If we truly care about our young people we should not prohibit professional counselors from cautioning against practices as described in the following medical journal article retrieved from the National Library of Medicine of the United States Public Health Service.  

Beyond Anal Sex: Sexual Practices among MSM and Associations with HIV and Other Sexually Transmitted Infections

Cara E. Rice, PhD, MPH1, Courtney Maierhofer, MPH2, Karen S. Fields, BSN3, Melissa Ervin, MT (ASCP)3, Stephanie T. Lanza, PhD1, and Abigail Norris Turner, PhD, MPH2 1Department of Biobehavioral Health, The Methodology Center, College of Health and Human Development, The Pennsylvania State University, University Park, PA, USA

2Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, OH, USA

3Sexual Health Clinic, Columbus Public Health, Columbus, OH, USA

J Sex Med. 2016 March ; 13(3): 374–382. doi:10.1016/j.jsxm.2016.01.001

Abstract Aim—Unprotected anal intercourse is often used as a single indicator of risky behavior among men who have sex with men (MSM), yet MSM engage in a variety of behaviors which have unknown associations with sexually transmitted infection (STI) and HIV. We assessed the prevalence of a wide range of sexual behaviors as well as their associations with prevalent STI and HIV.

Methods—We used a standardized, self-administered survey to collect behavioral data for this cross-sectional study of 235 MSM seeking care in a public STD clinic. Using modified Poisson regression, we generated unadjusted and adjusted prevalence ratios (PRs) to characterize associations between recent participation in each behavior and prevalent STI and HIV.

Results—Participants’ median age was 26 years. One-third (35%) were STI-positive. STI prevalence was significantly associated with using sex slings (adjusted prevalence ratio (aPR): 2.35), felching (aPR: 2.22), group sex (aPR: 1.86), fisting (aPR: 1.78), anonymous sex (aPR: 1.51), and sex toys (aPR: 1.46). HIV prevalence was 17% and was significantly associated with fisting (aPR: 4.75), felching (aPR: 4.22), enemas (aPR: 3.65), and group sex (aPR: 1.92).

Conclusions—Multiple behaviors were significantly associated with prevalent STI and HIV in adjusted analyses. To provide a more comprehensive understanding of sexual risk among MSM, prospective studies are needed to examine whether these behaviors are causally associated with HIV/STI acquisition.

HHS Public Access Author manuscript J Sex Med. Author manuscript; available in PMC 2017 March 01.