A while ago, a friend of mine, who is around 55 years old and from Europe, sadly looked back on his life during a birthday dinner. He said that none of his (gay) friends from when he was in his twenties and thirties was alive to celebrate his birthday with him. They had all died - most of them, by far, died of AIDS.
He said: "Condoms? Nobody used them at that time. It was true; I had syphilis, gonorrhea and chlamydia several times, but those could be treated easily. That was not it, for sure."
So, what then? He answered: "It is the fact that I HATE anal sex which must have saved my life!"
It is an interesting conclusion, with a lot of truth in it. Anal intercourse is the sexual behaviour which is - by far - most likely to transmit HIV among gay men (and - much less well known - maybe among some heterosexuals, too).
The reasons are simple: the rectum is not naturally lubricated, as is a vagina or a mouth. It is also much narrower, increasing the pressure on the penis during intercourse. This adds to its appeal for many men, but it also increases the chance that sperm (or pre-cum) of the 'penetrator' can come in contact with the blood of the 'receptor', so that the penetrator can transmit HIV to the receptor. Likewise, there is a chance that tiny blood vessels on the inside of the foreskin (if present) and the glans of the penis of the penetrator are broken and that his blood comes in contact with the blood resulting from broken blood vessels inside the rectum of the 'receptor'.
Both can lead to HIV transmission (as well as the transmission of several other sexually transmitted diseases). The fragility and the surface of the inside of the rectum are greater than that of the foreskin and glans penis; hence, the chance for a receptive person to become infected with HIV are bigger than for the 'penetrator'.
How about oral sex then? During oral sex there is plenty of lubrication... Just think about that mouth-watering lollipop, and don't you start to automatically salivate? During oral sex, there is much less pressure and friction between the penis and the mouth, no matter how hard you suck, decreasing the chance for tiny blood vessels in the foreskin or glans of the penis to break. The 'walls' of the mouth are also much better protected against breaking blood vessels. While your mouth can harbour a series of sexually transmitted infections, as my friend had already noted, oral transmission of human immunodeficiency virus (HIV) is considered to be CLOSE to impossible. Even if you 'swallow', the acids in your stomach will deal with possible virus particles effectively.
So why is oral sex not widely recommended as an extremely low-risk activity?
I don't really know. Fact is, there are a few people out there who have HIV and swear that they had only oral sex. Perhaps infection took place after they swallowed and before the cum reached the stomach - i.e. in the pharynx.
Or it may be a matter of timing. During 'acute infection' of HIV - during the first 2-8 weeks of infection - a newly infected person's viral load is skyrocketing, hence he is much more infectious during that time than later in his HIV infection, when the viral load is low(er) (especially if he takes antiretroviral medicines). So, a tiny little cut in someone's mouth that comes in touch with cum that has loads and loads of HIV in it might then just do the trick, just during that period of time. But the chance is considered to be very, very tiny.
Imagine a city with one million gay men who have sex two times a week. Imagine most of that sex is anal sex. Imagine little condoms are used, as was the case in the time my European friend was young. If HIV is introduced in this population, it is likely to spread rapidly. Look, for example, at Bangkok: 17 percent of gay men were infected in 2003, rising to nearly 31 percent in 2007.
But what would happen if all these one million men, as if by magic, discover the Magic of Sucking, and stop having anal sex?
Sure - a tiny, tiny number of cases of transmission could still occur via oral sex (... and were these really caused by oral sex, or by anal sex or - God forbid! - vaginal sex, but was the person too shy to admit it?). But the chance of HIV transmission would be so small that it would not be enough to sustain levels of HIV in the population.
Hence, HIV would stabilise, and over many years it would gradually die out....
So, rather than speaking about 'safe sex' as if all sex has the same risk of HIV transmission, we should educate our sisters and brothers about the virtue of oral sex versus anal sex. If we would all switch from having anal sex to only having oral sex, we would not only be able to walk straighter, but we would turn the HIV epidemic around...
Conclusion: Let's all start sucking around!
Editor’s note: Anyone who has cuts or open wounds in their mouth or throat can still be prone to HIV infection; and risks contracting sexually transmitted infections (STI) such as genital herpes and syphilis when engaging in unprotected oral sex. By using condoms or other barriers between the mouth and genitals, individuals can reduce their risk of contracting HIV or another STD through oral sex. Read more about oral sex and its associated risks: Oral Sex & HIV (TheBody.com).
Jan Wijngaarden has worked, in different functions and roles, on promoting HIV prevention, care and support for men who have sex with men (MSM) since 1994. He is also the moderator of MSM-Asia, an information network on MSM, HIV and human rights, with nearly 600 members from across the region. If you want to become a member of MSM-Asia, or for information requests or comments, pls contact him at jwdlvw@gmail.com.
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Reader's Comments
Every time I read this guys articles I get really angry. Condoms are the most effective way of preventing HIV both through oral and anal. Any other message can be misleading and confuse people. I advise fridae to stop posting his articles.
THIS PSEUDO EXPERT IS NO LESS THAN A BLOODY MORON WITH MORONIC CREDENTIALS .
FRIDAE TEAM, GET HIM OUT OF HERE !!!
JP.Soleau
Jan's information is accurate and accessibly written. Anyone who is not aware that oral sex entails a much smaller risk of HIV transmission is not staying current with information on the matter. I don't feel he is "dumbing-down" his writing so much as aiming for an audience that largely does not have a college education. Do not forget that the writer (and editors) must also be concerned with how an article will translate. Simple writing translates from one language to the next with the fewest errors.
As to his comment (and the title of the article) "Let's start Sucking Around," this is a play on the widely-used Western expression "Fucking Around." Fucking around refers to enjoying multiple sex partners. Sucking around, as Jan used it, implies continuing to enjoy multiple sex partners in a way that drastically reduces the odds of HIV transmission, which is the heart and soul of his column.
People who post commentary online rarely are pursuaded to think differently by opposing views, and that's not why I have posted. Jan is an expert who has built a career on trying to educate people about HIV. Fridae's editors picked him, of the thousands of such educators available, to reach as wide an audience as possible in an effort to modify risky behavior. He sees the big picture--that while skin to skin oral sex may still entail some risk on an individual level, statistically if everyone practiced it exclusively the HIV/AIDS epidemic would die out on its own even if the virus continued to be transmitted among our population. This is not a hollow claim.
While I understand the message that the writer is trying to convey to his audience, his argumentative style is flawed. For example, his friend stated "It is the fact that I HATE anal sex which must have saved my life!" The writer has grossly oversimplified here. It's like saying "The fact that I hate McDonald's must have saved me from dying of a heart attack." It just doesn't work like that. In effect he is telling his audience, "Hey, if you hate anal sex you won't contract and die from HIV/AIDS." This kind of deductive reasoning is not valid.
The writer also states "So, rather than speaking about 'safe sex' as if all sex has the same risk of HIV transmission, we should educate our sisters and brothers about the virtue of oral sex versus anal sex." Here, the writer has taken oral sex, something that millions of people around the world do everyday, and glorified it as a miracle which could end the HIV/AIDS pandemic. He uses the word "virtue" to elevate oral sex to a "morally acceptable" status while demeaning anal sex as a profane and "dirty" act. This kind of language will only further stigmatize those who participate in anal sex which could lead to them ignoring the scientific community.
He further spreads this ideology by stating "Conclusion: Let's all start sucking around!" This is a hasty generalization. The writer has offered no references or evidence aside from the fact his friend is still alive to support his conclusion that we should all start performing oral sex to protect ourselves against HIV. In fact, the writer does not even mention condom use when making this conclusion! That is something that the editor had to add at the very end of this article! It seems as if the writer is promoting unprotected oral sex as an alternative to unprotected anal sex.
These statements the writer makes are both irresponsible and dangerous, not because of his intention (which I believe is GOOD at heart) but again because of the way he writes it. In fact, this reminds me of his first post on this website (which caused a lot of controversy) regarding alternatives to condom use (another poorly written article in my opinion).
I'm afraid so far I have not been impressed with this authors writing style. Hopefully that will change soon and he will give us some articles that would better serve the community in which he is targeting, or else Fridae will find someone who is better able to communicate effectively.
I agree that his articles are irresponsible. Whatever his intentions, the message the article leaves is that is is ok to go sucking around indiscriminately. Fine if you want to expose yourslef to the risk (however small) of HIV infection. Fine, if you want to catch the other STIs he mentioned (in passing).
And his refeernces to "mouth-watering lollipops" (sic.) suggests that he is far more interested in titillation than providing clear sexual health advice.
I really don't know why fridae uses him.
Je verhaal is waar, maar om via deze site verder te gaan lijkt mij niet zo handig. Kun jij mij je werkelijke email adres doen toe komen.
mijn nic name is nortuss.
Ik ken je van uit thailand waar je in 94 met een project bezich was, vertaald mam helpt man. Je hebt toen Don leren kennen die een aantal maanden bij je gewoond heeft op je woon boot. Ik ben Frank
Hoop graag wat van je te horen.
Het email adres dat friae heeft laten zien is geen actueel adres.
Groetjes Frank
Often in Asia context (which is Fridae's supposedly targetted audience), many don't feel comfortable to approach a professional medical practioner, to ask questions on HIV, esp in relation to oral and anal.
So, many may rely on popular Gay website like Fridae to get such medical, HIV related info. Fridae should pride itself to provide factual advices in its Health column. It should not allow individuals to publish un-factual, "personal opionion" in Health column, to mis-guide others into believing what the author said is "factual".
This is especially critical, when the author is contributing the article as "Fridae’s Men’s Sexual HEALTH columnist". Such title attracts the readers' trust in believing the views covered is factual, in health aspect. It'll be a totally different story, if the author is using title such as "Fridae’s Men’s Sexual SENSATIONALIST columnist".
If Fridae does not officially endorse the author's viewpoints, it should have a clear and visible alert messsage in the beginning of the article, that cautions the reader that the topic covered may be controversial, unverified, sensational and does not constitute as a health advice.
If Fridae really prides to "empower" gay asia, and not just "sensationalise" gay asia; it should pride itself in social responsibility to the Asia gay commmunity and not resorting to posting such unfactual "sensational" article just to attract surfers' readership.
If my high regard to Fridae, as a mainstream Asia gay website operator, is wrong, please do correct me.
Regrets,
A reader who hopes Fridae will continue to empower gay asia (in a responsible way)
*He said: "Condoms? Nobody used them at that time. It was true; I had syphilis, gonorrhea and chlamydia several times, but those could be treated easily. That was not it, for sure."*
Oh yeah! Syphilis, gonorrhea, chlamydia. I had them, and even several times. What's the big deal? They could be treated easily. Well, not everybody even in that period was as reckless and as unthoughtful as that particular person. The fact that "hating anal sex probably saved his life" does not make him a role model, by far.
That's one. And the next: "Let's all start sucking around". This is simply not practical. People don't pick their sexual practices as they do their shopping. It is a bit more complex. There is a thing called libido - there are such things as emotions - and a sexual relationship is a human relationship. Have you ever heard of those, Mr. Wijngaarden?
Enough said.
However, I would like to add what is amissed. Unprotected oral sex though has a low risk for HIV transmission, has a moderate risk for sexually-transmitted infections (via oral to genital and vice versa) like herpes, gonorrhoea, chlamydia, syphilis (with painless chancres).
So this is about risk management versus quality of life ! Every cause produces an action ! Of course, the diehards or obsessives will have no leeway to enjoy sex if this article miraculously revolutionalizes the mindsets of majority gays.
Wonderful article !
It's really irresponsible for this so-called "sexual health columnist" to recommend people to just go and suck around. This article, and some of the references he used, sickens me. Fridae should get rid of him for good
What the author is suggesting is maybe people can choose sucking over fucking to reduce the risks...
btw, bjs no fun with rubbers on - so me kinda mixed sensations on this point LOL
Facts are on your side. Congratulations. I just hope that governments will
fund better EDUCATION and make sure young people in particular have a broad knowledge about their body and disease.
Oral is a simple and delightful form of low-risk sex.
What is the risk difference between unprotected oral sex and anal sex WITH a condom?
This article and the discussion focus on risk difference between unprotected oral sex and unprotected anal sex. For most the gay men of my generation (at least whom I know), who came of age post AIDS crisis, unprotected anal sex is completely out of the question, especially for those with multiple partners. The sexual health education campaigns we grew up with were (thankfully) very effective. I know many gay men in this age group, however, who eschew oral sex altogether (unprotected for safety reasons, protected because... well, because it's just no fun for anyone involved), and choose to engage solely in protected anal sex, under the assumption that protected anal sex must be less risky than unprotected oral sex.
If anyone has any concrete information on this, I, and many others, would love to know about it. Which is a greater risk, unprotected oral sex or protected anal sex?
The author is not saying that you get AIDS only through anal sex. Neither is he saying that oral sex is one hundred per cent safe. He is merely stating a fact that compared to anal, oral sex is safer. Nothing is foolproof. It is up to you to bear the risks in whatever preference you have decided upon.
I'm sure Jan's heart was in the right place when he wrote this article, and I do understand the barrage of comments up above that attack him for apparently entitling the article "Let's all suck around".
However, while there are those who are questioning his credentials for being allowed to write this article, I'm just wondering how many gay Asians out there will go out and have oral sex indiscriminately just because of an article they read on Fridae.
Fine, we can criticise Jan for his article, or we can just label it what it is. One person's opinion. A person who just so happens to be a contributor here on Fridae and an HIV/AIDS adviser to UNESCO.
Problem with this is that there isn't exactly a statistical background to base his claims on, which is why I wish we had a modern day Alfred Kinsey studying gay sex patterns particularly in Asia instead of just focusing on Indiana.
And if we don't believe in what he says, what are we basing our thoughts on?
If we were to push a critique on Fridae, look at the related articles posted at the bottom of the article. There's actually one title that mentions that while oral sex is safer, the chances of infection are still there.
One cannot just simply push the blame when there are gullible people who, when it comes to sex, all they refer to is Fridae or Jan, or the word of any sexual health writer.
Especially when there are those who are vigilant enough to go about and read multiple opinions and come up with their own damned conclusions.
stupid, huh? same with getting paranoid about sex... the whole thrust of this article is that the risks of oral sex are so small (some self-reported cases but not one documented out of a wold wide total of 33 million cases of HIV!) that it's ridiculous to let our overblown fears force us to practice abstinence or monogamy
maybe the best way is loyalty to your lover, dont lie to others......
reading some of the well-informed comments above, the, er, bottom line seems to be: unprotected oral sex COULD still kill you, though it is probably less likely to do so than unprotected anal sex. but it still CAN do so. are you listening, you very young friends here? let's try to think more using what some call the sexiest organ - the brain - and not the other one. hey, i know it's really, really hard, excuse the pun, but hey, you have so much to live for. use your uncommon sense and live really, really long and prosper... :)
I do not doubt that Jan does a lot of valuable work in the gay community.
However UNESCO is a UN group focused on education, science and culture. If the article was simply on how to educate people then I would have respect for what Jan has to say. However he uses a lot of statistics and scientific information which are normally handled by UNAIDS or the WHO.
Maybe in order to prevent conflict in the future Jan could work alongside someone from UNAIDS or the WHO thus allowing us to get an educational and a scientific perspective combined. UNAIDS works at the cutting edge of research and they may have wider access to information than UNESCO. Thus a collaboration may lead to a more scientific approach.
And guys, if you expect to be sucked, please make sure your "lollipop" is clean and dry, not oozing with precum, and preferably circumcised. There may be dirt lying underneath the foreskin. The odor is enough to make anyone puke. Sorry but I don't suck every Dick and Harry in town!
Suckers should rinse their mouth with listerine or Oral B before the act to minimize bacteria in the mouth. And suckees should pee immediately after to flush out any bacteria that may find their way into the urethra. You might get infected with Streptoccocus B bacteria if not the more serious ones, and get urethritis which is fortunately curable with penicillin.
And boost your immune system!
If Fridae really is enticing, encouraging and evangelising the young of Asia to change their behaviours, why don't we see more activism?
People, and especially the "young", are not as impressionable or as ignorant as some of the comment-leavers would have us believe.
Perhaps a good way to continue the debate would be a web-based live discussion with Jan W and some other "expert" with a more conservative view. The two could field questions and respond real time to the "suckers" and "duckers".
Thank you Jan.
But there is no doubt that what Jan said is scientifically accurate when it comes to risk of infection, sucking is much less risky than fucking without a condom and possibly with a condom considering the number of people who do not know how to use a condom properly. Let's be clear, condoms are the best protection against HIV infection when used consistently and properly. The later being a disclaimer you will have seen everywhere.
The bottom line is that it is about risk, and about people knowing and understanding what are the risks associated with their sexual practice. It is about responsability and empowering people rather than lecturing them, because nowaday, if you had not noticed, lecturing, tut-tutting and finger wawing does not work anymore.
Sucking is not without risk... but less risky than anal sex without a condom - and even POSSIBLY less risky than anal sex WITH a condom, "considering the number of people who do not know how to use a condom properly"!
another familiar red light just lit up! (and, what about pre-cum in some instances that is present before, or when the condom is put on?)
i think the above observation or reminder from com 41 bears repeating...
http://notb4weknow.blogspot.com
1) Perform fellatio (blow job) only with a condom wrapped on that member (hard cock) before you put in your mouth.
2) Perform anal sex only wearing a condom. However, the receptor (bottom) may be at risk if the top's condom breaks.
Therefore, think with the head attached with a brain, not the other head between your legs. The wrong decision can turn your life 360 degrees around like night and day! Regrets will be too late.
SafER sex = More fun!
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