12/23/2013 10:11 am ET Updated Dec 06, 2017

Hey CDC, You Can Suck My...

Great news. The Centers for Disease Control (CDC) finally updated their fact sheet titled "Oral Sex and HIV Risk." I won't quibble about the first bullet: "The risk of HIV transmission through oral sex is much less than that from anal or vaginal sex -- but it is not zero."

I'd prefer if it said "much, much, much less," but epidemiologists never write like that. The best website outlining the risks of oral sex is on the always excellent NAM, based in the U.K. (see their fact sheet titled "Oral Sex").

It was the next bullet I wasn't happy with: "Performing oral sex on an HIV-infected man, with ejaculation, is the riskiest oral sex activity."

While technically true, this is infuriating for what it leaves out. It seems to assume folks can know who is not "HIV-infected." It also fails to mention treatment as prevention, or the implications of an undetectable viral load (the Aidsmap website thankfully does mention this).

2013-12-22-SafeSex.jpgI'm HIV positive, and I've been on treatment and consistently undetectable for many years. Whose dick is riskier to suck -- mine, or the guy telling you he's HIV negative on Grindr? He might even think he's negative, but became infected shortly after his last HIV test, and therefore has a viral load count through the roof. Even if he tested last week, he could be newly infected during the "window period" before an HIV test can find antibodies needed for a positive result.

Bottom line: You can't have safer oral sex with a "negative" guy because you can never know for certain that he is in fact negative. Any sexually active guy claiming to be negative could potentially have a higher viral load, and thus be more infectious, than most HIV positive guys on effective treatment.

Don't get me wrong -- we can't say there's zero risk when giving a blow-job to an HIV positive, undetectable man. There haven't been any reported cases of this happening, and only one reported case of it happening during unprotected anal sex. Undetectable viral load in the blood doesn't always mean undetectable in semen, and viral load "blips" could marginally increase risk. But little in life carries zero risk. Over 15,000 Americans die from AIDS every year, while 26,000 die from accidental falls, mostly at home. Good luck eliminating all risk in your life.

The one bullet the CDC definitely got right highlights common sense oral sex safety tips: "Factors that may increase the risk of HIV transmission through oral sex are oral ulcers, bleeding gums, genital sores and the presence of other sexually transmitted infections."

Translation: If your mouth isn't in good health, give it a break.