For many people, the collection of sexual practices that fall under the category "S&M" can be a very arousing, enriching, and intense experience. For some, the mere thought of these behaviors can be intimidating or frightening. Finding where you lie on this spectrum of behaviors and desires is an individual choice for everyone.  The potential for bodily harm, injury, and/or disease transmission does exist with at least some S&M practices...but that doesn't mean you can't have a healthy, safe and fulfilling S&M sex life if you really want to.  The best way to counteract these risks is educating yourself, knowing your own limitations, open communication with partners, and following some very general tips about safer practices.

We've borrowed a lot of the information below from a great booklet that was published a few years back in San Francisco called S&M SEX...Safely: Practical Tips from the San Francisco Bay Area S&M Community.  This booklet is a basic guide to S&M sex and was put together with the help of medical experts and others experienced in safe, sane, and consensual S&M practices. They have intentionally used the language that is used in the playroom in order to be most clear to their target audience - people who need to know how to keep themselves and their play partners healthy while enjoying safe S&M.  So let's dive right in:

HIV can be prevented. HIV is passed from one person to another when blood, semen (cum) or vaginal fluids get from an infected person into the bloodstream of another. Transmission of HIV can occur through even very small cuts or broken skin anywhere on the body, rips or abrasions of the rectum or vagina, irritated gums, the mucous membranes of the urethra, even chewed cuticles. Body fluids that you don't have to worry about in terms of HIV transmission are spit, sweat, urine or feces on the outside of the body on unbroken skin. You can make any kind of sex safer by using common sense (which means you have to keep your senses about you!) and remembering these basics.

S&M Risk Reduction is every player's responsibility. Most SM activities are low-risk for passing HIV and other STDs, but there are other safety concerns involved. Responsible SM has always meant practicing safety. Learning from an experienced player is a traditional way you can learn new techniques or types of play.

S&M Etiquette is based on respect for yourself and the people you play with. You should discuss what you want to do, and what you will not do, and a fare word before the scene starts. A safe word or signal is used by any participant to stop the scene immediately. It can be used if either the top or bottoms needs a break, or to ask a question or to end the play session now. There is no shame in using your safe word - that's what it's there for. Along with each player's limits and feelings, safe words should be respected. If you are unsure of your ability to safely perform an SM activity, then hold off until you get more information and maybe some practice on an inanimate object. As a bottom, you need to let the top know your experience level, particularly if the activity is new to you. Doing this allows you to relax and enjoy the play, instead of worrying. Always ask before touching someone else's toy, or someone else's bottom, or breaking into someone else's scene. Indicate your interest and wait to be invited.

By following the guidelines from this booklet, being aware of your own and your partner's health, and practicing safe sex, you will be making the S&M community a safer place for everyone.  Listed below are some of the key tips or areas of concern:

Lube is necessary when inserting anything larger than a finger into the ass or vagina. A good rule on lube is, "Too much is almost enough." If you're going to insert something into someone's ass or vagina, the "something" should be covered with latex and a water-based, unscented lube. Brands like KY Jelly, Probe, Astroglide and Wet are widely available, inexpensive and safe. Never use oil-based products like Crisco, butter, Vaseline, hand lotions and cremes - they weaken latex, making condoms and gloves more likely to break. Scented or flavored condoms should only be used for blow jobs. Additional ingredients, including Nonoxynol-9, can irritate the mucous membranes of the ass and vagina.

If you take lube from a large container, put plenty to use for this session in a paper cup or a paper plate, and make sure you only "share" from a pump container. This way you can make sure that clean lube is all that you're sharing! Or, buy small packets ("pillows") or pick up samples when available. In either case, use what you need with one person and throw the rest away.

Your Ass is more delicate than most parts of your body. Putting things, whether a finger, cock, dildo, fist or zucchini, up you ass can tear the lining. Even extremely small tears or scrapes provide a route into your bloodstream. HIV and other STDs can get in or out.  Once you get past the muscle ring inside your asshole, there are no pain receptors. You cannot rely on feeling pain to signal that you are being hurt. You and your partner must use care and latex barriers to be safe. 

Anal sex without protection is a high-risk activity - cocks cum, fingernails scrape, fingers have paper cuts, toys aren't clean. Latex barriers must be used, and used properly.  To put on a condom: Make sure the cock is hard. For increased sensation, put a little lube on the tip. If it's uncut, pull back the foreskin first. Slide the condom on, squeezing the air out of the tip. If there's no tip, leave about a half inch of the condom empty, to hold the cum. Lubricate the outside really well (see "Lube" above), push some lube into the ass, and insert carefully at first. Pull out soon after you cum, making sure you hold on to the ring at the open end of the condom to be sure it doesn't slip off.  If either partner is allergic to latex, a non-latex substitutes like female condoms and polyurethane condoms are available.

For playing with dildoes and other sex toys or objects, follow the same steps, although you don't have to deal with foreskin or space for cum. Make sure the dildo is cleaned thoroughly between uses (see "Toys") and covered with a condom. Same for vibrators. Never insert a breakable object into the ass and be sure it has a wide base. You don't want to lose it up there.

Rimming is licking someone's anus or asshole. It is low risk for spreading HIV, but high risk for passing STDs like herpes, anal warts, parasites and hepatitis. Use a barrier between your mouth and tongue and your partner's hole. Use a dental dam (a square of latex found in some safe-sex kits), a piece of non-microwaveable plastic wrap, a condom cut lengthwise, or a glove you have cut the fingers off of. Don't rim if you've brushed or flossed your teeth within three or four hours.

Your Vagina  can be easily penetrated, and can generally handle a wide variety of shapes and sizes. You do have to take care that anything that goes into it is clean, unbreakable, latex-covered and has no sharp edges.  And lube, lube, lube! Hard fucking, whether with hand, cock or toy, can feel great but bruise the cervix, so locate it first and avoid hitting it by changing the angle of penetration. Its location varies with each woman, where she is in her menstrual cycle, and how excited she is. Scrapes or tears in the lining of the vagina are a direct route to and from the bloodstream for HIV and other STDs, so latex barriers are necessary to protect both of you. Going down on a woman is low risk for HIV unless she's having her period, but can expose you to other STDs, so protect both of you: latex barriers, no sores in your mouth, don't brush or floss your teeth for a few hours before.

Fisting can be done to ass or vagina, or both. If you're going to be fisting, you'll want to make sure your fingernails and cuticles are well-trimmed and smooth. Choose your gloves carefully. The right size is important; a wrinkle in a too-big glove can be excruciating in an ass and a too-small glove can cut off your circulation, rip more easily as you push, and come off as you come out. Latex and vinyl exam gloves come in sizes from extra small through extra large, powdered or not, textured or not. They are available at drugstores in boxes of 50 or 100. For most uses, they will work fine. For deeper anal fisting, use a calving glove. They're available at veterinary supply stores and some leather stores. To avoid the glove bunching up in painful wrinkles, cut the fingers and thumb off but leave the base of the thumb attached. Then put it over an exam glove. In either the ass or vagina, remember to keep your hand well lubed. When coming out, remember that a vacuum has been created inside, and it will require steady, strong pulling. When pulling out, hold the cuff with your other hand so the glove doesn't slip off. Take the glove off by pulling it over itself, inside out. Be sure not to touch the lubed side with your ungloved hand. If either partner is allergic to latex, use two vinyl gloves.

If you are going to be fisted, you want your ass to be as empty as possible (feces can be abrasive), but enemas can wash away the mucous that creates some natural protection. If you want to clean your ass, do it a few hours before playing, so your rectal lining has a chance to relax and replenish itself. Relaxation is the most important element of successful fisting, so the more comfortable you feel with your partner the better. Allow plenty of time for a fisting scene. Assume that it's not going to happen the first time, and communicate! The bottom, while not feeling pain past the sphincter, will feel pressure, and should let the top know. The top can let the bottom know before moving - "A little deeper?" "I'm going to stop here for a minute." "Let me know when you want another finger." Communication, time, relaxation, trust. Immediately after you've been fisted, never let anything else that might have someone else's cum, shit or blood on it into your ass.

Enemas can be part of your anal play, or an enjoyable activity on their own. Your must never share your douche equipment. Clean it and your nozzle after each use. Also, don't share the nozzles of metal shower douches. Bring your own to your friend's; get a separate nozzle for each friend. Use only your own, and keep it clean!  After sex, don't douche or have an enema, because you could be pushing bacteria farther into the body.

Blow Jobs are considered a low risk activity for getting HIV. However, cum in your mouth, if you have any type of sore, after dental work or brushing of flossing your teeth, or even if you have an irritated throat, makes unprotected sucking riskier. Use an unlubed condom to play safe. Of course, if the partner you're sucking has any sore or sign of an STD, condoms are required.

Tit Play involves no risk for getting or passing HIV or other STDs unless your play involves broken skin. If it does, follow the advice in the "Blood Sports" section. There are other safety factors, however. Medical professionals recommend that breast bondage be left in place no longer than 15 minutes or so, depending on how tight it is, as that is the point at which tissues begin to get damaged. There is no connection between striking tits and susceptibility to breast cancer, but if there is a history of cystic breasts or abnormal mammograms, more than light slapping is not okay.


Toys make playtime fun, but forget everything good you've ever heard about sharing! Sex toys should be used with one person and put aside until they are thoroughly cleaned before being used again. Anything that's been inside someone - anally or vaginally especially - could transmit HIV and other STDs. Anything that has been in contact with blood, cum, urine, or feces, can also transmit HIV and other STDs. Toys that can't be cleaned completely should only be used on one person.  Cleaning sex toys is easy if you always use a condom. Just remove it and most of the mess goes with it. Later, wash the toy in hot, soapy water, wipe it with an alcohol wipe, or soak it in water mixed with bleach (nine parts water to one part bleach) for at least 20 minutes. Remember to wear exam gloves while washing! Rinse well under running water, and let air dry.

Other toys have different needs. Porous things like leather floggers and wooden paddles that have drawn blood should be wiped but not soaked with soap and hot water or with a disinfectant toy cleaner available at leather shops. Scrub ( a hard toothbrush is good) to make sure the cleaner reaches into nooks and crannies, let sit for a few minutes, rinse and let dry overnight. Leather should be treated with a conditioner after drying; cranes will periodically need to be re-varnished. Rubber and latex toys should be washed with hot, soapy water, wiped with alcohol pads, rinsed under running water and allowed to air dry. It's always a good idea when buying a toy to ask the maker or seller the best way to clean and care for it.

Metal toys are the easiest to clean. Neuro wheels, clothespins and other metal non-insertable toys can be sterilized by soaking in the bleach and water solution described above and rinsed thoroughly under running water. Metal toys that are going to be inserted into the body, such as sounds, must be autoclaved. You can get this done at a piercing shop for a small fee.

Clips and Clamps often break skin, intentionally or by surprise. For this reason, they should be cleaned or thrown out (one of the joys of clothespins is how cheap they are!). Be prepared by having exam gloves handy, and wipe up blood with alcohol wipes. To dispose of bloody wipes, gather them in the palm of your gloved hand and pull the glove off inside out, enclosing the soiled items inside. Tie the glove closed and put it in a garbage bag.

Whipping can also break the skin, so be ready before you start. If you have gloves and wipes within reach, there is no reason to stop the scene when blood flows. Be aware that droplets of blood may be flicked from the ends of the toy on the back swing. This requires precautions in a crowded playspace.

Blood Sports include piercing and cutting. Permanent piercing is best done by a professional piercer in a shop with the right equipment and conditions. For play piercing, use new, disposable needles, or "points." Use them only once, and do not recap after taking them out - that's when you are most likely to get stuck. Put them in a sharps container when you remove them. These containers are made to safely hold used needles, scalpels, etc. They are free - ask for one at the prescription counter of most Walgreen stores - and when it's full, return it there. They won't question you. You can also put bloody cotton balls, alcohol wipes, gloves, etc. into them for safe disposal. Cutting the skin can be done with a knife or a disposable scalpel. The blade of the knife must be cleaned, before and after, by soaking in alcohol, or bleach and water for at least 20 minutes and rinsed under running water. Disposable scalpels can be bought at most medical supply stores, are sterile, cheap, and made for cutting skin. Again, do not reuse or recap, just put the whole thing in a sharps container. Shaving should be done using a new, disposable razor. If you know how to use a straight razor, get one with disposable blades. If you are using an old-fashioned straight razor, clean it before and after using as you would a knife. Before piercing, cutting or shaving, the skin should be wiped with alcohol on a cotton ball or prep pad, or with a betadine swab, available at drug stores. Allow the skin to air dry. Wear at least two pairs of gloves, because alcohol and other cleaners eat through latex and you will likely have holes in the outer one after cleaning the skin. Just peel it off and you can continue. Afterwards, blot up any blood with sterile cotton balls or gauze pads. Gather them in the palm of your gloved hand and pull the glove off inside out, enclosing the soiled items inside. Tie the glove closed and put in your sharps container.

Temperature Play such as with cigars, cigarettes and candles can be great fun. Disease transmission can only happen if blisters or charring cause broken skin. Of course, neither is a good idea anyway - stop at reddened skin. The safest candles are plumber's candles, unscented and untinted. These burn at the most consistent temperature.  Playing with fire can be a very exciting activity, and is one of those that you should learn from an experienced player before doing.

Water Sports are safe on the outside of the body, on unbroken skin. Both urine and feces can transmit STDs. Any infections the top has can be transmitted by urine, and parasites and hepatitis can be caught from feces. If there are any cuts on the skin, keep urine and feces away. Remember that a zit is open skin. If you have cold or canker sores, recent dental work, have brushed or flossed your teeth in the last few hours, or even have severely chapped lips, having shit or piss in your mouth is high risk for STDs. Keep in mind that you can't catch anything from your own piss.

Electricity is a low risk activity for transmission of STDs. If you use a violet wand on broken skin, just wipe the wand off with an alcohol pad when done. Electrical contact pads, used with TENS and similar units, are sticky and can't be cleaned, so you should have a pair for each partner. Throw them out if they get body fluids on them.

Learning from Experienced Players, as mentioned throughout the article, can make these activities more exciting and safer. Here in the Rochester, NY area the Rochester Kink Society (RKS), a "pansexual organization...that [does] not discriminate on the basis of gender or sexual orientation..." offers workshops for people of all different skill levels to learn how to safely engage in different types of play. You can learn more about the organization at their website. The website offers an overview of the organization, as well as a two part interview conducted by Jeanne Gainsburg of the Gay Alliance that details her attendance at several RKS events and provides insight into the organization's inclusion of LGBT identified members.

Additional Resources

From Bottom to Top: BDSM for Beginners - This brochure provides a general overview of BDSM safety and offers additional books and websites to read up on.

Canes and Caning:When It Hurts So Good - Tips on caring for your cane, as well as safety information on how to safely use canes.