Fisting, Risk, and What Harm Reduction Actually Means

One of the things I've noticed over the years is that people often misunderstand what harm reduction actually means.

Sometimes it's interpreted as encouraging risky behavior. Other times it's dismissed as "not being careful enough." But that's never been my understanding of it.

To me, harm reduction starts with a simple idea: people deserve accurate information, practical tools, and compassionate support, regardless of the choices they make.

Recently, I came across a study looking at the sexual health of men who engage in FF. As you might expect, the researchers found higher rates of HIV and other STIs within that group. That doesn't necessarily mean FF itself is the cause. Like many findings in sexual health research, multiple factors can overlap, making the picture much more nuanced than a single behavior alone.

What caught my attention wasn't the increased risk. It was that the same group was also significantly more likely to be using PrEP, using or expressing interest in DoxyPEP, and getting tested for STIs regularly.

To me, that's what harm reduction looks like.

It acknowledges that some sexual practices carry different risks while also recognizing that many people are actively taking steps to reduce those risks. Those two realities can exist at the same time.

I think that's an important distinction because conversations around FF often become very black and white. Either it's portrayed as something reckless that nobody should do, or people avoid talking about the risks altogether.

I've always believed education sits somewhere in the middle. It's possible to have honest conversations about injury, STI transmission, communication, anatomy, gloves, lubrication, and biomedical tools like PrEP and DoxyPEP without shame or fear becoming the center of the conversation. I think that's how people make better decisions.

One thing I appreciated about this study is that the authors didn't simply call for more warnings. They argued for more nuanced, affirming public health guidance that recognizes fisting as its own distinct practice with specific educational and prevention needs.

That resonated with me because it's also a big part of why I continue doing this work.

The goal has never been to convince everyone that fisting is for them. It's to make sure that people who are curious, exploring, or already participating have access to thoughtful, evidence-based information that helps them navigate it more safely.

To me, that's what education is for.

—Danny Mercer

If you'd like to read the study that inspired this week's reflection:

Carpino, T., McCormack, M., & Wignall, L. (2026). Sexual health outcomes and biomedical prevention behaviors among men who have sex with men engaging in fisting. Sexual Medicine, 14(4), qfag032. https://doi.org/10.1093/sexmed/qfag032