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.

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.

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.

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.

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.

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%.