HPV and cancer risk associated with giving unprotected oral sex

[stardust]

I have some data and I am having trouble linking it all together.

Risk factors:
* Sex partners who have been together for many years tend to share HPV regardless of condom use.
* Having multiple partners increases the risk of contracting HPV.
* A relatively large cohort study of heterosexual couples found that when someone's partner had oral HPV, they had a high risk of being diagnosed with oral HPV themselves, which speaks to the probability of transmission from kissing.
* Oral malignancies are the most common HPV-related cancer (37.3 percent).

Constraints:
* Condom use only partially reduces the risk of transmission.
* Having multiple partners does not necessarily increase the risk of developing cancer, as it is not well established if all strains cause cancer.
* Preliminary data indicates that across the entire US population, the incidence rate of cancer from HPV is rare by itself and when compared to the incidence rate of people with HPV infections.
* The vaccine is effective in prevention of acquiring a select few strains.
* Tests are not FDA-approved (read: widely available) for the mouth and throat.
* Correlation between non-sexual activities (such as sharing cups) and oral infection has not been made.

I am thinking that if one were to be cautious, they would want to wait until they have known a sexual partner long enough to have been given their sexual history. Avoidance of partners who show profound shame over their sexual past to may reduce the risk of being lied to. If the number of persons they have received unprotected oral sex from is very high, it is worthwhile to prolong condom use when performing oral sex on them until confident that they will be an active partner for many years to come.

However, I am curious and would like to act reasonably rather than being ignorantly or unjustifiably overcautious. Is there data that I am missing? Given the state of research on the subject, the quantifiable risk seems to be fuzzy and imprecise. Given what is currently known of the risk for cancer from oral HPV infection, is it rational to accept the risk with respect to performing unprotected sex?

Indeed, this is a loaded question as it does not consider the other diseases that can be acquired, however their respective transmission risks are established as being very low and in cases of bacteria, can be further reduced by not allowing semen into the mouth. I have seen staff here perform risk analysis and would very much appreciate the help on that front.

[Heather]

Happy to help.

You know, I think the main thing at hand here is what YOU want to do based on what level of risk YOU feel you are or are not comfortable with. Then, obviously, you'll have to find out how any sexual partner feels about this, too, and take it from there.

There's just never going to be any solid, totally objective answer with things like this about what is or isn't reasonable, because this is really about what you want for yourself and then parters want, with anyone's more stringent limit always winning. It also can be a bit tricky to do in the abstract, because you're not likely to feel exactly the same about every single sexual partner, and that's likely going to be based on more than just sexual exclusivity and how long you have known them, you know?

So, let's start here: where are you at with this right now? Are you seeing someone where you're deciding about this? If not, are you not seeing/having sex with anyone right now? And if that's the case, how about we address what's then going to be most relevant for you and applicable for you for a while, which is deciding this with new partners?