Dear Dr. Jeff: Is it possible to have safe sex when you've been drinking?
?A.S.
Dear A.S.: If you haven't had much to drink, it's certainly possible to have safe sex. If your judgment's impaired, on the other hand, then I'm not sure you can?and for the same reasons you probably wouldn't be able to have truly consensual sex.
"Safe sex" was promoted in the early 1980s in response to the outbreak of the HIV epidemic. The initial lists of proscribed behaviors were discouragingly long, prohibitively broad, and overly focused on gay men. They were also misleading. There is no such thing as completely safe sex. "Safe" sex recommendations were eventually replaced by "safer" sex recommendations, grounded for many in a more balanced and acceptable understanding of the nature of risk.
People have safer sex to protect themselves and their partners from STIs, including HIV, and from unplanned pregnancies. They understand that sex is more enjoyable if they are not afraid. Safer sex is about what they do, or don't do, and not about who they are. It is about figuring out their own "risk limits," and then avoiding sexual activities that fall outside of them. Safer sex practices require self-reflection, some familiarity with the "tools of the trade," and above all, a great deal of communication between partners.
Drinking heavily, on the other hand, puts you at risk for a variety of unhealthy, unsafe, and possibly unwanted outcomes. Getting drunk might allow you to "get a little wild," but it might also involve increased risk-taking and carelessness. Some of those "inhibitions" that get pushed aside may be self-protective and might have been well thought out. We all know that heavy drinking often leads to unplanned and unprotected sex. Any condom use, never mind proper condom use, is simply much less likely in this setting.
We also know that heavy drinking leads all too often to unwanted sex.
Studies continue to show that over 70,000 reported cases of campus date rape occur each year, and that up to 90 percent of reported sexual assaults on college campuses involve the use or abuse of alcohol.
Health educators have suggested we think through the risks of sex and safer sex like we do other risks in life, such as driving a car. There are people who simply choose not to drive for fear of getting hurt in an accident. Most people seem willing to accept some level of risk, and try to find ways to reduce it. They wear seat belts, maintain their cars, drive defensively, and avoid driving in bad weather?or after drinking.
Practicing safer sex is really very similar.
Be well!
Jeff Benson, MD
Dudley Coe Health Center