Sex and Risk: Suck and be Safe

The Wockner Wire

by Rex Wockner

Bedroom gambling

The 2005 November issue of POZ magazine had a very interesting piece about "the odds of [HIV] transmission during mixed-status sex."




The magazine said it "combed through the University of California San Francisco's online vault of the latest research to chart the odds of infection in the absence of protection."

The article noted that unprotected sex is much more dangerous when the positive partner has an "uncontrolled viral load" (isn't on treatment), when either partner has another sexually transmitted disease at the time, or when you have "rough sex."

Here are the numbers:

There's a 1 in 122 chance of infecting your partner if you're positive and you top him (or her) in anal sex.

There's a 1 in 1,666 chance of infecting your partner if you're positive and he tops you in anal sex.

There's a 1 in 1,666 chance of infecting your partner if you're positive and he (or she) sucks you off.

There's virtually no chance of infecting your partner if you're positive and you suck him off.

Lesbians and straight men apparently don't have to worry about vaginal oral sex. The article said there was a "negligible" risk of transmission either way.

And for straight people, if you're positive and you are the inserter in penile-vaginal sex, there's a 1 in 111,111 chance you'll infect your partner. If it's the woman who is positive, then the chance is one in a million she'll infect you.

It almost makes you wonder how so many people became HIV-positive if the virus is so damned hard to transmit.

One interesting tidbit I learned a couple of weeks ago at a California state AIDS meeting in Long Beach was that they now believe that a huge percentage of all HIV transmissions occur in the months right after the transmitter gets infected. Apparently that's when an individual has tons of virus to spread around. The risk of infecting someone apparently drops significantly thereafter -- even when you're not on treatment.

One thing I appreciated about this POZ piece is that it acknowledged that taking HIV-positive semen into your mouth carries perhaps the same risk as being the inserter in anal sex with an HIV-positive partner.

The San Francisco Department of Public Health's STD Prevention and Control Services pretty much has refused to acknowledge any risk from sucking, with Director Jeffrey Klausner insisting "the risk of transmission of HIV via oral sex is very, very, very, very, very low and may be zero."

"Other sources of information ... are not based on sound epidemiological data," Klausner has written. "We recently completed a study of men in San Francisco who have only had oral sex and found zero new HIV infections. ... In terms of HIV, oral sex both ways is very, very safe."

Klauser says "saliva has natural anti-HIV factors" and maintains that sucking remains safe even if you have a sore in your mouth.

"There are no data that show that bleeding gums, sore throats, bad teeth or mouth sores actually increase the risk of transmission," he wrote. "For years, either we have not had data or had bad data. Now, reliable data shows the risk of HIV from oral sex is either zero or very, very low."

Klausner recently reiterated these beliefs in "FAQs" posted on the Dept. of Public Health Web site, concluding, "[M]y advice is: Enjoy oral sex and get regular check-ups."

That's probably right. But if you're gonna blow a positive guy to the point of ejaculation every day for five years, you might wanna keep POZ's findings in mind, too.

Are blogs stupid?

The editor of the gay paper in Raleigh, N.C., is being forced to keep a blog as part of a university course he's taking. He hates it and recently demanded that I "explain what is it I don't GET about blogging?" Of course, I love a good challenge.

1. Blogs steal power from the mainstream media, which until a couple of years ago pretty much got to decide what got reported. Here's a typical example: Why was Rep. David Dreier, R-Calif., passed over for House leader? One strong theory is that they realized late in the process that gay and alternative-weekly media have outed him. Did you read that anywhere in the daily media? Nope. It got out via the blogosphere.

2. Suppose you have a lot of friends you keep in touch with via e-mail. You could spend all day responding to them. Or, you could throw up a personal blog entry and your friends could sometimes know what's up in your life that way. Not that you never write to your friends again, but it's a way to reclaim some of the time you might have spent writing similar e-mails.

3. Suppose you're some kind of public figure. A blog lets you get your ideas out there immediately, unfiltered and unedited. And it gives folks who are interested in you a more personal glimpse into your world.

4. My friend Eleanor, who is a journalist, says she finds it useful just to write every day. Makes her a better writer, she feels.

5. Finally, when I'm in a blog-everyday mode (which I haven't been lately), it forces me to do something interesting every day. Or at least to think some interesting thoughts. It can be an antidote to mental laziness or couch-potato-ness. When I'm blogging regularly, I get out of the house more, take my camera with me, and look at the world through an additional set of lenses: What about my city, my everyday life, my world might make for interesting reading or an interesting photo?

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