Monday, May 22, 2006

Oral Exam: Dam-med if You Do, Damned if You Don't?

As someone who will probably be re-emerging back on the dating scene some week or other after a long hiatus, I've been doing some thinking and reevaluating how I want to handle sexual encounters in the future. And this brings up the issue of protection.

In general, I have been careful about picking sexual partners (as in, I would not be the kind of person you'd be able to term "promiscuous," unless you were an extremely conservative person). I've also been relatively careful about condom use when it came to sex. But what I mean by "sex" in that last sentence is coitus. Which I think most people have defined it as up until recently.

Now, oral, that's been a different story. With all my sexual partners, whether giving or receiving, I never used any form of protection. And I don't know, because I haven't been in other people's beds, but from what I hear out there in the world, this seems to be the norm for many other people, too.

And yet you read that really, we should all be protected during oral sex, too--that we should be using dental dams, flavored, unlubricated condoms, plastic wrap with lube, etc. while engaging in cunnilingus, fellatio, or rimming.

You hear all the time now that you can contract diseases through oral sex. But how likely are you to? It's nearly impossible to find useful statistics. In general, you mostly read that the percentage of risk is far lower, but still present. Here's a good site that tries to balance theory with actual documented cases of AIDS transmission--but of course AIDS isn't the only STD. It's much more difficult to find any fast data on other STD transmission through oral sex.

In any case, though perhaps extremely low, the risk is there. And I'm wondering in light of that, what are people doing out there these days? Particularly those of you who are sexually active but not in long-term relationships, or who are in a serious relationship but aren't sure if it will be your last and only sexual relationship--or if you are polyamorous, or in any other kind of multiple-partner situation.

Are most of you playing the odds when it comes to oral sex? Or have things changed and are many of you using safe sex alternatives during oral contact?

And if you are using safe sex alternatives, how are they to use? I've got to be honest, just the thought of giving oral to a banana-flavored-condom-encased cock sounds gag-worthy to me. And I wonder how it would feel to receive oral or a rim job through a dental dam (or to give it). I mean, I know I'm capable of coming with a barrier between my clit and whatever is stimulating it, but it's certainly not the same as direct tongue contact. Is a dental dam thin enough to feel not much different? And does it taste gross? Smell strongly of plastic?

If anyone out there has any information or experience with this, please do share; I'd really like to get some input (heh). (And remember, you can always leave an anonymous comment if the info is too personal and you don't want to identify yourself.)

Oh...and also...
Let's say you normally don't use protection during oral. If your next partner felt it was important to him/her, would you be willing to have protected oral sex every time? Or would you think that was just too sterile and decide to look elsewhere?

Do tell.

P.S. Though I know this is petty and probably unwise, I'll fess up that the thought of barrier-protected oral sounds entirely unsexy and unappealing to me. I like the intimacy and feel and taste of full-on mouth-to-skin contact. But I suppose that's rather short-sighted and obnoxious of me to say. I'd be really annoyed if a guy gave me the "a condom isn't natural, therefore I should get to have sex with you without it" speech. It really isn't any different for oral sex. And honestly, I really don't want to contract an STD of any sort, through any means. So maybe I just need to heave a big sigh and kiss my carefree, barrier-free oral days goodbye...

In any case, there might be a difference between what you're DOING and what you think is the right thing to do; so if this is the case, that would be good to know, too.

(photo credit: Bike Kill 2005 no105 (K kiss no1) by beigeinside)


Anonymous Circe said...

In the course of my long, very long, extremly long life and through working at the Health Department, I think I must have come to believe that the best way to deal with any kind of human contact at all is to shun it utterly. Heh.

(Have I mentioned my developing misanthropy?)



5/23/2006 7:41 AM  
Anonymous Tory said...

Yea i am rolling the dice on oral. I am not opposed to using some kind of barrier during oral but i am surely not an advocate of it either.

5/23/2006 4:39 PM  
Anonymous Darkhawk said...

I suspect that I'm "playing the odds" or whatever, but ....

Yes, I'm poly; I've been actively so since I was sixteen (and I'm twenty, uh-eight now), and have only not had multiple partners for about two years out of that time -- for a grand total of six sexual partners lifetime plus a couple of gropes. And I'm the most "promiscuous" member of my extended polyweb, both now and historically.

I'm picky about partners, and so are my partners; I only don't know the entire sexual history (at least to the point we stopped having sex) of one ex. (Trusting that people are telling the truth, at least, which I'm strongly inclined towards in the relevant cases.) I have been disease-tested in the past, and will ask for same again at my next physical.

The thing is, my major sex-life concerns healthwise are pregnancy and UTI. I'm a hardass (ahem) about condom use for anal because of cross-contamination concerns. I have knowledge of recent (as in, within the past six months recent) tested-clean results for my husband and my lover's other partner. I don't spend a lot of cycles on it, in other words.

By some people's standards I'm utterly careless and casual about safer sex procedures. I'm within my comfort zone, and my partners' comfort zones, though.

If I were dealing with someone who wanted barriers for oral, I'd probably just not engage in oral with that person. That would be less of a big deal to me than figuring out how to go about use of barriers for such things. (But I'm not someone who really, really gets off on oral.)

5/23/2006 4:58 PM  
Anonymous Buck said...

First of all: my despondancy at not having sent you questions when I had the chance knows no depths. I came by, I saw, and.... I froze. Now you know.

Second of all: I'm allergic to latex (though I sometimes test that for reasons of kink, 'cause I also have a deathwish). I've had about twentysomething sexual partners - I don't count - and I've never once successfully used a condom or dental dam of any kind. I am the poster child for what not to do.

....well, mostly. I don't do spontaneous sex anymore, which is a drag, but. I also insist on going as a couple and testing with any potential partner. I test myself anyway roughly every four months, anonymously (I'm actually late for that right now -- The last time I went was just before Xmas, but my only partner lives in a monastery).

I used to work in HIV outreach and prevention, so I know the stats if you want 'em. But you probably don't want 'em.

5/23/2006 7:13 PM  
Blogger Miss Syl said...

Circe: Been there. AM there. But I don't think I'm gonna stay. I decree there will be sex! Sex for all! And um, for me, hopefully a little more than sex, too.

In any case, I'm a big "try before you buy" girl. Don't think there's much chance of celibacy until marriage (or whatever) on my part.

Misanthropy. Huh. You mean you have to LIKE someone to have sex with them?

Kidding. Coming from picky me, that's one big, big joke.

5/23/2006 10:22 PM  
Blogger Miss Syl said...

Tory: Yeah I think I would say okay if my partner asked for it. And now I'm a bit paranoid, but I just don't know...

Man, I feel like a bit of an idiot saying, "I know I could die or get sick, but whatever..." What kind of karmic luck is that gonna bring me?

Darkhawk: I've also been picky about partners and know their sexual history (assuming they didn't hide any less pleasant things from me). And yet, in that sexual history I knew there were one night stands, for instance. And I also knew one of my partners had been with a prostitute once. And so I may have KNOWN who they were with, but I didn't know what THOSE people they were with may have been involved in, and what they might have transmitted. The thing that's a little freaky is there are latent STDs that may not show up for years...

The truth is, even if you get tested before each new partner, you can still have an STD and not know it. They don't test for everything when they do those tests.

Buck: Silly thing, no need to explain. And you can certainly ask me anything you want, any time, via email and if you beg nicely I'll answer. Heh. Nah, YOU don't have to beg. Just everyone else.

Now I'm curious what you *would* have asked if you'd stayed liquid.

When you say you test regularly, do you mean for AIDS or for a battery of all kinds of STDs?

I'd love the stats, actually, but from what I can tell, the maximum percentage that any study seems to have shown for oral/penile sex is about 8%. And that was a male/male study.

If it's true (based on the link I gave) that there have only been a *few* cases of transmission through cunnilingus and only ONE through rimming, I'd say those behaviors have to be fairly low-risk, don't you think? Or do you know of different numbers?

Do tell.

5/23/2006 10:34 PM  
Anonymous Darkhawk said...

When I said "know sexual history" I included knowing the chain all the way back -- I have two points at which vector is unknown. (A one-night stand in 1996 in which latex was used; the aforementioned ex.)

This is less impressive than it sounds, really; bad habit of seducing the sexually inexperienced, me.

5/23/2006 10:51 PM  
Blogger raylilah said...

I've been wondering about this too, but not because I haven't had sex fairly's only been a year. More because I'm old enough now that it's pretty much a given that everyone I encounter is going to have had multiple sexual partners, and I *fear* STDs. And I've never heard of anyone using dental dams or condoms during oral sex. Yet, I think I'd rather, for safety's sake. And I think I'd rather not, for enjoyment's sake.

5/23/2006 11:08 PM  
Blogger Miss Syl said...

raylilah: Thanks for stopping by and commenting. Yeah, it's the age-old conundrum, isn't it? What's safe or what's fun...

Although, I guess Billy Bragg might be right in that cute little song: "Safe sex doesn't mean no sex, it just means use your imagination."

But I'm having trouble using my imagination positively on this one...

5/23/2006 11:27 PM  
Blogger Miss Syl said...

Darkhawk: If all of your lovers have done a thorough investigation into all *their* lovers' sexual histories, you're hanging out with much more careful people than I have been, for sure.

I can manage to get info on who my partner has slept with, but it seems most of them haven't been any too careful about asking about their former partners' partners (and of course, thier partners, and their partners, and so on...).

5/23/2006 11:29 PM  
Blogger What the Chuck said...

Hi Ms. Syl,

OK, no jokes here.

The reality is, of course, that with every person you sleep with, you're really sleeping with everyone they've slept with. That's all true.

However, what is ALSO true is that AIDS is spread through blood-to-blood/semen contact. There is a much lower rate of heterosexual AIDS in the US because in places like Africa, syphilis and other venereal diseases that create open sores are much more common, and serve as AIDS vectors.

Re: oral sex, your risk, if both partners have healthy mandibles and parts (something relatively easy to figure out), have no history of IV drug use, and with men, have not been bisexual, ranks as extremely low. Making sure you don't do anything that gives lesions in your own mouth (like burning the roof of your mouth with pizza), as well as going to the dentist and making sure all your toofies are in good shape, will proof you in many ways. As far as sucking dick, I can't imagine any women wanting to go down on someone who had a lesion on their penis. And I can't imagine any woman wanting a man to go down on her that had a big herpes blister on his lip.

AIDS is a real threat, and I'm not meaning to belittle it in any shape or form with what I'm going to say next. But when you look at the dynamic around the disease, and the obvious things you can and should do to protect yourself (wearing condoms and such during heterosexual intercourse, or making sure you don't fuck so hard you tear your vaginal wall tissue) I think some of it is designed to scare people.

Nothing is risk-free. But oral sex, with a minimum of inspection and care, is pretty safe. You can always finish off that blow job with a couple of strokes of your sweet little hand, until you get to be better friends and both get tested. FWIW, I'd worry more about HPV and chlamidya if I were a young woman. These are real things that get spread that have none of the obvious warning signs that the other more nasty bugs have, but can still cause sterility. And both are pretty much impossible with a diet alone of oral sex!

Hope this helps.



5/24/2006 11:43 PM  
Blogger Cherrie said...

My rules: Condoms for sex with men, vaginal or anal (I don't do much anal), except for my man, who gets to ride bareback. However, when HE does someone else, he has to wear one. (He doesn't mind.)

No condoms, dams, Saran Wrap, etc. for oral sex. If the organ looks diseased, I don't touch it. Otherwise, I enjoy it!

5/25/2006 8:38 PM  
Blogger Miss Syl said...

Cherrie: Now you're the kind of "Rules Girl" I can get into! Heh.

5/25/2006 10:21 PM  
Blogger Miss Syl said...

Chuck: I agree. As I said in the post, AIDS isn't the only STD to be concerned about. It's certainly not the only one I'm concerned about. It's pretty easy to see if someone has lesions. Less easy to tell if they have other types of STDs, which may be transmittable via oral contact.

5/25/2006 10:25 PM  
Blogger Anastasia said...

The scariest thing I read (more than two years ago) was about a couple who contracted HIV supposedly orally (through kissing) and this was based on one of them having broken skin within their oral cavity. But this was never substantiated by other doctors at the time and because the article appeared in an afternoon edition of a newspaper as a short blurb further put its credibility in question.

I think any exchange of bodily fluid does require a barrier not only due to HIV but the other (and usually not considered), Hepatitis B, and then there's infectious mononucleiosis (glandular fever or Epstein Barr Virus).

Have I used barriers throughout? No, not really and it's only after reaching a hiatus, where I undergo the usual tests, and receive the much anticipated negative results that I remind myself (as well as my casual stance at past moments of lust).

5/25/2006 11:20 PM  
Anonymous Buck said...

Hey there Syl, I know everyone else has moved on, but...

Firstly, to answer your question: I test for everything. And so far, I'm clean for everything. Which feels reassuring.

>Here's a good article
on HIV transmission rates for you. This pretty closely agrees with what we used to deal with when we did our work. If you don't feel like heavy reading here's the bit you specifically asked about:

"...There has been considerable debate concerning the risk of HIV transmission through oral sex. Epidemiological evidence indicates that oral sex carries a much lower risk of HIV transmission than anal or vaginal intercourse. There have been only about 30 reports in the medical literature of documented HIV transmission via receptive fellatio (oral sex on a man), and fewer documented cases attributable to giving cunnilingus (oral sex on a woman); there have been only three reports of transmission to the insertive partner in fellatio. Most population-based epidemiological studies have not found significant evidence of transmission via fellatio; however, research in this area is difficult because few people have only oral sex to the exclusion of other sexual activities...."

This is in all the literature, period, as of 1999. However, these facts are misleading, and the probabilities only look small until it's you that's infected.

By the way, HepB rates are twice as high, so double all probabilities if that's your poison. Multiply them by about 100 if it's HepC you're worried about.

If, on the other hand, Herpes is your bag, we're playing a whole new ballgame. The best stats I can find right now say that 80% of the American population has HSV-1 (oral herpes or cold sores), 20-25% has HSV-2 (genital herpes). Let's err on the side of paranoia and say 25%. Some studies to back that up:

and Here

If you're specifically talking about oral sex, the number that keeps cropping up here is 1.67%. That's the chance of developing HSV-2 because your partner has HSV-1 and goes down on you without a condom. If you're performing I don't know your chances of picking up HSV-1. so that's 1.67% of 80%, or about 1.3%, I guess. That probability changes if you're one of the 80% of Americans who already have cold sores, because HSV-1 antibodies provide some immunity to HSV-2. So again, this gets complicated, and there's a reason that you can't get a hard number. But yeah, a dental dam would definitely make a difference in this case if you are recieving. If you're performing, not so much, and not at all if you already have cold sores.

That's it for Viruses you can pick up. Similar Data exists for nonviral infections (syphillis, chlymadia, et. al) but anecdotally I've never been infected and if I ever was I'd just take my course of antibiotics like a good boy, so I don't care and I've never looked them up.

Dental dams reduce the probabilities of infection by orders of magnitude, but there's no such thing as safe anyway. I ask potential partners to test first, but even that's not safe - seroconversion takes 2 weeks to 3 months for different viruses in different individuals, and just because a potential partner tests negative now doesn't mean they aren't still recently infected and shedding virus. You're always playing a numbers game.

5/27/2006 4:11 AM  
Blogger Miss Syl said...

Ana: Thanks for your comment. I've not heard of kissing transmission (except for mono), but I have noticed in the literature repeated warnings NOT to brush one's teeth before performing oral on anyone, as it can open up small cuts in your gums and mouth. That had never occurred to me before, and sounds like wise advice. I bet loads of people ignore it, though--you want to have fresh breath when you start snogging with someone. Time to make the switch to mouthwash prior to, I guess.

Buck: Thanks so much for all the statistis. Actually, in terms of transmittable viruses, you left out HPV. Just thought I'd mention for the general public, but in any case, that was greatly helpful.

It's a bit frustrating to me, as a heterosexual woman, that the risk is always higher for the person being inserted into, rather than it is for the inserter. Life just isn't fair.

You can get immunized for Hep B, though for some reason this is not common knowledge, and not widely encouraged by medical personnel. I have no idea why, since it's become so rampant. I had a gynecologist who suggested to all her sexually active patients in non-LTRs that they get immunized, and so I have done. One wonders why this advice is not more widely given.

5/27/2006 10:13 AM  

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