Is Oral Sex Really Safer Sex?

It is not uncommon for people to assume that oral sex is safer than vaginal or anal sex, but the truth is that condomless sex of any kind is inherently risky. In particular, the risk for sexually transmitted diseases (STDs) is high if you don't take the right precautions.

Learn more about common sexually transmitted diseases and the risks you may face if you have oral sex without condoms or other forms of barrier protection.

What to Know STIs and Oral Sex - Illustration by Laura Porter

Verywell / Laura Porter

HIV

The risk of getting HIV through oral sex is relatively low, particularly when compared to vaginal or anal sex.

With that said, the risk is largely confined to the person performing oral sex. Even so, the per exposure risk of infection is low, hovering at around 0.04%. This means that HIV might be passed on in one in 2,500 acts of oral sex.

Using external condoms, internal condoms, and dental dams are effective ways to reduce your chances of getting HIV through oral sex.

Preventing HIV With PrEP

One of the more effective ways to prevent HIV is with pre-exposure prophylaxis (PrEP). PrEP is a preventive strategy in which a daily antiretroviral pill can reduce your risk of getting HIV by as much as 99%. With that said, PrEP does not prevent other types of STDs.

Herpes

Oral herpes (cold sores) is usually caused by herpes simplex virus type 1 (HSV-1) and genital herpes is usually caused by herpes simplex virus type 2 (HSV-2). But it is possible to get genital herpes from a cold sore—and vice versa—while performing oral sex.

According to a study published in BMC Medicine, HSV-1 is responsible for more than half of new genital herpes cases.

Herpes can be passed through skin-to-skin contact even when there are no outward symptoms. While condoms can reduce the risk, people who use condoms consistently are only 30% less likely to get HSV-2 than those who use no condoms.

Preventive Herpes Therapy

It is possible to reduce the risk of herpes by taking a daily antiviral drug like Valtrex (valacyclovir). The practice is encouraged in couples for whom one partner has HSV-2 and the other does not.

Human Papillomavirus

It is possible to pass human papillomavirus (HPV) through oral sex. In fact, HPV transmitted through oral sex is considered a major risk factor for oral and throat cancers.

There is also evidence that oral HPV can be passed from mother to child during childbirth as the baby passes through the birth canal. You can even innoculate yourself with HPV by touching infected tissues on your genitals and then placing your fingers in your mouth.

As with herpes, condoms or dental dams can help reduce the risk of HPV but not eliminate it. This is because HPV, like herpes, spreads through skin-to-skin contact rather than through body fluids.

Gonorrhea

Gonorrhea is a bacterial STD that can be transmitted to the throat during oral-penile sex (also known as fellatio or a "blowjob"). Throat infections with gonorrhea—known as pharyngeal gonorrhea—are notoriously difficult to treat. Gonorrhea can be passed from the throat to the penis, albeit less commonly.

Giving or receiving oral-vaginal sex (cunnilingus) can also transmit gonorrhea, although the risk is compared to oral-penile sex. The same applies to oral-anal sex (rimming), although the risk is higher in some groups than in others.

Oral Gonorrhea in MSM

The rate of oral gonorrhea is especially high in men who have sex with men (MSM) Some studies suggest that up to 6.5% of MSM who seek treatment for an STD have pharyngeal gonorrhea.

External and internal condoms as well as dental dams are effective in preventing the transmission of gonorrhea during oral sex.

Chlamydia

It is possible to pass chlamydia through oral-penile sex, both to the person performing oral sex and the person receiving it. A 2020 study in BMC Medicine suggests that 13% of penile chlamydia cases in MSM are the result of oral sex.

While it is possible to transmit chlamydia through oral-vaginal sex and oral-anal sex, the risk is thought to be lower than with oral-penile sex.

The only exception may be among MSM with HIV, in whom the risk of anal chlamydia through rimming is double that of MSM without HIV.

As with gonorrhea, barrier protection like condoms and dental dams can significantly reduce the risk.

Syphilis

Syphilis is extremely easy to transmit via oral sex. In the United States, the per-act risk of syphilis through oral sex is around 1%—a significant number given the frequency of oral sex in young sexually active people.

Although syphilis can only be transmitted in the presence of symptoms, typically an open sore called a chancre, they can be easy to miss during the stages of the disease, particularly in the vagina, rectum, or under the foreskin of the penis.

Condoms and dental dams are considered essential for the prevention of syphilis through oral sex.

Hepatitis A and B

Hepatitis A can definitely be passed through rimming as the virus is present in the feces (stool) of people who have been infected. Hepatitis B can also be passed through oral sex given that the virus is present in blood, semen, and other bodily fluids.

With that said, hepatitis B is rarely passed through rimming and is more likely when coming into contact with mucus-secreting tissues like the vagina and those under the foreskin.

Hepatitis A and B Vaccination

Hepatitis A and B can be prevented by vaccines. If you practice rimming, speak with your healthcare provider about getting the hepatitis A vaccine. The hepatitis B vaccine is currently recommended for all children and unvaccinated adults 19 to 64. A combination hepatitis A/hepatitis B vaccine called Twinrix is also available.

Summary

Oral sex may be considered "safer" sex compared to anal or vaginal sex, but it is still an efficient way to pass sexually transmitted diseases like chlamydia, gonorrhea, hepatitis A, hepatitis B, herpes, human papillomavirus (HPV), and syphilis. The transmission of HIV by oral sex is considered rare but is theoretically possible.

External condoms, internal condoms, and dental dams can significantly (and sometimes greatly) reduce the risk of STDs through oral sex, but they are only partially effective in preventing oral transmission of herpes and HPV.

Hepatitis A and hepatitis B can be prevented with vaccines. People at risk of getting HIV can reduce their risk by taking a daily antiretroviral drug referred to as pre-exposure prophylaxis (PrEP).

A Word From Verywell

It is important to talk to your adolescents or teens about oral sex. Among some sexually active teens, oral sex is not considered "real" sex since you can't get pregnant and haven't "gone all the way." Beliefs like these account in part for the rising rates of chlamydia and gonorrhea in many high schools.

It is also important to advise teens—and anyone else who is sexually active—that having an STD increases the risk of HIV, in some cases by 200% to 300%.

Frequently Asked Questions

  • What are the signs and symptoms of STDs in the mouth?

    The signs and symptoms of oral STDs can vary but may include sores, blisters, white spots, sore throat, difficulty swallowing, redness in the mouth or throat, and swollen lymph nodes. But there may be no symptoms at all, which is why it's important to protect yourself with internal or external condoms and dental dams.

  • What are the best ways to practice safer oral sex?

    Barrier methods remain the best way to avoid STDs during oral sex. This includes external condoms, internal condoms, and dental dams. They are not 100% effective, especially with viruses like herpes and human papillomavirus (HPV), but are the best form of protection short of abstinence.

  • What increases the chances of getting an STD from oral sex?

    Risk factors that can increase the risk of STDs from oral sex include poor oral hygiene, ejaculating into the mouth, and having cuts, abrasions, or sores in the mouth or on the genitals

18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. Department of Health & Human Services. Preventing sexual transmission of HIV.

  2. Barré-Sinoussi F, Abdool Karim SS, Albert J, et al. Expert consensus statement on the science of HIV in the context of criminal law. J Int AIDS Soc. 2018;21(7):e25161. doi:10.1002/jia2.25161

  3. Centers for Disease Control and Prevention. How effective is PrEP?

  4. Centers for Disease Control and Prevention. Genital herpes - CDC fact sheet.

  5. Ayoub HH, Chemaitelly H, Abu-Raddad LJ. Characterizing the transitioning epidemiology of herpes simplex virus type 1 in the USA: model-based predictionsBMC Med. 2019;17:57. doi:10.1186/s12916-019-1285-x

  6. Martin ET, Krantz E, Gottlieb SL, et al. A pooled analysis of the effect of condoms in preventing HSV-2 acquisition. Arch Intern Med. 2009;169(13):1233–40. doi:10.1001/archinternmed.2009.177

  7. Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021: genital herpes.

  8. Centers for Disease Control and Prevention. Genital HPV infection - fact sheet.

  9. Bharti AH, Chotaliya K, Marfatia YS. An update on oral human papillomavirus infection. Indian J Sex Transm Dis AIDS. 2013;34(2):77-82. doi:10.4103/0253-7184.120533

  10. Javanbakht M, Westmoreland D, Gorbach P. Factors associated with pharyngeal gonorrhea in young people: implications for prevention. Sex Transm Dis. 2018;45(9):588–93. doi:10.1097/OLQ.0000000000000822

  11. Fairley CK, Hocking JS, Zhang L, Chow EP. Frequent transmission of gonorrhea in men who have sex with men. Emerging Infect Dis. 2017;23(1):102-4. doi:10.3201/eid2301.161205

  12. Centers for Disease Control and Prevention. STD risk and oral sex.

  13. Barbee LA, Khosropour CM, Dombrowski JC, Manhart LE, Golden MR. An estimate of the proportion of symptomatic gonococcal, chlamydial and non-gonococcal non-chlamydial urethritis attributable to oral sex among men who have sex with men: a case-control study. Sex Transm Infect. 2016; 92(2):155-60. doi:10.1136/sextrans-2015-052214 

  14. Chow EPF, Fairley CK. The role of saliva in gonorrhoea and chlamydia transmission to extragenital sites among men who have sex with men: new insights into transmission, J Int AIDS Soc. 2019;22(Suppl Suppl 6):e25354. doi:10.1002/jia2.25354

  15. Saini R, Saini S, Sharma S. Oral sex, oral health and orogenital infections. J Glob Infect Dis. 2010;2(1):57-62. doi:10.4103/0974-777X.59252

  16. Tripathi N, Mousa OY. Hepatitis B. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2021.

  17. Centers for Disease Control and Prevention. Adult immunization schedule: recommendations for ages 19 years or older, United States, 2022.

  18. Goodreau SM, Pollack ED, Wang LY, Aslam MV. Impacts of changing sexual behavior on chlamydia and gonorrhea burden among US high school students, 2007 to 2017. Sex Transm Dis. 2021;48(9):635-42, doi:10.1097/OLQ.0000000000001390