Safe Sex Question About "Pulling Out"

[jackboy48]

I signed up for a series of 6 weekly discussions about developing new relationships, and last week we discussed our own standards for safe sex practices. One of the group leaders stated that if someone refused to wear a condom during anal sex, he might reduce the risk of HIV transmission by pulling out before ejaculation. I objected and it turned into a rather heated exchange. The group leader is a therapist and does counseling with HIV infected men. He also stated there was "scientific" proof supporting his claim. I was incredulous in disbelief. Since then I have tried to do some research and cannot find any "scientific" study that even addresses this issue for the last few years. I did find that the practice is mentioned as a manner of reducing the risk by several groups that counsel and educate gay men. The CDC and NIH sites seem to condem this practice for obvious reasons, but the last survey that I could find on the subject is dated, and was from 1997 in San Francisco. So, is this true? Is "pulling out" before ejaculation ever recommended, considering "pre-cum," microscopic skin tears, as well as the sexual mastery required to "pull out" and have both parties be satisfied?

[Guest Merlin]

Pre-cum is said to contain the virus, and, IMO, pulling out is not safe for the bottom. Since anal sex is also not safe for the top, that should be a complete answer. I should point out that uncircumcised tops are at greater risk that those who are cut. The skin on the head and inside the foreskin is thinner and susceptible to microscopic tears and cuts.

[josephga]

pulling out is not safe. also like merlin2 said uncut guys are at a higher risk. imo people that don't want to wear condoms are just lazy

[Bob]

I don't think they are lazy. They just don't get pleasure while wearing a condom. I have never achieved ejaculation while wearing one. Pulling out is probably not safe in most cases since the moment of ejaculation cannot be scheduled with total certainty. Sometimes I just explode most unexpectedly.

[+ deej]

Pulling out is roughly as effective in preventing disease as it is in preventing pregnancy, i.e. not very. "I promise I'll pull out" is right up there with "I won't cum in your mouth". Every teenage boy promises it when their girlfriend is *almost* willing, and he *almost* remembers during the deed.

 

It's just not worth the risk. Wrap it up!

[traveler1954]

Pulling Out

 

Pulling out will not help the top cut his risk for getting HIV especially if he is uncircumcised.

 

Pulling out may theoretically cut the risk, but not eliminate it, for the bottom, since the viral count left in the rectum will be less. A certain minimum number of virus particles, bacteria, protozoa etc. are needed to establish an infection. But you are still playing with fire.

[Guest countryboywny]

How many teenage girls ended up pregnant when their boyfriends "pulled out"?

[doitb4ugo]

I believe I got my HIV from this very activity....The guy only fucked me for a few minutes and then pulled out....From my perspective it was definitely unsafe....enjoyable but unsafe.

[whipped guy]

I personally find it incredulous that a group leader/therapist would make such a claim regarding “scientific” proof… Of course there is something called “junk science” where the so-called scientific data are manipulated to deliver the desired result with all statistical logic and reasoning thrown out the door… I would bet that just might be the case here… if indeed such a “study” were even done...

 

At any rate, I agree with the responses above… and most of them involve simple common sense that transcends any “scientific facts”…

[josephga]

I believe I got my HIV from this very activity....The guy only fucked me for a few minutes and then pulled out....From my perspective it was definitely unsafe....enjoyable but unsafe.

 

When you mentioned this in another thread that was the first thing that popped into my head that's when it happen

[uwsman2]

Where is that counselor getting his information? It's totally screwed up. For infected people who are not taking protease inhibitors in the currently fashionable cocktails, virus may be present in high concentrations in pre-cum, presenting a big risk to the bottom. Screwing without a condom is not safe, period.

 

Back in the "old days" before safe sex, I was an enthusiastic top. What I discovered was that I can't stay hard with a condom. I've tried and tried and it never seemed to work. I guess that psychologically I associated condoms with HIV, and the mere thought of HIV shrinks my willy. So I became a bottom, and learned to be an enthusiastic one at that. But I always insist that the top wrap it up!

[josephga]

I can't cum with a condom on either. However condoms don't bother me I don't know of life without them. I normally just pull out once the bottom reaches orgasm pull off the condom and jerk off or let them blow me..

[JT Brooklyn]

"Oh I'll pull out" the guy said! This type should NEVER be let in!

[Guest verymarried]

Does anyone know someone who has gotten HIV from oral sex? I have read the warnings - that sores and other infection in the mouth make oral sex unsafe.

[Steven_Draker]

One of the group leaders stated that if someone refused to wear a condom during anal sex, he might reduce the risk of HIV transmission by pulling out before ejaculation. I objected and ...

 

I think the group leader isn't wrong, however one have to clarify and complete that statement: pulling out (coitus interruptus) MIGHT reduce the risk of HIV transmission COMPARED to ejaculating inside. On the scale of HIV risk-taking behavior pulling out is considered high risk.

 

The following article might be of interest as it sheds some light on the subject.

 

Abstract:

Many people do not use condoms during sexual intercourse. In so doing, they may expose themselves to infection with HIV. Alternative risk reduction techniques are therefore needed for these people. So far, only the vaginal use of spermicides has been considered publicly as a possible option, although it has yet to be shown to be safe and effective. There are scattered reports from North America, Europe, and Australia that in some male-male and male-female couples where the insertive male partner may or definitely have HIV, the couples choose to avoid ejaculation into the receptive partners' bodies rather than use condoms. This approach is applied during vaginal and anal intercourse, as well as oral sex, in hopes of reducing the chance of HIV transmission. The preventive effectiveness of this practice is far from proven. Coitus interruptus would be a viable possibility only if HIV is not likely to be transmitted in other fluids such as the pre-ejaculate released in the urethra during arousal and before ejaculation. Pudney et al and Ilaria et al, however, reported in their two small studies finding HIV in the pre-ejaculatory fluid of some evaluated HIV-seropositive subjects. They therefore conclude that this fluid should be regarded as potentially infectious. Even vasectomized men can transmit HIV; it should therefore be clear that transmission is not dependent upon the release of semen. On the other hand, one recent study of 122 heterosexual HIV-discordant couples reported at the 1993 Berlin AIDS Conference, yet still unpublished, suggests that withdrawal does significantly reduce the risk of HIV transmission. It was found among these couples who used condoms irregularly that symptomatic HIV-related illness, sexually transmitted disease, and ejaculation affected the risk of transmission. In so far as ejaculation was concerned, seroconversion over two years was highest among women whose infected partners nearly always ejaculated, far lower when the men ejaculated in about half of sexual contacts, and nonexistent for those whose partners did not ejaculate inside them. There was also no seroconversion among partners in 123 couples who always used condoms during this period. For now, epidemiological evidence and available basic physiological information are too scant to responsibly recommend withdrawal to sexually active couples as a means of preventing HIV transmission.

 

source: http://www.k4health.org/popline/coitus-interruptus-could-it-reduce-risk-hiv-transmission

[traveler1954]

I can't cum with a condom on either. However condoms don't bother me I don't know of life without them. I normally just pull out once the bottom reaches orgasm pull off the condom and jerk off or let them blow me..

 

I m another guy who cannot stay hard or cum with a condom. Fuck!

[whipped guy]

I think the group leader isn't wrong...

If he indeed used the word MIGHT he probably is not technically totally wrong... but... and a very big BUT... he did not help matters with his statement... and in fact did the group a disservice.

[seeker630]

Sort of like playing Russian roulette with 'only' 4 rounds in the chambers instead of 5.

[Phil_musc]

While I am by no means advocating for pull out as a safe sex alternative, the study in Steven's posting seems to indicate that it is in fact a viable means of safe sex. The study seems to be saying that in sero-discordant couples, in no instance where the inserting person never ejaculated and always pulled out was there a seroconversion for the receptive party. The wording is "non-existent" - that seems pretty definitive to me. The study goes on to say that no discordant couples changed their status with the use of condoms; but that is muddying the issue, since sex with condoms is about the safest you can get and still indulge in anal sex. Unless I'm misreading this, they seem to be saying pulling out is safe. The only issue then is remembering to pull out. Granted, the stakes are high here and there is an awful of trust that enters into this. But the study ran for two years, long enough for a conversion to take place and none did where there was no ejaculation.

[+ purplekow]

Phil i believe you hit the main point, "when there was no ejaculation". Unfortunately not all are adept at stopping the ejaculation prior to pulling out. The Time to do so is less than with a condom, that is pulling out and using a condom. In addition, critically reading the analysis you find three groups within a total group of 122, or about 40 per group. Highest rate of infection among sporadic condom users with ejaculation almost all the time. Less common infection if the partner ejaculated infrequently. Now as to the last group, no seroconversion in the group when ejaculation did not occur. There is no information as to how many times ejaculations happened in that group. There is similarly is no documentation as to how many times it happened in the other groups. There clearly is a risk of HIV transmission HIV transmission with ejaculation, but to say there is no risk because of the pulling out, you would need to compare the number of pull outs in each group and then perform a statistical analysis. One sero conversion in the second group is not likely to be statistically significant in a small group of 40 over a long period of time. Too many other factors are involved. The best one can say here is: Pulling out and not ejaculating may be safer than pulling out with ejaculation and that there seems to be a relationship between the number of ejaculations and how likely there is to be transmission. The fact is, these groups are too small to make a blanket statement about safety and since it was done in 1993, it would seem that a definitive study would have been done if there was a real consideration that pulling out was as safe as a condom.

[Phil_musc]

OK, but you seem to be creating a new sub-group here: pull out with no ejaculation as one group and pull out with ejaculation as another group. The operative concept here is pulling out. What isn't clear to me in the division is in the second category - pull out with ejaculation - does this mean pull out after the fact of ejaculation (which seems like locking up the barn after the horse has been stolen). Nevertheless, the study says that NO sero-conversions took place with the the pulling out group (I can only guess that they are talking about pulling out before ejaculation - otherwise what's the point of pulling out?). Yes, this is a small study and we don't have the statistical break-down of how many were in each group. But it does seem to indicate that pulling out without ejaculating is hardly in the same classification as full bareback sex to orgasm. The point was raised in an earlier post about pre-cum being a vessel for carrying HIV and as such pulling out before orgasm should have resulted in some sero-conversion. That did not happen in this study.

[whipped guy]

... since (the study) was done in 1993, it would seem that a definitive study would have been done if there was a real consideration that pulling out was as safe as a condom.

Exactly.

 

May the gods help us if our health care providers and advisers are using research and techniques that are similarly as old...

[Steven_Draker]

If he indeed used the word MIGHT he probably is not technically totally wrong... but... and a very big BUT... he did not help matters with his statement... and in fact did the group a disservice.

 

I concur, WG. He did a disservice to the group.

 

Let me briefly clarify that I DO NOT condone pulling out/withdrawal/coitus interruptus as a safe practice. I exposed the facts of the study and firmly believe that one should always wear a condom. The study ends with the following

 

For now, epidemiological evidence and available basic physiological information are too scant to responsibly recommend withdrawal to sexually active couples as a means of preventing HIV transmission.

 

And since I'm not a MD or health professional, I'll shut the f**k up now.

[whipped guy]

I DO NOT condone pulling out/withdrawal/coitus interruptus as a safe practice...the study ends with the following

Steven... I applaud you for mentioning that... Plus I am positive that the bold print in your original post was your idea as well... Even in bold type some people still seem to read into things that which they want to believe... and that is fine... but...

[+ purplekow]

The study cited actually made the divisions Group one Frequent ejaculation Group two Occasional ejaculation Group 3 No ejaculation Based i guess on how successful the participant was in getting out of town on time.

 

As to your last sentence, phil, the study sample is small and therefore one should not expect seroconversion. For example, needle sticks from HIV positive patients cause transmission in untreated individuals about once in in every 200 needle sticks. Clearly needle sticks from HIV negative individuals do not cause seroconversion at all. Still,statistically speaking, on could have hudreds of needle sticks without a seroconversion in the HIV positive group. Rate of infection and number of incidents need to be reported in order to make any sense of the numbers. In the brief review of this study which was presented here, no numbers were given and as a result one should not presume statistical significance.