3 min

Weighing the oral pleasure/danger odds

Dear Dr Ren:
I am on one of the adult personals sites and I notice many of the profiles have pictures of guys giving oral to men and none of the receiving men are wearing condoms. I thought lots of STDs could be transmitted this way.

Is this impression false? Should I insist that someone I’m giving oral to wear one? Should I wear one when receiving? How risky is it not to use them for oral? Is it a good idea but most people just don’t do it? Or am I being overly…


Dear Dr Ren:
I have a concern about rimming.

It seems that many guys are willing to ram their slobbering tongues into a stranger’s ass and feast away like it was a mocha slurpy without a barrier. I worry that the practice may be unhealthy for both the rimmer and the rimmee.

I know that medication can be administered successfully through this channel. What about germs and diseases? From the rimmee’s perspective, the thought of all that bacteria and other possible surprises being injected into my ass makes me slam shut faster than you can say dirt chute.

Obviously, the rimmer is at risk of digesting a bum full of e-coli should the poo sluice not have been recently and decently douched. I guess that’s his choice, but it can’t be good for one’s health.

Can you please enlighten us about the reality of this practice?

Puckered Out

Dear Puckered Out and Cautious:
As is so often the case, the answers depend on your goal.

If you are trying to avoid HIV, rimming is a low risk activity as neither fecal matter nor saliva carry the virus in significant amounts. However, they do harbour GI tract infections such as Giardia, or the potentially very serious E coli.

Parasites can also be passed in this way. The danger is to the rimmer. For both participants, syphilis, HPV or herpes can be transmitted through skin-to-skin contact in the anal area.

I think you are correct that this is not a behaviour to be engaged in with imperfect strangers without a barrier.

Yes, I know that some activities just aren’t much fun being done with a square of latex between your sensitive nerve endings and someone else’s. That is one good reason to save those behaviours for the people with whom you have a fluid bonded contract.

Nevertheless, in the heat of passion — and sometimes with the dulling of our good senses with club drugs — shit happens, especially in this instance. That’s when it’s good to know your risks. HIV? Not so much. Other bugs? Risky.

As for oral sex, the giver is at low risk for HIV unless he has cuts in his mouth or bleeding gums.

Risk is fairly high for gonorrhea, which can be contracted in the mouth or throat. This is also true for syphilis and herpes. Caution is advised here. Condoms are not as effective as one might think, for both syphilis and herpes are spread by skin-to-skin contact, and condoms cover only a portion of the area exposed during sexual contact.

As far as the givee is concerned (the guy being blown), the risk of contracting HIV is also low. However, the risk of catching a dose of the clap or a case of syphilis is significant. While the giver would get these in the mouth, the givee would likely find the point of infection on the penis. Herpes can also be spread in this way.

Sex is a game that most adults love to play and, like other sports, it has risks. We are most consistent in our behaviour if we determine our guidelines and stick to them, rather than deciding on a case-by-case basis.

If we want completely safe sex, we can choose masturbation, phone sex, and porn. Once we venture further, we have to weigh our pleasure/danger odds and behave in our own best interests — or not.

The latest research on sexually transmitted infections is ever changing. We cannot stay current all of the time.

Right now, alarming numbers of gay men in San Francisco and Boston are falling prey to a mysterious, new treatment-resistant bacteria. The cautious would assume all strangers have everything and behave accordingly.

Too few sexual partners have a safe sex talk prior to getting down, and anyway, people lie. Passion is a powerful disinhibitor. We would much rather think about heat — or heart — when we should be discussing lab results. How can we trust ourselves not to have a personal rule about sexual conduct?

Perhaps we balk because we rebel against sexual rules. We do not want anyone — even symbolically — telling us what we can or cannot do with our bodies.

Understandable, but off-point. We hurt only ourselves by rebelling against latex.

The core of the issue is personal responsibility. Once we decide how much danger we will tolerate for how much pleasure, sex with strangers need not generate anxiety.

Eroticize latex, choose your partners and behaviours intentionally, be tested regularly, stick to your personal contract. And have fun.