The Peter Sodann Library
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Oral Sex and Public Health Fear-Mongering


We've all been bombarded with messages about safe sex. Often, these messages are manage to be both hysterical and curiously vague. We are warned that all sex is dangerous, there's no such thing as safe sex, only safer sex, and solemnly enjoined to do ludicrous things like use condoms and dental dams during oral sex. Dental dams!

The patronizing tone of this propaganda always annoyed me. I felt as if I were in a dictatorship, constantly being told what to do, but never why. I remember looking up the actual statistics of HIV transmission in the 1990s and being amazed at how incredibly tiny they were. Over at Salon, Tracy Clark-Flory takes a look at the question of exactly how risky oral sex is:

University of California, San Francisco, study put the per-contact risk of transmission through “receptive” fellatio with an HIV positive partner at 0.04 percent. (For perspective, consider that the same study found a much higher per-contact risk of 0.82 percent for unprotected receptive anal sex.) The researchers calculated the rate of HIV transmission to be 4 out of 10,000 acts of fellatio. Without ejaculation in the mouth, though, some experts have called HIV transmission via performing fellatio “extremely low risk.”

As for the danger of having someone perform unprotected oral sex on you: “The only risk in this scenario would be from bleeding wounds or gums in the HIV positive person’s mouth or on their lips, which may transfer blood onto the mucous membranes of the other person’s genitals or anus, or into any cuts or sores they may have,” according to AVERT.

This more or less conforms to the information I got looking at controlled clinical studies of HIV transmission. The canard that everyone was at equal risk for HIV was just that, a canard. If you are healthy, straight, and don't use IV drugs you can have unprotected oral or vaginal sex with an HIV-positive person literally thousands of times without contracting HIV. And, as Flory reports, pretty much the same goes for other sexually-transmitted diseases and oral sex. Note how the public-health experts she quotes constantly emphasize the risks, but are then forced, almost sheepishly, in the fine print, to admit that actual number of cases of transmission by oral sex is small. And if you use your imagination, you'll probably conclude that most of those transmissions involved the kind of moist, unhygienic frolicking that most sensible people are not going to find tempting.

Obviously, these diseases are unpleasant, people should probably try to have safer sex, etc., etc. But I've always thought the fear-mongering does more harm than good. After all, if you suggest to people that obvious common sense (i.e. that oral sex is less risky than other kinds) is misleading and warn them they must use absurd precautions or they will die, they're going to stop taking you seriously. People wanna have fun. Don't point fingers at them. Explain to them like adults the risks they face, and design a better condom so it's a bit safer for them to do what they're going to do anyway.