Oral sex may be important risk factor for HIV infection
A study of homosexual men living in San Francisco who were
recently infected with HIV-1 suggests that in about 7% of cases
the virus was likely to have been
transmitted during oral sex.
Dr Frederick Hecht of the
University of California, San Francisco, and colleagues there and at
the Centers for Disease Control
and Prevention (CDC) in Atlanta
evaluated 122 people recently
diagnosed with HIV-1 infection
who were presumed to have
acquired their infection between
June 1996 and June 1999. They
tried to determine how the men
contracted the disease.
The exhibition Body World (Koerperwelten), opened on 11
February in Cologne, consists of anatomical specimens made from
plastic. It attracted controversy when it was previously shown in
Mannheim and Basle, with critics claiming that it dehumanised
people. (INSTITUT FÜR PLASTINATION)
The researchers used a new
HIV testing method that makes
it possible to determine if an
individual has been recently
infected. The subjects were interviewed in unusual depth and,
whenever possible, excluded
from the "oral sex" category.
Of all the cases, researchers
determined that 20 were potentially acquired through oral sex.
On further evaluation, and elimination of cases in which HIV-1
transmission may have occurred
through another means, the
researchers classified eight cases
(7%) as probably due to oral
transmission.
All eight cases were men
who reported that they thought
oral sex carried no risk or only
minimal risk of transmission. "I
think this is the best data available to date," said Dr Robert
Janssen, director of the division
of HIV/AIDS prevention at the
CDC. He added: "I think it reinforces what we've said already -
which is that condoms should
be used for whatever type of sex
you have."
Earlier research suggested
that HIV transmission was possible during oral sex, but the new
study is being received as the
strongest evidence that it may
actually occur at a significant rate.
The new findings, which are
based on retrospective data and
subject to recall bias, may not
resolve the question entirely.
None the less, the researchers
concluded that, even though oral
sex was associated with a lower
risk of transmission than were
other sexual behaviours, it might
be an important mode of transmission because of its frequency.
The results were presented at
the recent 7th conference on
retroviruses and opportunistic
infections in San Francisco.
Scott Gottlieb, New York
studentBMJ 2000;08:45-88 March ISSN 0966-6494
