LETTERS From CAMP Rehoboth |
CAMPsafe: Hard to Swallow |
by Salvatore Seeley |
Early last month, a team of US researchers presented some interesting but essentially tame statistics about oral sex and HIV. Their study suggested that eight out of a group of 122 men newly infected with HIV were almost certainly infected through oral sex. Big deal, you may well say. While it can be argued that, from a strictly studious, scientific point of view, the study is of great value, the resulting statistics offered AIDS commentators nothing new to talk about. We have known for a long time that HIV can be transmitted via oral sex and that, compared to unprotected anal intercourse, the threat is minimal. Eight in 122, just under 7%, is about what I would have guessed. However, the debate did not begin and end with AIDS commentators. Enter, stage right, the American media with its typically sensationalist, inaccurate and homophobic agenda. As ever, the coverage of the study essentially overlooked the reality of the statistics and comprehensively ignored any sense of responsibility. The Associated Press headline screamed "AIDS Study: Danger of Oral Sex High." Meanwhile, the Los Angeles Times reported: "At least eight percent of all cases of HIV infection result from oral sex." (Memo to the LA Times: eight out of 122 is 6.6 percent not eight percent.) As well as this utter irresponsibility, journalists also completely ignored a crucial caveat in the researcher's report. In announcing their findings, they insisted that "despite a lower transmission risk, oral sex may be an important mode of HIV transmission due to its frequency," adding that the percentages found in their relatively small sample could not be generalized to the population as a whole. So don't believe the hype. Frederick Hecht, MD, University of California San Francisco (UCSF), the researcher and co-author of the study that unwittingly generated all this media nonsense agrees that the hype was over the top but he argues that gay men have become too sanguine about the safety of oral sex. "There is some risk," he says. "The basic message should be that if you have enough lower-risk behavior, it can be a substantial mode through which people are infected. "In earlier messages that oral sex is safer, the 'er' has been dropped off and people have just assumed oral sex is safe." This is the sort of commentary we need; accurate advice rather than hype, and facts rather than scare mongering. Utterly missing from the American media's coverage of the risks of oral sex was the basic messages that gay men need to hear. Messages like the fact that in almost all reported cases, HIV was passed from the active partner to the passive one. There are only a handful of reports of HIV being passed to the insertive partner, and the general consensus is that the risk to the active partner, while probably not zero, is extremely low as to almost be negligible. While there is abundant evidence that receptive anal sex without a condom is the major route of sexual transmission among gay men, there have been numerous reports in medical journals about HIV transmission via oral sex. In 1996, researchers from the University of Washington reported four out of 46 newly-infected patients had no identifiable risk factors other than oral sex. But it has been hard for researchers to develop a precise estimate of the risk involved. Kenneth Mayer, MD, director of medical research at Fenway Community Health in Boston, noted, "The trouble has been that a lot of people who have anal sex also have oral sex, so it's hard to know what the source of the infection is." Another complicating factor, he added, is that since HIV is fairly difficult to transmit, researchers have to follow a huge number of people to develop meaningful data. Scientists face considerable difficulties in accumulating accurate data of this sort, starting with the fact that most of the information needed relies on the accuracy and honesty of individual's accounts of their sexual histories. Are you always honest when you fill in those questionnaires about the type of sex you're having and whom you're having it with? I'm not, and I know the importance of it. Who knows which boxes other people are ticking? Still, Mayer tell us, "There are several of us who have said for years that we could have had much better data about oral sex than we do now." He insists that the authorities must find a way to fund an in-depth study looking at gay men who don't have anal sex. That must surely be the way forward and one that must be looked into without delay. In the final assessment, the only risk-free option is to stop all forms of unprotected sex completely. Given that a lot of gay men see that as a safety step too far, two precautions are instantly important and should be publicized. First, avoid performing oral sex if you have any cuts or sores in your mouth or gums. Second, and perhaps even more critical, is to agree with your partner at the outset that you will not ejaculate in each other's mouths. If the media would only report these basic facts rather than returning to the sort of hysterical scare mongering we endured in the early 1980s, that would be a fantastic service to us and a credit to them. Why aren't health promotion groups lobbying for this? Sadly, any sort of responsibility or accurate reporting is precisely what the gay and AIDS communities have given up trying to get from the mainstream press. Press Officers these days only seem to talk to HIV-specific magazines and the gay press. And who can blame them? When there is the whiff of a "plague" in the air, a chance to whip up some public panic and bash some queers in the process, the world's media seems to hit the typewriters with a vengeance. Sensing blood, they hunt for the most hideous headlines possible leaving the truth in their wake. If such ignorant reporting leads to young gay men being denied the sort of information they deserve and need, then it goes beyond the usual gay-bashing and into much more sinister territory indeed. These editors will quite literally have blood on their hands. |
LETTERS From CAMP Rehoboth, Vol. 10, No. 15, Nov. 22, 2000. |