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      The Duality of Oral Sex for Men Who Have Sex with Men: An Examination Into the Increase of Sexually Transmitted Infections Amid the Age of HIV Prevention


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          Several studies suggest that the increase in sexually transmitted infections (STIs) among men who have sex with men (MSM) could be due, in part, to human immunodeficiency virus (HIV) risk reduction strategies, which include engaging in oral sex over anal sex. The aims of this study were to evaluate oral sex behaviors and STI diagnoses and to investigate the potential dual role of oral sex as being protective for HIV, yet perpetuating STI transmission among MSM. We analyzed records from 871 MSM presenting to the Rhode Island STI Clinic between 2012 and 2015. We compared outcomes in men engaging in two HIV protective oral sex behaviors: (1) HIV/STI outcomes by men engaging only in oral sex versus those that did not, and (2) HIV/STI outcomes by men engaging in condomless oral sex with 100% condom use for all other sex acts versus those that did not. Men engaging in HIV protective oral sex behaviors were more likely to be HIV negative compared to men not engaging in them (99% vs. 93%, p < 0.01). In contrast, there was no significant difference in STI diagnoses between those that engaged in HIV protective oral sex behaviors and those that did not. The findings provide evidence to support the unique duality of oral sex: decreased risk for HIV and perpetuation of STI risk. Promotion of routine STI testing, including extragenital sites, is critical to address STI prevention among MSM. In the age of HIV prevention, addressing the ambiguous risks of discrete sex acts would be beneficial for both HIV and STI prevention education for MSM.

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          Author and article information

          AIDS Patient Care STDS
          AIDS Patient Care STDS
          AIDS Patient Care and STDs
          Mary Ann Liebert, Inc. (140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA )
          01 June 2017
          01 June 2017
          : 31
          : 6
          : 261-267
          [ 1 ]Department of Psychology, University of Miami , Coral Gables, Florida.
          [ 2 ]Department of Behavioral and Social Sciences, Brown University School of Public Health , Providence, Rhode Island.
          [ 3 ]Division of Infectious Diseases, The Miriam Hospital, Brown University , Providence, Rhode Island.
          Author notes
          Address correspondence to: Philip A. Chan, MD, Division of Infectious Diseases, The Miriam Hospital, Brown University 1125 North Main Street, Providence, RI 02906, E-mail: pchan@ 123456lifespan.org
          PMC5488256 PMC5488256 5488256 10.1089/apc.2017.0027
          Copyright 2017, Mary Ann Liebert, Inc.
          Page count
          Tables: 4, References: 39, Pages: 7
          Behavioral and Psychosocial Research

          HIV,MSM,oral sex,sexually transmitted infections,STIs,men who have sex with men


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