Friday, June 26, 2009

Let's all start sucking around!

by Jan Wijngaarden

Fridae’s Men’s Sexual Health columnist Jan Wijngaarden wonders why oral sex has not been as widely recommended as a 'safer option' given that it has been found to be of much lower risk compared to anal sex.

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.

I was intrigued. Why did he survive? Was he immune, or what? Or was he the only one who used condoms? When we were alone, after the dinner was finished, I decided to ask him.

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).

Read the rest.


Nico said...

What a shameful joke. What starts out as an AWESOME article from a harm reduction point of view -- ie. oral sex is lower risk than anal sex and is yet one more way to reduce the level of risk in your sexual repertoire, along with condoms, lube, getting vaccinated for Hep A & B etc etc -- finishes up as a 2009 gay version of fear-based harm elimination. That approach to HIV prevention was proven to be ineffective long ago, so why is IRMA sharing an article that makes it look like a laughing stock?

Is the author seriously suggesting that all gay men should stop having anal sex and only have oral sex? *More importantly* does IRMA seriously believe this is within the realm of likelihood EVER?

Is it truly THAT hard to give up the fantasy that we can tell people how to have sex? Are we TRULY that arrogant that we believe they'll do what we say??

For goodness sake, just offer the scientifically factual, extremely useful information that oral sex (with or without a condom) is a great alternative to higher risk unprotected anal sex and leave it at that.

Going further and suggesting that gay men should give up anal sex entirely is like fundamentalists suggesting everyone should just wait until marriage before having sex.

I read IRMA because I thought it was a credible source of information. The conclusion of this article makes you look about as reliable on HIV prevention best practices as George Bush.

Marc-André LeBlanc said...

I think we should strongly encourage those groups and prevention educators who are willing to provide information to community members about what we know/don’t know about the levels of risk involved in various sexual activities. This includes information on what factors may reduce or increase risk. Doing effective prevention messaging and incorporating risk reduction information is complicated. I hope that the debate about whether it should be done or not is behind us though. Pun intended.

“If you are having (anal sex/oral sex/fill-in-the-blank type of sex), you should know the following: The risk of this happening to you is probably […] For your partner, you might want to consider […] [XYZ] may help to reduce risk of these things... [ABC] might increase the risk of that happening…” I definitely mean including information here about risk reduction measures in the absence of condoms.

The above is always more helpful in my mind – yet so much more complicated – than:

“Don’t do it. Just say no.”

Armed with accurate information about the levels of risk involved with anal sex/oral sex/other activities and the factors that may reduce or increase the risk of HIV/other STIs being passed on between me and my partner, I can make my own decisions about oral and/or anal sex. [Assuming of course that when, what, how and with whom I have sex is within my control, but that is a whole other story!!]

We should also pay close attention to the endlessly creative ways we have of attempting to minimise risk and maximise pleasure. Sometimes we succeed, sometimes they are misguided efforts. It is always an excellent source or research questions. How effective is sero-sorting? What effect does douching have on risk? To what extent does taking ARVs reduce the risk of transmission – when taken by someone who is positive; when taken by someone who is negative? What role does saliva as lube play in transmitting STIs? How safe are the lubes we use? Does circumcision have an effect on risk for anal intercourse?

Marc-André LeBlanc
IRMA Secretrary

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