For me this study underlines the importance of re-visiting the risks people take when it comes to sex – there is always a risk!
It seems that if people do not perceive they have engaged in any risk taking behaviours, they then do not feel it necessary to test, but risk is very subjective & is difficult to quantify in all circumstances.
I am increasingly concerned about the risks associated with giving oral sex – this is lower risk compared to unprotected anal sex, but by how much lower can vary depending on a variety of factors.
Prevention campaigns have quite rightly focused on condom use in the past 2 yrs for anal sex & there has been a shift away from promoting “risk reduction” strategies – possibly because of the mixed messages they can send out.
We need an open debate about the risks people take & why they take them if we are to bring down new HIV infections. Regular testing helps as does consistent condom use; we need to openly talk about the sex we have & re-examine risk!
I think people have had enough of “re-examining the risk”. They want sex. Now. They want love. Now.
Now is immediate. The rest of your life is a long time to go without sex. And no one fantasizes about sucking on plastic. Until that simple fact is reconciled, there will be sex, irregardless of risk. Only the truly mature can accept that – and by the time you are truly mature, you are too old!
I advocate testing for all, so they can go forward with information that will help them in their situation.
I agree at regular testing is important & will help drive down new infection rates, but here in the UK undiagnosed HIV has remained at approx 25% for the last decade or so.
Increased testing would reduce this figure and also have a marked effect on transmission rates somI guess we need to ask the question why people do not test at least once a year, which I think is strongly linked to perceived risk.
Is oral sex ‘risky’?
Compared to unprotected anal sex, oral sex poses less of a risk. It is estimated that about 5% of all HIV infections are via the oral sex route, with an estimated risk of transmission per exposure to HIV being 0.4% which is extremely low.
However there seems to be a growing “real life” reports amongst +ve individuals, where they have received a shock diagnosis as the individuals considered that they were being “careful” & consistently used condoms for anal sex. This observation comes from my involvement in a UK based HIV forum, together with other personal accounts. The risk from oral sex is likely to be greater to the person giving the oral sex, particularly where ejaculate it taken into the mouth. In addition undiagnosed STI’s significantly increases the risk of HIV being transmitted where one partner is +ve but is unaware of their status…….
We know that up to 80% of new infections come from undiagnosed individuals; often these individuals have extremely high levels of HIV in their semen, particularly in the the acute phase of infection, before anti-bodies have been produced in the HIV infected partner. Levels of HIV can be as high as 2 million per ml of semen during this period, which also increases the risk.
The fact is it is not easy to quantify the exact level of risk where another STI is present & the partner being given oral sex has an extremely high level of virus. Some studies have suggested that an individual in the acute infection phase can be 28 times more infectious than when sero-conversion has occurred & the body is able to recognise HIV & reduce the virus to levels often seen at diagnosis which are frequently below 100,000 (this is also variable). If we work on the premise that the expected risk per exposure is 0.4% this could rise to 1.2% per exposure.
Given that oral sex tends to be unprotected & the risk per exposure could be as great as 1.2% this suggests that the more oral sex an individual has where the ejaculate is taken into the mouth there is a greater risk of HIV transmission occurring where either partner has an undiagnosed STI & the undiagnosed +ve partner is in the acute stage of HIV infection.
In summary my take on oral sex is to be particularly careful if you are the person giving the oral sex & you do not know much about your sexual partner – perhaps this is stating the obvious, but in my experience I have never either been asked to use condoms or suggest condoms be used for oral sex. Perhaps there is much to debate here?
This in essence is what I am suggesting we need to revisit our perceptions around sex & the risks involved. Any sexual contact can be risky & we all have different views on the level of risk that is acceptable. The rate of new infections is stubbornly high we need to find out why!
I would like to see more studies carried out in relation to the transmission risk of oral sex – the standard advice regarding not flossing or brushing teeth prior to giving oral sex or being mindful of cuts or poor gum health is important, but there seems little information about the effect of STI’s & high levels of virus which to my mind could be playing a greater role in infections acquired via oral sex.
I agree entirely with Christopher. The problem is with male contraception more than anything else. I would very happily use contraception it didn’t mentally feel like a barrier between myself and my partner. And as he said, sucking on plastic is not exactly romantic!
I believe that regardless of education, people are going to be aware that there is a risk of infection. But the prize outweighs that. Until there’s a some sort of vaccine or there are better methods of male contraception, the warnings will fall on deaf ears.
“The new data shows that young people between the ages of 13 and 24 represent 26 per cent of new HIV infections each year and 60 per cent of these people do not know they are infected” …
Think about it logically a person that knows they are HIV positive will not take the test!
This study is all based on estimates. And the pieces that aren’t is about having more then 4 sexual partners by the age of 24! So Scandalous … not!
And you can’t even string a sentence together!