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The other night, I was deep-throating a friend when I felt a nostalgic pang for a more innocent time — earlier that afternoon, before I'd seen this headline:

VIRUS SPREAD BY ORAL SEX IS LINKED TO THROAT CANCER

The story, on washingtonpost.com, was about a study published in the May 10 edition of the New England Journal of Medicine about human papillomavirus, or HPV. The virus comes in more than a hundred varieties, about thirty of which are sexually transmitted and widespread. A handful of these cause anogenital warts and most cases of cervical and anogenital cancer.

Researchers have long suspected a connection between HPV and certain cancers of the throat. But the new study put to rest any doubt about the relationship, finding that exposure to the variant HPV-16 increases the odds of coming down with oropharyngeal cancer by thirty-two times.

Scary sex headlines are nothing new to me. I was a year or two away from losing my virginity when I learned from the San Francisco Chronicle that AIDS was sexually transmitted. And I've always known that oral sex is an efficient way of contracting herpes, syphilis, gonorrhea and Chlamydia.

Still, as I went down on this guy, I felt the epidemiological rug being pulled out from under me. Some inner voice was protesting that oral sex was supposed to be safe. The voice was repeating what AIDS educators have drummed into my head since I was a high school freshman.

"Oral sex, oral sex, oral sex — that's what the HIV-prevention message is about," said an STD and HIV counselor in San Francisco who asked to remain anonymous because she wasn't authorized to speak to a reporter. "It's about practicing the safest sex you can have with respect to HIV. STD counseling is a totally different harm-reduction message."

In some cases, HIV counselors are preaching the oral-sex gospel to unfortunate extremes. Two people in my circle of friends were recently told by a counselor at San Francisco's lauded STD clinic, the Magnet center, that they could gargle with HIV-positive semen and not worry about getting infected.

But even if individual counselors are prone to exaggeration, who can blame the AIDS-education machine for selling oral? While researchers have linked individual cases of HIV transmission to oral sex, the five-year HIV Oral Transmission Study reported in 2003 that zero percent of 239 male participants contracted HIV through fellatio. Other studies have supported this suggestion that it's pretty tough to get the virus via blowjob.

Publication of the throat-cancer study comes as the medical establishment, governments and the general public are paying attention to HPV's cancer implications. Last year, the FDA approved Gardasil, a vaccine from Merck that targets four strains of HPV that together are responsible for ninety percent of genital warts and seventy percent of HPV-related cancers. But the approval came only for girls and women aged nine to twenty-six. (Subjects are still being recruited for studies of the vaccine's effectiveness in men.)

So what's an oral enthusiast outside that category to do with the latest news? Approval of an HPV vaccine for men is months if not years away, assuming it comes at all. And because the vaccine is only effective when administered prior to HPV exposure, it's doubtful that someone with a sexual history would even benefit from it. Most of us are going to have to wait for the next medical breakthrough before we have any more protection against HPV than our cavemen ancestors did.

Let me put that blowjob on pause one last time to check in with one more medical authority. Jeff Klausner is the director of STD prevention and control services for the San Francisco Department of Public Health, the medical director of the city's STD clinic, a professor of medicine at UCSF's division of infectious diseases and AIDS & oncology, and the president of California's STD Controllers' Association. If anyone is responsible for the safer-sex message in my neck of the woods, it's Dr. Klausner.

"Oral cancer is still a rare disease," he said in response to the study findings. "And oral sex is quite common. People need to be aware of the risk, but in the context that that outcome is very uncommon."

To get an idea of how uncommon cancer of the throat actually is, I called the CDC. They had just published their cancer statistics for the year 2003, during which there were 2.6 cases of tonsil cancer per 100,000 men, and 0.6 cases per 100,000 women. (The numbers for tongue cancer were higher, but those included cancers firmly associated with smoking and drinking.)

In the same period there were 541.8 cases of cancer generally per 100,000 men, and 403.6 per 100,000 women. There were also 38,252 traffic fatalities, or about 13 per 100,000. About half of the mouth-cancer patients were still alive five years later. All of the traffic-fatalities were still dead.

In the end, after weighing what I know and what I've done and what I like to do, I resolved to wear my seatbelt and keep sucking dick.  n°

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