts of the pathogens are present in saliva. However, infectious skin lesions can also occur in the mouth. Transmission through kissing can therefore primarily occur with infections that are associated with skin lesions.
An exception is Pfeiffer’s glandular fever (mononucleosis), which is called “kissing disease” for a reason and is often transmitted through saliva. The viral infection manifests itself with a sore throat, swollen lymph nodes, fever and fatigue.
Where can I find help?
You can generally get tested by a gynecologist or urologist, and sometimes even by your family doctor or dermatologist. There is also a contact point at the health authorities, as well as at the AIDS service organization. There are also some private providers where you can get fully tested. Examples of such test providers are Samhealth, Zavamed and Verisana
Who do I need to tell?
To prevent the further spread of infection, you should of course inform all your partners. Aidshilfe also offers a telephone or online counseling service that deals with this topic and advises you on this issue.
Legally, HIV and syphilis must be reported in accordance with the Infection Protection Act. This is done anonymously via the laboratory reporting requirement. All other STIs were previously not notifiable. They were listed anonymously in a study by the Robert Koch Institute between 2003 and 2009. One exception is Saxony (Germany), which introduced a reporting requirement for gonorrhea and chlamydia infections in 2001.
This was Part I of the Deviance series on sexually transmitted infections. Also interesting:
STI and STD Part II: The 8 most common
STI and STD Part III: misconceptions and clichés
