Oral sex and hiv risk reduction: Perceived risk, behaviors, and strategies among young hiv negative gay men

The potential HIV transmission risk associated with unprotected oral receptive intercourse continues to be an area of confusion and concern for HIV negative sexually active gay men. To assess this issue, we closely examined the perceptions of 20 ethnically diverse, young (ages 18 to 30) HIV negative gay men in New York City with regard to HIV transmission through unprotected receptive oral intercourse and contrasted these perceptions with their sexual behaviors. Data were collected using in-depth qualitative interviews emphasizing two sexual narratives, which were analyzed using techniques of grounded theory. The participants consistently indicated perceptions of HIV transmission risk and anxiety associated with unprotected receptive oral intercourse. Regardless of their perceived risk or their anxiety attributed to unprotected receptive oral intercourse, this sexual behavior represented a common form of sexual interaction between young gay and bisexual men. This reality is complicated by the fact that many of these men reported unprotected receptive oral intercourse in the context of harm reduction techniques based on faulty or mythological reasoning regarding the transmission of HIV through oral intercourse. Findings suggest that AIDS prevention efforts should be targeted towards correcting misconceptions regarding HIV transmission through unprotected receptive oral intercourse by providing clear and accurate information about the transmissibility of HIV through oral sex.