Sex & Relationship: The dangers of unprotected oral sex2 Comments

By gossipmama
Posted on 10 Dec 2011 at 5:24pm

In reality, unprotected oral sex is responsible for nearly 8% of HIV infections, so the risk of HIV transmission from oral sex should probably be revised upwards. English and American studies suggest that this type of sexual activity is responsible for more HIV infections than previously thought.

HIV infection through oral sex is a downplayed risk

Performing oral sex without a condom can be dangerous. For a long time, researchers have been faced with a real dilemma: how do you determine whether HIV transmission has occurred as a result of oral sex or other sexual penetration. However, the widespread use of condoms, particularly amongst the homosexual community, means that researchers have been able to single out oral sex as a type of risky sexually behaviour.

Studies carried out since 19981,2,3 have concluded that although uncommon, the risk of contracting HIV through oral sex was not insignificant.  Some of the most significant findings come from a survey4 carried out amongst the homosexual community in London between 1996 and 1998. This early research estimated that 6% of the 494 HIV+ patients questioned, believed they had contracted HIV though oral sex.

Findings 5, presented at the seventh conference on retroviruses and opportunistic infections, challenged previously held beliefs.  Researchers at the prestigious Centre for Diseases Control and Prevention (CDC) associated with San Francisco University Hospital followed 102 HIV + gay men, eight of whom (or nearly 8%) had been infected through oral sex. Frederick Hercht, co-author of the study, stated that, “…[they] did not expect to find as many cases of infection as a result of oral sex.”

AIDS prevention campaigns focus on transmission through vaginal and anal intercourse, representing 90% of infections. However, it appears that transmission through oral sex is more significant than previously thought. Most of these cases were due to fellatio without condom use although some cases of infection3 through cunnilingus and annulingus have also been reported.

Other STIs transmitted through oral sex

In light of the findings of a report6 on HIV and oral sex, UK authorities believe that the public need to be made aware of the dangers of transmission so that they can decide for themselves what constitutes an acceptable risk. But AIDS isn’t the only danger; other sexually transmitted diseases can also be transmitted through fellatio, in particular syphilis, gonorrhoea, hepatitis B and herpes.

A number of localised outbreaks of syphilis in Europe (Manchester, Dublin, Paris, Oslo etc.) led to researchers identifying unprotected oral sex as a key risk factor in transmission. The widely documented outbreak of syphilis in Manchester7 highlighted the inability of the UK health authorities to prevent the spread of the disease despite awareness campaigns. Oral sex also appears to be a significant risk factor in the transmission of herpes8 and Chlamydia 9.

A condom is the only means of ensuring safe oral sex

Oral sex is the most risky when the man ejaculates in his partner’s mouth. However, the pre-ejaculatory fluid (which moistens the head of the erect penis) can also contain HIV infected cells. In addition, drops of semen can also leak out of the penis before ejaculation.

Mouth infections or oral diseases increase the risk of AIDS transmission. Good oral hygiene reduces the risk of oral transmission but brushing teeth before fellatio may have the opposite effect… Using a mouth wash before or after oral sex also kills off the friendly bacteria naturally present in the mouth therefore, giving less rather than more protection.

A condom is the only way to protect oneself from sexually transmitted infections and there are of course flavoured, non-lubricated condoms especially designed for oral sex.

1. AIDS 1999 Apr 16; 13 (6): 737-8
2.  JAMA, 2000 Mar 8; 283 (10): 1279
3. AIDS 1998 Nov 12;  12 (16): 2095-105
4. BMJ 2000; 320: 1510-1
5. Lancet 2000; 356: 272
6. Department of health. Report of a Working group of the UK Chief Medical Officers’ expert Advisory Group on AIDS. Review of the evidence of risk of HIV transmission associated with oral sex. London: Department of Health, June 2000.
7. Commun Dis Rep CDR Wkly 2001; 11 (15)
8. Int J Epidem 1997; 26: 698-709
9. Int Journal J STD and AIDS 2001; 12 (suppl 2): 53


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