03/02/09

Does oral sex protect against HIV? Suck it and see

Public health types are always agonising about oral sex. Should we say it’s dangerous or not? Now, Swedish researchers have shown that lots of oral sex with an HIV-infected partner may actually be protective against the virus.

The study, published in the (expensive, subscription only) AIDS journal and helpfully summarised by Aidsmap suggests that men who give lots of blow jobs to their HIV-positive partners develop antibodies specific to that partner’s virus, protecting themselves against infection. The more virus their partner has kicking around in their semen, the higher the concentration of specific antibodies, and the protection seems to last for quite a while too. None of the men became infected over the course of the study, even though their partners were not all on treatment.

I’ve never been one for warning people off oral sex — while it is not 100 percent risk free it’s almost always safer than any of the alternatives that provide as much fun. But I’d hate to lose my agonised public health type credentials entirely, so I’ll point out a caveat in this study. The couples who were recruited, an infected man with an uninfected partner, had to have been together for at least 6 months — beyond the most dangerous period for infection in most cases. Any guys who did get HIV through oral sex in that risky early part of their relationship wouldn’t be in the study, because they would no longer be in a “discordant” relationship.

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This post was published on 03/02/09 in Pisani's picks, Science.

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13 comments

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  1. Comment by Bbucko, 04/02/09, 01:26:

    This confirms my suspicions regarding the whole HIV/oral question. Thank you for publishing it.

  2. Pingback by Oral Sex and HIV, 04/02/09, 01:55:

    […] lots of oral sex with an HIV-infected partner may actually be protective against the virus”; according to a study published in the AIDS journal. What now? Don’t rush into it before you check the p-value; no pun intended. Tough Guy […]

  3. Comment by Daniel Reeders, 04/02/09, 04:05:

    I was whooping and hollering with joy when I read this in Aidsmap, thinking of the calls we take on our information line asking ISORALSEXRULLYSAFE? — “Yes, in fact, we recommend sucking as many positive men as possible to build up your antibody response”.

  4. Comment by Nico, 04/02/09, 04:34:

    Thank you for giving me more resources to debate the fear-based crowd who’d probably warn me against sucking even my own cock…

    You are absolutely right. People need options for getting off in fun, hot ways without having to feel paranoid and guilty afterward. We have to give people options for guilt-free sex or they will end up taking even greater risks out of despair and exasperation.

    Here is how it plays out in the lives of gay men:
    http://ickaprick.blogspot.com/2008/11/why-no-one-wins-blame-game.html

  5. Comment by Nayantara, 04/02/09, 05:51:

    I think it is very irresponsible to even suggest to the general public that unprotected oral sex might infact be a way to increase ones immunity against HIV. Especially based on the results of this one study. I haven’t read the study, but just from what you post, there is the obvious concern you mention: discordance in and of itself is a condition where HIV positive persons are able to not infect their HIV negative partners even without using protection. So if the couples being recruited were already discordant (and you know this because the negative partner hadn’t gotten infected in the 6 months they have been together), then no amount of unprotected oral, vaginal or anal sex will make them not be ‘discordant’. We already know this about discordance! So a real issue that needs to be addressed before we jump the gun on whether unprotected oral sex is safe, is to understand how HIV discordance is related to a combination of factors that include genetics, HI-virus type, the extent to which the infection has progressed in the HIV-positive partner, other sexually transmitted diseases and circumcision — which research indicates may reduce the risk of HIV infection. Without that, this study has no basis at all!

  6. Comment by KCN, 04/02/09, 12:29:

    Daniel, that is not at all what this study says at all. This study was on discordant couples. You can not extrapolate that giving blow jobs to a bunch of different men would provide the same antibody response as being repeatedly exposed to the same partner.

  7. Comment by Dallasquestion, 04/02/09, 09:24:

    I’m confused. If my partner is HIV positive (which means he has been exposed to HIV and has anitbodies to the virus in his bodily fluids) and I am sucking him off regularly (I wish…)and I build antibodies to his particular strain of virus…isn’t that the same as saying I’ve become positive (antibodies to his specific virus are now in my bodily fluids)? Confused…any clarification?

  8. Comment by gis, 05/02/09, 01:45:

    I am glad you posted the results, but I feel you were irresponsible with the details. Yes, there was a significant results mathematically (p=.0001) that some men acquired a HIV neutralizing factor in their saliva…..but, while significant, that number of men was 13 out of 25. Half chance isn’t protection.
    You also failed to mention that this “protection” is only present in the saliva…thus it isn’t systemic, and does not really provide protection.
    I recommend you reading the article before placing such amazing claims online.

  9. Pingback by More oral sex (studies needed) « Time Enough at Last, 06/02/09, 01:10:

    […] over to the schools of biology & medicine as well.   I agree with my Andrew Sullivan that this study needs to be verified and more studies like it to be done.  But it scares me, […]

  10. Comment by MedHead, 06/02/09, 07:41:

    I didn’t know that the first 6 months was the most dangerous period of an infected/un-infected relationship. Is that because it takes that long to determine if the couple is “discordant”?

  11. Comment by Paddy, 18/02/09, 11:56:

    Possibly one factor is that people in a relationship tend to have sex less often and/or less energetically after a while. A more HIV-relevant reason is that the positive partner may be more likely to be newly infected at the start of the relationship since they’d have been more likely to have been sleeping with other people then, and thus could have a higher viral load. Finally, the couples whom for whatever reason are at higher risk for transmission may well have transmission in the first six months; the couples who stayed discordant for that first period may have some particular reason to be less likely to have transmission.

  12. Pingback by The Sex Round Up « Neuroanthropology, 21/02/09, 03:25:

    […] Pisani, Does Oral Sex Protect against HIV? Suck It and See A nice summary, with an important caveat, on a very cool study on antibodies, immune systems, and […]

  13. Comment by anto, 08/10/12, 07:39:

    I am HIV positive and my boyfriend is not what I want to know is if I give him a blow job will he get HIV too? Thanks

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