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Challenging the ol' Davester
May 21, 2005

Dr. Wohl,

You say that data of discordant couples shows oral sex must be a very low risk. But have you read the Schoofs article right here on It shows many things about receptive oral that make it riskier. Also, most of these dicordant HIV couples have a negative top and a positive bottom. And most sexual behavior remains consistent in couples - a top will be the insertive for oral sex as well. A bottom will be a receptive for oral as well. So that when the data shows oral to be a non risk in transmitting a bottom's HIV back to a top, the type of oral occurring is one that would only put the bottom at risk anyway. So what does this data show us? Absolutely nothing. Come on Dave, there's no way around this - the issue of receptive oral risk has not properly been addressed. And the Schoofs article shows that those HIV positives who alleged their only risk was oral - all - refer to their risk as receptive oral, specifically. It would be one thing if the article discussed claims of both insertive and receptive in these men, but they're all saying the same thing - that giving head was their only risk. If one is going to lie about their risk, why admit to being the one performing the oral. It doesn't make sense. Why not say they received it? It is a reason to take the claims very seriously. People lie about their risk mainly to avoid humiliation. Giving a blowjob is certainly more humiliating than getting one. Anyone who understands sexuality can see this. And it is a reason to take the Schoofs article more seriously than the sloppy data collected on discordant couples.

Response from Dr. Wohl

Dude, the article you are pointing me to if from the Village Voice and was published in 1996.

There is no debate. On the list of risks for acquiring HIV oral sex ranks pretty low. Is it impossible to get HIV this way? No. Can we quantify the risk accurately? No. Sure, there are behaviors or factors that can increase or decrease the risk during oral sex, just like for any exposure. I totally agree, having someone cum in your mouth is likely riskier than having some one perform oral sex on you.

I just feel we should not over blow (okay, bad word choice) the risk of oral sex, while also not ignoring the fact that it can involve the transfer of virus from one to another.

There are no concrete data as the study you would need to do is unethical.


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