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or How to Calculate and Minimize Your Sex-Risks

Sex comes with risk.

So does crossing the street or making an omelet.

In no area of life is zero risk ever achievable. Just sitting there in front of your computer or phone (I see you), you run the risk of a meteorite barreling down through the atmosphere and slapping you in the face (.00014% chance).

You also run a slightly better risk of winning an Olympic gold medal (.00015%). It’s a small risk, but it’s a risk.

Like sitting in front of your computer, sex comes with its own particular risks and rewards. It’s important to be familiar with the risks that you take on a regular basis and how to best minimize them, both in your sex life and in your life in general.

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Driving, for instance, has a worldwide death rate of about .01%, a very low and generally acceptable risk (although we are working to get it lower). Additionally, if you decide never to drink and drive, you can reduce that risk by about 1/3 to an even lower and more acceptable risk of .0071%. (This is statistically similar to the 1/3 risk differential percentage between road fatalities in the USA and those in Afghanistan or Colombia.)

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I play basketball. Among recreational basketball players, there is an ankle injury rate of about .39%, with three major risk factors (history of ankle injuries, type of shoes, and warm up routine). Two of those risk factors I can control. If I stretch before playing, I can reduce my risk of ankle injury from .39% to .1% (one tenth of one percent). If I both stretch first and wear the right shoes, I can reduce my risk of injury by leaps and bounds.

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On one hand, the amount of risk you’re willing to accept in your life is sort of up to you. But on the other hand, everyone has to live with some amount of risk.

You really like bacon, but it comes with a risk of causing cancer. But you really like bacon, so you accept that risk and charge deep into cancer territory, crunching merrily.

In actual numbers, your risk as an average human of developing colorectal cancer at some point in your life is about 5% (no decimal). If you eat bacon, your risk goes up to about 6%. So the overwhelming majority of the risk of developing colorectal cancer comes with being a human and cannot be avoided by abstaining from bacon. But you do have control over that last 1%.

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Acceptable Risk
It can be hard to nail down what percentage of risk is ‘acceptable’ or ‘tolerable’ to you. The World Health Organization cites the following examples of acceptable/tolerable risk levels:

  • .1% – UK HSE annual tolerable risk for general death rates of workers
  • .01% – US EPA annual acceptable risk for microbial infection from drinking water
  • .0001% – US FDA definition of essentially zero

How to Calculate Your Sex-Risks
Here is a step-by-step guide on how to calculate the amount of risk you accept in your sex life. Thinking this way can help you minimize your risks as much as possible. Analyzing and controlling your sex-risks can also help you minimize your sex-worries.

  • 1: Decide on a sex-risk you would like to be informed about.
  • 2: Start with finding out the prevalence rate in your region.
  • 3: Subtract any high-risk communities you are not a part of.
  • 4: Add any prevention measures you are taking, making sure to subtract their failure rate.
  • 5: For STIs, factor in the transmission rate.
  • 6: Compare to similar statistics.

Let’s demonstrate this using myself as an example.

  • 1: What are the odds that I will contract X? Let’s use HIV for our example.
  • 2: Mexico has an overall HIV prevalence rate of about .2% and falling.
  • 3: Key at-risk communities that I am not a part of are gay men (MSM), female sex workers (FSW), and intravenous drug users (IDU), which together can be estimated to account for approximately 75% of all cases in Mexico. Subtracting these leaves us with an HIV prevalence rate, in my demographic, of .05%.
  • 4: Consistent condom usage has a conservative HIV prevention rate of 85%, leaving a generous failure rate of 15%. Condoms break about 2% of the time, and the rest is an additional margin of error for incorrect usage or slippage. Adding this safety net and then subtracting its 15% failure rate lowers our HIV infection risk to .0075%.
  • 5: Unprotected insertive vaginal sex has an HIV transmission rate of .04%. Coitus involving a penis inserted into a vagina will transmit the virus approximately one time out of 2,500. Factoring the HIV transmission rate into our calculation brings our HIV infection risk to a grand total of .0003%.
  • (Double check: To be clear on the math, we took the prevalence rate of .2%, subtracted the unconcerned high-risk communities of 75% [.2 x .25 = .05], added a condom failure rate of 15% [.05 x .15 = .0075], then added the transmission rate of .04% [.0075 x .04 = .0003.], leaving us with a protected insertive vaginal sex HIV transmission rate in my heterosexual male demographic of Mexico – deep breath – of .0003%.)
  • 6: 0.0003% translates to odds of about one in 333,333. This tiny fraction of a percentage point is a very difficult number for our brains to process. Statisticians usually solve this by comparing events with similar rates of low probability. One in 333,333 is about equal to the probability of being killed (not just struck) by lightning. These are also similar to the odds that global warming is fake (specifically, that the global warming statistics for the Northern Hemisphere are due only to natural variability). Or the very unscientific odds that you will be electrocuted by your alarm clock.

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Outrageous Outliers
Here it’s important to note the ‘law of truly large numbers,’ which states that with a sample size large enough, even outrageous things can be likely to happen. But let’s not underestimate the breadth of ‘truly large.’ If I have sex with 500 people (which is in itself outrageously unlikely), my risk barely inches from ‘acceptable’ to ‘tolerable.’ It’s only when I begin to have sex with 100,000 people that my risk jumps to ‘broadly possible but still improbable,’ or 200,000 people when it finally moves to ‘probable.’

I’m looking at you, Wilt Chamberlain.

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Stigma vs Solutions
Also worth mentioning is today’s treatibility of most sex-risks. Adding PrEP, for instance, to any step of our calculations will instantly bring the risk rate of contracting HIV to zero, no questions asked. PrEP can be an excellent-albeit-expensive solution for both high-risk and high-worry communities, and there are similar medical solutions for most other sex-risks.

Because there is a greater negative stigma associated with sex, people often tend to overestimate the risks involved. This can lead to more negative judgement, which can lead to more negative stigma, which can lead to even riskier behavior such as dishonesty with sexual partners or avoiding regular checkups. Taking a look at the numbers with an honest, open mind can help to solve this negative spiral.

Don’t be afraid; be informed.