Perugia is a college town, is it a good place to learn extreme sex?

When Meredith Kercher was found dead, the Italian girls who lived in her flat called their lawyers and Kerchers British friends fled Italy and went back to the U.K.

It appears that Amanda Knox made a big mistake by staying in Italy, which has some of the highest numbers of extreme-sex aficionados in Europe, according to a poll by La Repubblica newspaper.

When Amanda came to Italy, her knowledge of sexuality was limited to the vanilla sex she had some experiance in. Her hometown in Washington state is a puritanically minded middle class community in which extreme sex is only understood by a perverted minority.

Amanda thought Meredith was killed by some horrible criminal who broke into the house and failed to realise that since she lived in the same household as Meredith, the rough sex Kercher perished during, might have been assumed to be business as usual, in that house.

When the police examined the crime scene it appeared to them to be another one of those sex games gone wrong they had read so much about.

Not to be confused with sexual predators who attack their victims, extreme-sex participants engage in risky, mutually consensual sex that they know could kill them if something goes wrong. One in 10 Italian couples practice “extreme sex,” which is defined as sex that could put one partner’s life at risk—and even those who aren’t doing things that could end in death are still risqué. Sixteen percent of Italian couples use masks and forms of bondage, and 5 percent admit to regularly engaging in mild sadomasochistic practices. Over half use erotic props in their usual sexual rapport. Just under 13 percent of the population has had sex with more than one person at a time, and slightly less than that have had group sex involving three or more partners.

Ayzad (he goes by only one name), author of A Guide to Extreme Eroticism published last year in Milan, told The Daily Beast that sexual extremism is a growing phenomenon across the globe primarily because of the Internet, which hosts thousands of websites and message boards where fetish fanatics can post their ideas and learn how to fulfill the most fringe erotic fantasies.

"I should have had the knife closer, as they suggest when practicing this type of bondage. By the time I found it, it was too late."

But the surge in high-risk sex has also led to an increase in accidental death when sex games go wrong. As many as 1,000 young men die each year of auto-erotic asphyxiation, or AEA, which is the practice of cutting off oxygen at the moment of orgasm to heighten the sensation. Michael Hutchence, the lead singer of INXS, allegedly died of an auto-erotic accident, as did Kung Fu star David Carradine. Only a few hundred women suffer the same fate. Many AEA deaths are called “suicide” since the victims are frequently found either hanging from a belt or rope or with a plastic bag over their heads. If a partner wasn’t involved, the victims are often found in the nude with pornography nearby.

But the real question is whether accidental death by orgasmic accident should be treated the same way as other accidental deaths. Every year there are hundreds of cases that make it to court. Last week a Swedish man was sentenced to 16 years in prison for “accidentally” killing a 17-year-old girl he met via the Internet. The girl had been strangled with a live electric cord during consensual sex. She had actually blogged about the thrill of the experience before the game turned fatal. In 2010, a Sicilian man accidentally killed his wife when they were playing with a pistol during an erotic session. He was not charged with murder but instead convicted of a lesser crime. The year before, a Transylvania woman died of electroshock when her husband upped the amps on their “sex battery” which was wired to her nipples and vagina. He was charged with involuntary manslaughter but is already out of prison. In the U.K., a new law prohibits any citizen from possessing “extreme pornography” in the form of photographs from necrophilia to bestiality. Offenders can face prison time of up to two years and hefty fines. But the law stops short of making it a crime to engage in acts that could cause death to a participant.

“Accidents in extreme sex are rare,” says Ayzad. “You understand right away if it is for you or not.” And even if it is, that might not be enough to keep you alive."