About Sexually Transmitted Infections (STIs) and Oral Sex

What is oral sex?

Oral sex involves using the mouth to stimulate the genitals or genital area of a sex partner. Types of oral sex include the penis (fellatio), vagina (cunnilingus), and anus (anilingus).

What may increase the chances of giving or getting a sexually transmitted infection (STI) through oral sex?

Certain factors may increase your chances of getting human immunodeficiency virus (HIV) or other sexually transmitted infections (STIs) during oral sex if exposed to an infected partner. Factors like:

• poor oral health, which can include tooth decay, gum disease or bleeding gums, and oral cancer;
• sores in the mouth or on the genitals; and
• exposure to “pre-cum” or “cum” (pre-ejaculate or ejaculate).

However, there are no scientific studies that show whether these factors increase the risk of getting human immunodeficiency virus (HIV) infection or sexually transmitted infections (STIs) from oral sex.

Which sexually transmitted infections (STIs) can be passed on from oral sex?

• Herpes
• Syphilis
• Chlamydia
• Gonorrhea
• Human Papillomavirus (HPV)
• Human Immunodeficiency Virus (HIV) Infection

Can sexually transmitted infections (STIs) spread during oral sex?

Yes; many sexually transmitted infections (STIs) and other infections are spread through oral sex. Anyone exposed to an infected partner can get a sexually transmitted infection (STI) in the mouth, throat, genitals, or rectum. The risk of getting a sexually transmitted infection (STI) or spreading a sexually transmitted infection (STI) to others through oral sex depends on several things, including the particular sexually transmitted infection (STI), type of sex, and number of sex acts performed.

In general:

• It is possible to get some sexually transmitted infections (STIs) in the mouth or throat after giving oral sex to a partner who has a genital or anal/rectal sexually transmitted infection (STI).
• It is possible to get certain sexually transmitted infections (STIs) on the genitals and genital areas after receiving oral sex from a partner with a mouth or throat infection.
• It is possible to have a sexually transmitted infection (STI) in more than one (1) area at the same time. For example, you can have a sexually transmitted infection (STI) in the throat and the genitals.
• Several sexually transmitted infections (STIs) (i.e., syphilis, gonorrhea, and intestinal infections) that are transmitted by oral sex can spread in the body.
• Oral sex involving the anus (or anilingus) can transmit intestinal parasites (like Giardia) and bacteria (like Shigella).
• If you have a sexually transmitted infection (STI), you might not know it because many sexually transmitted infections (STIs) are symptomless. It is possible to spread sexually transmitted infections (STIs) even when you do not have any signs or symptoms.

Is oral sex safer than vaginal or anal sex?

• It is difficult to compare the risks of getting specific sexually transmitted infections (STIs) from specific types of sexual activity, because most people who have oral sex also have vaginal or anal sex.
• Few studies look at the risks of getting sexually transmitted infections (STIs), other than human immunodeficiency virus (HIV), from giving oral sex on the vagina or anus, compared to the penis.
• Studies show the risk of getting human immunodeficiency virus (HIV) from oral sex (giving or receiving) with a partner who has the infection is much lower than the risk of getting human immunodeficiency virus (HIV) from anal or vaginal sex. This may not be true for other sexually transmitted infections (STIs).
• In a study of gay men with syphilis, one (1) out of five (5) reported having only oral sex.
• Getting human immunodeficiency virus (HIV) infection from oral sex may be extremely low, but it is hard to know the exact risk. If you are having oral sex, you should protect yourself.
• It is possible that getting certain sexually transmitted infections (STIs) in the throat (like chlamydia or gonorrhea) may not be as harmful as getting a sexually transmitted infection (STI) in the genital area or rectum. Having these infections in the throat might increase the risk of getting human immunodeficiency virus (HIV) infection. Having gonorrhea in the throat may also lead to the spread of disease throughout the body.
  • Having infections of chlamydia and gonorrhea in the throat may make it easier to spread these infections to others through oral sex. This is especially important for gonorrhea, since throat infections can be harder to treat.
  • Infections from certain sexually transmitted infections (STIs), such as syphilis and human immunodeficiency virus (HIV) infection, spread throughout the body. Therefore, infections acquired in the throat may lead to the same health problems as infections acquired in the genitals or rectum.
  • Mouth and throat infections by certain types of human papillomavirus (HPV) may develop into oral or neck cancer.

What can I do to prevent the transmission of sexually transmitted infections (STIs) during oral sex?

You can lower your chances of giving or getting sexually transmitted infections (STIs) during oral sex. Use a condom, dental dam, or other barrier methods every time you have oral sex.

For oral sex on the penis:

• cover the penis with a non-lubricated latex condom; and
• use plastic (polyurethane) condoms if you or your partner is allergic to latex.

For oral sex on the vagina or anus:

• use a dental dam; and
• cut open a condom to make a square and put it between your mouth and the vagina or anus of your partner.

The only way to avoid sexually transmitted infections (STIs) is to not have vaginal, anal, or oral sex.

If you are having sex, you can lower your chances of getting a sexually transmitted infection (STI) by:

• being in a long-term, mutually-monogamous relationship with a partner who does not have a sexually transmitted infection (STI); and
• using condoms (the right way) every time you have sex.

It is important to remember that many people with a sexually transmitted infection (STI) may be unaware of their infection. Sexually transmitted infections (STIs) often have no symptoms and are unrecognized.

If you are having sex, ask your healthcare provider to test you regularly for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) infection. Talk openly with your provider about activities that might put you at-risk for a sexually transmitted infection (STI), including oral sex. You also should talk to your partner about sexually transmitted infections (STIs).