For all of the articles about traveling long term, and the packing lists, and the ultralight “I only carried 15 pounds down the entire Appalachian Trail” bragfests, there’s not a lot of outright discussion of safer sex.
It seems like at least half the residents of any given hostel are flirting with each other over the communal dinner table, and a lot of traditional backpacker activities (heavy drinking in local pubs, engaging in adrenaline-raising hikes through the Andes) result in the kind of situations where clothes might be shucked and risks might be taken. But none of the discussions about trip safety, either before you leave or while you’re already on the bumpy bus to the Guatemalan border, tend to include how to have the safest sex possible while you’re long-term traveling.
It’s slightly irresponsible to get all your malaria pills, and then fail to acknowledge the possibility of contracting significantly more common illnesses from your new friends. You should know your disease status before you leave home (another battery of tests to go along with your festive tetanus and hepatitis A shots!) so you know where you’re starting from, but here are some other things to consider.
I have a real pet peeve against people who use phrasing like “Are you clean?” to talk about disease status. There’s a lot of stigma against sexually transmitted infections, most of which are curable with a quick run of antibiotics assuming you catch them in time (syphilis, if you don’t catch it in time, can travel up your spinal cord and eat your brain!).
A significant amount of the time, people who transmit sexual infections are not aware they have them because they have no symptoms. Being mad at someone who didn’t know, and feels really guilty about it for passing on a mild illness, is the equivalent of ripping someone a new one because they gave you a cold. Getting chlamydia is kind of better than getting a cold, actually, because you can take medication for it; nothing you do for a cold will make it go away but time.
People with herpes simplex II can shed the virus (transmit it) without even having an outbreak, so it’s also possible the person who was nice and told you they had herpes is not the person who gave it to you…it could have been three partners ago, from someone who didn’t even know they were infected. So treat all partners with respect and honesty, because they deserve it, and so do you.
Get tested regularly, whatever that means for you. Yep, even overseas.
As the previous point states, a lot of STIs don’t necessarily have symptoms, so regular testing is the best way to catch them. I used to get tested for STIs after every new partner. That became unsustainable. So I set a solid goal that I would be tested every 6 months, more frequently if I had cause for alarm. Since then, I have stuck to this schedule rigidly, even when it’s difficult and inconvenient.
Obviously, if you’re in a place where getting tested for STIs could be life-threatening, either because of health conditions or because of prejudice against STI testing, don’t force yourself into dangerous situations. But also don’t let your STI tests suffer just because it seems like it’s not that important. Don’t be one of those people who treats dentistry as optional and then, ten years after the last teeth-cleaning, finds out they need a series of root canals to cover the damage. STIs are not just about your health — they’re about the health of your partners and your partners’ partners.
This means you are responsible for finding clinics or services that will do this for you. If you thought you had giardia, you’d go to the doctor, right? Medical treatment overseas is frequently a lot cheaper out of pocket than it is in a lot of developed Western countries — certainly the United States lags in affordability of healthcare — and you can often get clean, sterile tests with fast results in hospitals the world over. You can also look into the International Planned Parenthood Federation, which has affiliate networks globally, and may be able to help you find a place to do testing.
Seems obvious, but if you have a penis and plan to use it: Carry condoms.
I once had the opportunity to have a threesome with two superhot diving instructors in Honduras, and I had to forgo it because none of us had any condoms and the only drugstore on the island closed at 8pm. Let this be a lesson to you.
A friend told me that the small square leather coinpurses you can get from Ten Thousand Villages, the ones that snap shut, will fit two condoms easily. Get one. Carry them. Try to keep them out of direct sun, direct heat, or direct cold. The leather (or whatever else you put them in) will protect them from puncture or wearing through. Most of the free condoms you get at Planned Parenthood are fine for emergencies, and made in Bangladesh or Thailand anyway.
Important note about condom safety: A guy who sat next to me on the Greyhound between New York and Montreal told me he’d never heard that doubling up on condoms was bad so he did it all the time. Doubling up REDUCES the efficacy of condoms and practically ensures that they will break. So if you are concerned about someone’s disease status, shrugging and double-bagging it is not the way to go.
Sometimes negotiating condom use with strangers can feel intimidating. I am here to tell you that brand really does make a difference. Consider this your public service announcement: Skyn condoms and most non-latex (polyurethane) condoms are thinner, feel better, and are stronger and less likely to cause allergies than your standard latex. They are less porous, so protect more effectively against viruses, and — I can’t stress enough — feel way WAY better. Go forth, penis-havers, and trust my advice.
A note about pregnancy
Dealing with an unexpected pregnancy while you’re traveling is not a great idea. Even if you won’t be traveling that long, early pregnancy can make you nauseated, cranky, bloated, and constipated. If you intend to terminate the pregnancy, that can be an enormous hassle, and you still have to deal with all of the symptoms of pregnancy until you have terminated. It’s better to remain unpregnant if you can. (For the sake of understanding, I am using “men” and “women” here to mean cismen and ciswomen.)
Men: If you are lucky enough to travel to India, there’s a male contraceptive injection available for pennies that is tested and effective for up to five years. It’s not available in the United States at the moment because pharmaceutical manufacturers are not super excited about it. But, hey, if you happen to find a way to get it overseas: Enjoy! Otherwise, carry condoms, and use them.
Women: If you’re on the pill, your doctor probably told you to bring a sufficient supply for your entire trip. Time zone changes and distracting travel can mean you’re not taking them at the same time, though, which reduces their effectiveness to 77%. You might want to consider switching to something like the patch (stick one on every week), the ring (stick one in every month), or the Depo-Provera shot (jab to the arm lasts you for 3 months). If you’re not interested in hormonal birth control and want a longer-term solution, talk to your local clinic about getting an IUD. The nonhormonal ones are effective for up to 10 years, although they have a risk of side effects like migrating around your body and causing heavy bleeding between periods. There are some other nonhormonal portable contraception options, like the diaphragm and the cervical cap, which sound about as dated as an avocado-colored refrigerator. Still, they work pretty well, and are good options for people who don’t like hormones. None of these methods protect against disease — these are only contraception. If you want to protect against disease, ONLY barrier methods (condoms and dental dams) are the way to go.
Have a sense of humour.
It is a real shame that discussions of safer sexual interactions have been boiled down to a super medicalized discussion of what our genitals have touched recently. Sex is supposed to be fun, and you wouldn’t be interested in it with your exciting new travel buddy if they didn’t make you smile.