Is Oral Sex Really Safe Sex?

Risk of STIs is especially high with herpes and HPV

In This Article

Many people question whether oral sex is really sex. That depends on how you define sex, but one thing is clear: oral sex isn't inherently safe sex. Sexually transmitted infections (STIs) are definitely a risk, at least if you don't take proper precautions. Below, you can find an overview of some common oral sex STIs and the risk of STD transmission during oral sex.

HIV

Oral sex is a relatively low-risk activity for HIV transmission, particularly when compared to vaginal or anal sex. However, although such transmission is rare, it is possible to transmit HIV through oral sex.

The risk of HIV is largely limited to the person performing oral sex. Even so, the per-act risk is considered low, hovering at around 0.04% in high-risk gay and bisexual men.

Using latex or polyurethane condoms, female condoms, or dental dams are effective ways to reduce your chances of contracting HIV when engaging in oral sex.

If you don't choose to use protection for oral sex, you should know that the risk of HIV transmission increases:

  • If the person performing the act has cuts or sores in his/her mouth
  • If ejaculation takes place in the mouth
  • If the individual receiving oral sex has any other sexually transmitted diseases

Herpes

Although genital herpes and oral herpes are usually caused by different strains of the herpes virus, HSV-2 and HSV-1 respectively, it is possible for either virus to infect either site. Therefore, it is possible to transmit herpes during oral sex. Unlike HIV, the herpes virus can be readily spread from either partner during oral sex.

According to a 2019 study in BMC Medicine, the majority of HSV infections are the result of oral sex rather than genital-to-genital sex.

The risk of herpes during oral sex is significant and can even occur when symptoms are not present. Condoms and other barriers can significantly reduce the risk of transmitting herpes during oral sex. However, condoms are not completely effective, since the virus can spread from skin to skin.

Prophylactic medications, such as Zovirax (acyclovir), can reduce the likelihood of both outbreaks and transmitting the herpes virus to your partner, but they can not eliminate the risk entirely.

Human Papillomavirus

It is possible to spread human papillomavirus (HPV) through oral sex. In fact, it is believed that HPV acquired while performing oral sex is a major risk factor for oral and throat cancers and it is associated with recurrent respiratory papillomatosis. HPV can also appear in the oral cavity through vertical transmission (transmission from mother to child during birth).

As with herpes, it seems likely that the use of condoms or dental dams during oral sex should reduce the risk of infection, but they will not necessarily eliminate it entirely. This is because, as with herpes, HPV spreads via skin-to-skin contact, not through bodily fluids.

According to research issued by the Centers for Disease Control and Prevention (CDC), the risk of HPV via oral-penile and oral-vaginal sex was more or less the same as vaginal intercourse.

Gonorrhea

In recent years, teenagers with throat infections caused by gonorrhea have often been in the news. Gonorrhea can be transmitted in both directions when oral sex is performed on a man, and throat infections with gonorrhea are notoriously difficult to treat.

However, transmission in the other direction is relatively unlikely since the site of infection is the cervix. That's a part of the female anatomy not usually reached during cunnilingus. Condoms and dental dams should be extremely effective in preventing the transmission of gonorrhea during oral sex.

The rate of oral gonorrhea is especially high in gay and bisexual men, with some STD clinics reporting that up to 6.5% of men of who have sex with men (MSM) have pharyngeal gonorrhea (gonorrhea of the throat).

Chlamydia

It is possible to transmit chlamydia during fellatio. With this STD and oral sex, both the recipient and the person performing the act are at risk. There has been little research on whether it is possible to transmit chlamydia during cunnilingus. However, due to the similarity of the diseases, the infection risk is probably similar to that for gonorrhea.

Syphilis

Syphilis is extremely easy to transmit via oral sex. In the United States, the per-act risk of syphilis via 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, during the primary and secondary stages of the disease, the painless sores it causes are easy to miss. Therefore, many people don't know they have syphilis symptoms when they transmit syphilis to their partners.

Hepatitis B

The research is inconclusive as to whether or not hepatitis B can be transmitted via oral sex. Oral-anal contact, however, is definitely a risk factor for hepatitis A infection. It may also be a risk factor for hepatitis B.

Fortunately, both hepatitis A and B can be prevented by vaccines. If you practice rimming, you should talk to your doctor about getting vaccinated. Vaccination is a good idea in any case, and the hepatitis B vaccine is currently recommended for all children and many groups of adults.

A Word From Verywell

It is possible to reduce the risk of getting an oral sex STD by using barriers during oral sex. Doing so won't eliminate the risk of diseases such as syphilis and herpes, which are spread skin-to-skin. However, practicing safer sex will greatly reduce the risk of oral sex STDs. 

In the end, unprotected oral sex puts you at risk for numerous sexually transmitted diseases. If you perform unprotected oral sex on your sexual partners, you should mention it to your physician. The doctor may want to check your throat when screening you for other STDs.

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Article Sources

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