The Washington Blade - February 11, 2000
Lisa Keen

The reports were that, in the "most definitive study to date," researchers found that eight out of 102 Gay and bisexual men most "likely" acquired HIV through oral sex (seven as the recipient partner, one as the insertive partner). A previous study by the U.S. Centers for Disease Control and Prevention calculated the risk of oral transmission, for the receptive partner when the top does not use a condom, as 0.04 percent per contact -- a risk that was the lowest for all sexual practices but "not without risk."

In all those news reports last week, nobody discussed to what extent, if any, the eight men who contracted HIV through oral sex were suffering from ulcers or gum disease. The presence of bleeding gums, scratches, and ulcers is known to facilitate HIV's ability to enter the bloodstream. The detail was not on the poster at the Retrovirus Conference, not in the press release issued by the CDC, and was not known readily by the University of California-San Francisco researcher who was taking questions about the study at the conference.

But that researcher, Rick Hecht, did, at the Blade's request, look up the information back at his office, and this week he responded: "About half did have gum disease or an oral ulcer."

Thus, it would seem that "about half" of the eight out of 102 men did have an additional risk factor for contracting HIV through oral sex, suggesting that about 4 percent of men contracted HIV that way -- a percentage more in line with previous studies.

It is worth noting again, however, that even before last week's study stirred up new attention for the risk of transmitting HIV through oral sex, most AIDS prevention messages have urged men to use a condom -- and women to use dental dams -- when engaging in oral sex.

"There is nothing in this study that should make us change our message about HIV transmission," said Gay Men's Health Crisis official Ronald Johnson in a Feb. 2 press release. "We have consistently been telling the public for many years that oral sex can possibly result in HIV transmission but that the risk is much smaller than the risk of unprotected anal intercourse." The GMHC press release noted that the Gay clinic received an increased number of calls following news reports last week from the Retrovirus Conference in San Francisco.

In related news, another poster at the Retrovirus conference indicated last week that some men with HIV "shed" virus through their semen even when they are asymptomatic. The study, from the University of Pittsburgh, examined the blood and semen of 18 men with HIV infection every week for 10 weeks. Five of the men never showed HIV in their semen, five always had HIV detectable in their semen, and the remaining eight men had HIV detectable 70 percent of the time.
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