Risks of Oral Sex: Related Issues

Condoms for Oral Sex

While many people have been willing to use condoms for anal sex, fewer have been willing to use them during oral sex for many of the same, as well as different, reasons.

Individuals state that condoms inhibit the spontaneity of sex and reduce the sensitivity of the penis. These are common complaints for not using condoms during anal sex. In addition, many people say that condoms taste and feel unpleasant, and that spermicides on condoms leave the mouth feeling "numb" and they taste and feel unpleasant. Also, some clients consider condoms to have odors that make them offensive to use during oral sex.

One manufacturer has developed a "mint-flavored" condom, which is designed to make the taste and odor of the condom more pleasant. However, this condom is not widely available. Gold Circle brand condoms, which have no scent or lubrication, are often mentioned as a preferred choice for oral sex.

Condom use during oral sex may lack general acceptance because health messages have not emphasized condom use for oral sex. Partners may be hesitant to raise the issue of condom use during oral sex because there has been little discussion of this topic in the community or among their peers.

In addition, while condoms were used as a method of contraception for many years before individuals became aware of HIV, they were not used during oral sex, and so there is a lower level of awareness that they should be used for oral sex.

Risks of Other Sexual Behaviors

Unprotected receptive anal sex with ejaculation continues to be the sexual behavior most often responsible for HIV infection. Risk of infection from anal sex is greatly reduced by the use of a latex condom and water-based lubricant. While use of a condom using anal sex is generally considered to reduce risk of infection, refined guidelines issued in 1990 by the American Association of Physicians for Human Rights (AAPHR) ranked insertive or receptive anal or vaginal intercourse with a condom as a "high-risk" activity.

In descending order of risk, the behaviors considered by AAPHR to be "high-risk" are:

• receptive anal intercourse with ejaculation without a condom
• receptive vaginal intercourse with ejaculation without a condom
• insertive anal intercourse without a condom
• insertive vaginal intercourse without a condom
• receptive anal or vaginal intercourse with a condom
• insertive anal or vaginal intercourse with a condom

Other activities considered to put indiduals at risk for infection include rimming, which is oral-to-anal contact, and fisting, or handballing, which involves inserting a hand or arm into a person's anus or vagina.

Some health professionals continue to believe that because of the severity of HIV disease, any sexual activity poses an infection risk. While "wet," or "French," kissing is generally believed to present little risk for HIV infection, some researchers state that the practice has not proven to be completely "risk-free," and AAPHR considers the risk from French kissing to be an "unresolved" issue.

Hugging, massaging, and dry kissing are behaviors generally considered to present no risk for infection. And mutual masturbation is believed to be without risk for people who do not have skin rashes, burns, cuts, ulcerations, lesions or sexually transmitted diseases (STD).