We’ve Done All the Work to Open Up Our Marriage. But There’s One Last Risk We’re Worried About.

How to Do It Photo illustration by Slate. Photo by SilverV/Getty Images Plus. Sign up for the Slatest to get the most insightful analysis, criticism, and advice out there, delivered to your inbox daily. How to Do It is Slate’s sex advice column. Have a question? Send it to Jessica and Rich here. It’s anonymous! Dear How to Do It, My husband and I are in our early 50s and have been together for 35 years. We have three grown children ranging in age from 30 to 25. We have decided to open up (we’ll be swinging together) and have some fun. We have read the books, listened to podcasts, and have been very honest with each other, and we are very excited. Here is our problem. We met as teenagers and were virgins when we got together. We have only ever been with each other. Our worry is HPV. We have built zero immunity from other sex partners. I have read that the cutoff for the vaccine is 47. I don’t mind paying out of pocket for the vaccine, but how does one go about this? I would prefer not to involve our family doctor that also takes care of our children. —Scared to Open Dear Scared to Open, Jen Gunter, an OB-GYN and author of The Menopause Manifesto, wrote about her own decision to be vaccinated for HPV in her early 50s a few years back and included a lot of useful information. You’ll want to pay particular attention to the parts where she addresses risk levels in various age groups and how the data shows that new sexual partners are a significant factor, because you may need these facts when you’re sitting with a doctor requesting these vaccines. Ideally, we’d live in a world where you’d be able to feel comfortable asking your family’s main doctor to help you access this, but you aren’t, and that’s OK. Hopefully you still see a gynecologist every year or two for routine checkups. Are they someone you can ask? Does your husband ever see a urologist? Failing that, there are still options. There’s a small chance that you’ll run into a doctor who adheres to a Hays Code-style belief that sexual expression outside of marriage deserves consequences, and, on the off chance you do find yourself in front of someone with that mentality, just leave. Far more likely is that you’ll find doctors who are reluctant to buck guidelines, or whose supervisors are sticklers about such things, and aren’t well-versed in recent research about things like HPV, in which case you’ll want to lean on the information in Dr. Gunter’s article linked above. The most important points to emphasize are that the two of you have likely never been exposed to HPV and that you will both be having multiple new sexual partners. Lastly, depending on the area you’re in and what kind of clinic you find yourselves in, there’s a strong chance you’ll luck into the kind of primary care or reproductive health professional who hears the word “swingers” and is immediately motivated to help you and your husband access the HPV vaccine in as easy a manner as possible and is happy to offer education around other STI risks and mitigation procedures as well. Major cities with large LGBTQ+ and sex worker populations tend to have a larger number of these doctors at private practices, even if they aren’t advertising as friendly to those populations. Planned Parenthood clinics are often staffed with similar professionals and have a sliding fee scale that charges based on financial circumstance. If the two of you strike out at all the types of places listed above and find yourselves turning to a clinic that serves “at-risk” populations, leave them a donation significant enough to cover the costs of services provided. A note about other sexual health concerns: Get education about safer sex practices and their limitations. This can be done by the right type of doctor, or by consulting with a sex educator who offers private sessions with individual adults or couples. The community that the two of you will be swinging in can be a great resource as well—some of the members probably have doctors who they have already vetted as being sex positive, and are willing to recommend to you. If nobody in your prospective swingers’ group is interested in these subjects, that’s a warning sign. Do use condoms, and get standard screenings for bloodborne pathogens and bacterial infections regularly. Make sure you understand the window periods for various infections, and what the date of any test results (yours or someone else’s) actually tells you about health status and risk. And if you or your husband ever see a new, odd patch near your genitals, your secretions smell or look different, or anyone is experiencing a painful or burning sensation, go see a doctor. —Jessica More Advice From Slate I’m a straight woman in my 20s, and I’m not interested in dating right now but still have sexual needs, so I have a rotation of “friends-with-benefits”–type guys. It took a while to weed out the guys who claimed they were cool with “no strings” but then suddenly wanted me to be their girlfriend. I finally have a good team—everyone knows about one another, no one gets jealous or attached, and it’s just fun. Advice Sex