Many, especially gay men, believe oral sex is a safer alternative to intercourse, but it may carry a real risk of spreading AIDS, according to a new study from San Francisco General Hospital and the U.S. Centers for Disease Control. And it may not be better to give than to receive in this case - the study says those who did catch HIV from oral sex got it from giving it, rather than receiving it.
Health agencies have never officially conceded oral sex as safe sex, and the study says frequent "unprotected" oral sex can also be risky, although nothing even close to the risk in anal sex.
"The message," Dr. Frederick Hecht of San Francisco General tells the Associated Press, "is not that everyone will get infected through oral sex." Hecht co-authored the study, and says anal intercourse could be one hundred times riskier in spreading AIDS.
High-risk AIDS exposure has fallen in hand with declines in unprotected anal intercourse, Hecht says, but low-risk exposure through oral sex without condoms remains, "and that low risk adds up."
The study says oral sex was the probable cause of eight percent of recent HIV infections among a group of homosexual men studies in San Francisco. Health investigators in the past, the AP says, have had difficulty being sure of reports indicating people catching HIV orally, particularly considering gay men often engaged in other, riskier practices like anal intercourse.
But diagnostic tests now let doctors narrow the timing of HIV infections, the AP continues. These tests were used in the current study, considered the most definitive to date.
CDC AIDS chief Dr. Helene Gayle tells the AP oral sex may still safer than anal or vaginal intercourse but "is not without risk and perhaps has higher risk than we would have expected otherwise."
The study's research team studied 102 gay and bisexual men who had recently been diagnosed with HIV. Oral sex turned out to be the only risk behavior in eight of these men, the study says, with most saying they thought oral sex had little or no risk. And, the study adds, and none used condoms.
The study's strict criteria means the real number of cases from oral sex may have been higher, the AP says - two men said they had oral but not anal sex, but they also said they had blacked out once and couldn't be certain what happened, so they were left out of the total.
"We know that the only safe sex," Gayle tells the AP, "is total abstinence or sex with a mutually monogamous, non-HIV-infected partner. Everything else has some degree of risk. The sense that oral sex is safe sex may have been an unfortunate message.'' But she adds the assumed risk of oral sex when using a condom is "close to zero".
