Sick from Sucking
Oral Sex and HIV and AIDS
By M.D. dela Cruz Tan


SAFEST SEX - NOT!
Always perceived as a low-risk sexual activity, oral sex has become the preferred act of many looking for the joys of the flesh. But with the growing number of people getting infected with HIV and AIDS through orogenital sexual activities, is it really as low-risk as it once was thought to be? And even if scientific researches prove it is low-risk, are you willing to take a chance?

Hector A.*, 25, insists he never had unsafe anal sex – at least not since his first one, “which would be over 10 years ago,” he recalls, “and I’ve had tests after that that showed my (negative) status.”  He, however, had “numerous sexual encounters, mainly oral, since then.”  The oral sexual experiences were done in, among others, sex clubs and bath houses (“I’ve been in all of them – those that already closed, and those that are still operational,” he says), pick-ups from clubs (“Meat markets”), sex parties (“Check schedules in G4M and LifeOut.com, among others”),  movie houses (“Even SM MegaMall is a sex area”), and encounters in sex beats (“Largely unrecognized, but we do have many in Metro Manila alone”).

“So numerous (the oral sexual encounters), in fact, that I’ve lost count, actually stopped counting, already,” he says.  “I guess you can say I’ve been around.”

It was, therefore, with mixed feelings that he met the news not a few months ago that he is HIV positive.  “There was this acknowledgment that, yes, mainly because I have been sexually active, getting (HIV) is probable,” he says.  “But there was this disbelief, too, that I am (positive), since my sexual practices were limited to what I, and many people I know, believe to be a somewhat safer sexual practices – I was just giving heads, not taking it up the ass.”

Hector A.’s case brings to light, yet again, the link between oral sex with HIV and AIDS, which is actually not a new issue, even if it is only starting to widely get the attention it deserves.  After all, as many like Hector A. believe, “who would have thought you can get HIV and AIDS from sucking, too!”

UNINFORMATIVE INFORMATION?

The lack of urgency to stress the link between fellatio and HIV and AIDS may be understandable, even if it’s unforgivable.  After all, even if the claim that HIV and AIDS, and other sexually transmitted infections (STIs) for that matter, can be transmitted orogenitally (mouth to genitalia), studies actually fail to prove the veracity of the claim.

A study by NATAP.org and HIVREALTALK.com involving 239 men who have sex with men (MSM) who exclusively practiced fellatio in the past six months (50% had three partners, 98% unprotected; and 28% had an HIV-positive partner), no HIV was detected, making the researchers admit that “the risk of HIV attributable to fellatio is extremely low.”

“(We) acknowledge that fellatio, although not an efficient route of infection, nonetheless appear(s) to carry a small risk.  (Other) studies provided quantitative estimates of the low risk among men who have sex with men (MSM), with one (estimating that) the per-contact risk of unprotected fellatio with an HIV-positive or unknown HIV status partner [4/10 000; 95% confidence interval (CI) 0.01%, 0.17%] to be lower than the per-contact risk of acquiring HIV from protected receptive anal intercourse (RAI) (0.18%; 95% CI 0.10%, 0.28%),” the groups say.
Understandably, in a survey of teens conducted for The Kaiser Family Foundation, 26% of the sexually active 15 to 17 year olds surveyed responded that one "cannot become infected with HIV by having unprotected oral sex."   An additional 15% were not certain if one can be infected with HIV through oral sex.

This is not to say that the position of those advocating safer sexual practices even when “just” sucking is not without merit.  NATAP.org and HIVREALTALK.com note a study done on the primary modes of transmission in San Francisco in the US, where 8% of HIV-positive participants acquired HIV from fellatio (Though this is not to say that 8% of people with HIV and AIDS were only infected through oral sex, which is a generalization OUTRAGE Magazine is not claiming – Ed ).

Adds the CDC HIV/STD/TB Prevention News Update in a fact sheet (What You Should Know about Oral Sex: Oral Sex Is Not Considered Safe Sex): “Because anal and vaginal sex are much riskier, and because most individuals who engage in unprotected (i.e. without a condom) oral sex also engage in unprotected anal and/or vaginal sex, the exact proportion of HIV infections attributable to oral sex alone is unknown, but is likely to be very small.  This has led some people to believe that oral sex is completely safe.  It is not.”

One study cited by the Public Health Agency of Canada (PHAC, phac-aspc.gc.ca) in Oral Sex and HIV Transmission calculates the per-sex-act probability of HIV transmission in a cohort of men who have sex with men (MSM) and determined that for unprotected receptive anal intercourse, the probability was 0.82% per act, for unprotected insertive anal intercourse 0.06%, and for unprotected receptive oral intercourse with ejaculation 0.04%.

Still another study, still cited by PHAC, calculates the “population-attributable risk percentage (PAR%, which refers to the incidence of a disease (in this case, HIV) in a population that can be attributed to a certain risk behavior, e.g. fellatio) at 0.18% for MSM who had had one partner in the previous six months, 0.25% for two partners, and 0.31% for three partners.”

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