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Q: I am 22 years old and have never even tasted another guy's cum, but I still feel anxious every time I put a dick in my mouth. Can't you just tell me once and for all if I can get HIV from sucking dick?
A: Here is what is currently known:
The risk of getting HIV from oral sex without a condom is very low. It is much lower than the risk of getting HIV through receptive anal sex. One eight-year study of nearly 1,000 men found HIV transmission through oral sex too rare to be measured. The risk of getting HIV is not zero. A small number of cases of HIV infection through oral sex have been anecdotally reported in professional journals, by doctors and by patients.
Most people find it difficult to decide what to do based on this information alone.
Does this mean you should consider oral sex essentially safe and stop worrying about oral transmission? Or does it mean it is risky and you need to stop oral sex without a condom altogether? If you think about driving, each time you go for a ride you have a small but real risk of being killed in an accident. Most adults know this and still continue to drive. Thinking about the strategies we might and do use to protect ourselves white driving may help you decide how to manage the risk of oral sex.
For example, if someone were to ask you to tell them "once and for all" if driving is safe, you might answer this way: Driving with a seat belt is safer than driving without one. Driving on dry roads is safer than driving on icy ones. Driving sober is safer than driving drunk. And so on. In real life you wouldn't think "is driving safe in general?" when you get into your car. Instead, you might think, "is it safe to drive tonight during light snow if I drive slowly on the back roads?"
The way you think about the risk of each instance of oral sex can be as specific and as nuanced. Oral sex in which there is a small amount of precum in your mouth is likely to be safer than sex in which there is a lot. Oral sex with a lot of precum is likely to be safer than sex in which your partner comes in your mouth. Oral sex is completely safe with someone you know to be HIV negative, and obviously entails more risk with someone whose status is unknown or with someone you know is HIV positive. Oral sex entails more risk if you mouth is cut or has sores.
As with driving, ask yourself: "is it safe enough for me to have oral sex given the way I'm feeling tonight? With this guy whose HIV status I don't know? Should I let him come in my mouth?"
Remember, oral sex takes two people, and so does safer oral sex. Your ability to communicate with your sex partner about what you do and don't want to do plays a crucial role in how safe any sexual encounter will be.
In addition to making each instance of oral sex safer by controlling variables like the amount of semen in your mouth, you can limit your overall risk of getting HIV from oral sex by limiting the amount of oral sex you have with people who are HIV positive. Some evidence suggests that a lot of partners in a short period of time may raise the risk of transmission particularly if you are using drugs that reduce pain, or are "deep-throating. " The less often you do something with a small risk, the safer you are.
How you use each of these methods -- lowering the risk of a given encounter, and limiting the total number of possible risky encounters -- will depend on you. Those who don't strongly value oral sex may rely more on limiting the number of encounters they have. Those who value oral sex more may decide to continue to have it but not allow partners to come in their mouths. Those who enjoy oral sex but who feel extremely anxious after even a very low risk encounter (such as oral sex without exposure to cum or pre-cum) may try to look at their anxious feelings and see if they are about oral sex or something else.
-- B2K (zine published by Gay Men's Health Crisis)
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