Male and female condoms shouldn't be used together, as the friction of the two rubbing together can compromise the effectiveness of both. It is also sold in generic formulations worldwide, and other drugs are being studied for use as PrEP. However, condoms are highly effective for birth control and STI prevention. This is because pre-ejaculate , a fluid that oozes from the penile urethra before ejaculation, may contain STI viruses and bacteria. If a sex toy is to be used in more than one orifice or partner, a condom can be used over it and changed when the toy is moved. HIV may be transmitted through contaminated needles used in tattooing , body piercing , or injections. This includes birth control pills , vasectomy , tubal ligation , periodic abstinence , IUDs and many non-barrier methods of pregnancy prevention. Anal stimulation with a sex toy requires similar safety measures to anal penetration with a penis, in this case using a condom on the sex toy in a similar way. Non-penetrative sex includes practices such as kissing, mutual masturbation, rubbing or stroking and, according to the Health Department of Western Australia, this sexual practice may prevent pregnancy and most STIs.
However, many monogamous people have been infected with sexually transmitted diseases by partners who are sexually unfaithful , have used injection drugs, or were infected by previous sexual partners. Bacteria from the rectum are easily transferred to the vagina, which may cause vaginal and urinary tract infections. Virginity pledges and sexual abstinence education programs are often promoted in lieu of contraceptives and safe-sex education programs. This includes penetration of the anus by fingers, hands, or sex toys such as dildos. The most common vaccines are HPV vaccine , which protects against the most common types of human papillomavirus that can cause cervical cancer , penile cancer , and genital warts , and the Hepatitis B vaccine. It is important that the man washes and cleans his penis after anal intercourse if he intends to penetrate the vagina. It is best if the damaged sex toy is replaced by a new undamaged one. Female condoms are inserted into the vagina prior to intercourse. Immunization before initiation of sexual activity increases effectiveness of these vaccines. If a sex toy is to be used in more than one orifice or partner, a condom can be used over it and changed when the toy is moved. Non-penetrative sex includes practices such as kissing, mutual masturbation, rubbing or stroking and, according to the Health Department of Western Australia, this sexual practice may prevent pregnancy and most STIs. This includes birth control pills , vasectomy , tubal ligation , periodic abstinence , IUDs and many non-barrier methods of pregnancy prevention. They are most frequently made of latex , and can also be made out of synthetic materials including polyurethane. Non-penetrative sex A range of sex acts called "non-penetrative sex" or "outercourse" can be enjoyed with significantly reduced risks of infection or pregnancy. It is also sold in generic formulations worldwide, and other drugs are being studied for use as PrEP. The same risks apply to polyfidelitous people, who face higher risks depending on how many people are in the polyfidelitous group. This is because pre-ejaculate , a fluid that oozes from the penile urethra before ejaculation, may contain STI viruses and bacteria. Some research has suggested that male circumcision can reduce the risk of HIV infection in some countries. That drug combination is licensed sold under the brand name Truvada by Gilead Sciences. Sexual abstinence is sometimes promoted as a way to avoid the risks associated with sexual contact , but STIs may also be transmitted through non-sexual means, or by involuntary sex. However, a technical report  by the World Health Organization has shown that Nonoxynol-9 is an irritant and can produce tiny tears in mucous membranes, which may increase the risk of transmission by offering pathogens more easy points of entry into the system. They reported that Nonoxynol-9 lubricant do not have enough spermicide to increase contraceptive effectiveness cautioned they should not be promoted. That two-drug combination has been shown to prevent HIV infection in different populations when taken daily, intermittently, and on demand. A dental dam originally used in dentistry is a sheet of latex used for protection when engaging in oral sex. However, non-penetrative sex may not protect against infections that can be transmitted via skin-to-skin contact, such as herpes and genital warts. Sexual activity using these devices is called protected sex. While the use of condoms can reduce transmission of HIV and other infectious agents, it does not do so completely.
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