Oral sex is a sexual activity that uses the mouth, lips, or tongue as a way to stimulate a partner.¹ There are many reasons why individuals enjoy oral sex, and it is a much more common sexual activity than people are led to believe. In fact, a statistic from the Centers for Disease Control and Prevention found that more than 85% of sexually active adults in the United States aged 18-44 years reported having had oral sex at least once.¹ Without the proper precautions, oral sex can result in the transmission of sexually transmitted infections (STIs) such as herpes, chlamydia, gonorrhea, syphilis, human papillomavirus, and human immunodeficiency virus.

Different Forms of Oral Sex

There are several different types of oral sex:

• Fellatio –  oral stimulation of the penis
• Cunnilingus – oral stimulation of the clitoris, vulva, and/or the vagina
• Anilingus – oral stimulation of the anus

When engaging in any of these forms of oral sex, being aware of the potential STI risks and prevention methods can improve overall sexual health and safety of all individuals involved. 

STI Risks of Oral Sex

Contrary to common perception, oral sex carries the risk of contracting an STI. The most common STIs that can be contracted from unprotected oral sex include herpes, chlamydia, gonorrhea, syphilis, HPV, and HIV. These STIs can be transmitted through mouth-to-genital and mouth-to-anus contact. The chances of STI contraction greatly increase if there is a direct transmission of bodily fluids into the mouth. 

The majority of people with an STI do not experience symptoms. Thus, many people with an STI do not know they are infected and will not take the necessary steps to prevent passing the unknown infection to their partners. Despite the lack of symptoms, STIs can still be transmitted to sexual partners.² The World Health Organization estimates that worldwide, over 1 million people contract an STI each day, resulting in about 376 million new infections each year.² This statistic highlights the need for individuals to take the necessary steps to prevent the transmission of STIs during oral sex and other sexual activities.  

Herpes 

Herpes is a viral infection also known as Herpes Simplex Virus (HSV). Herpes is one of the most common STIs and is categorized into two types: Herpes Type 1 (HSV-1) and Herpes Type 2 (HSV-2). HSV-1 is commonly known as “oral herpes” and is primarily transmitted through direct contact with open sores on the skin or sharing of objects in contact with the mouth (such as toothbrushes or eating utensils). Symptoms of HSV-1 include blisters or sores on or around the mouth or lips. HSV-2 is commonly known as “genital herpes” and is primarily transmitted through sexual contact, including oral sex. Symptoms of HSV-2 include blisters or sores on or around the genitals or rectum.

Both HSV-1 and HSV-2 have the ability to spread to other parts of the body during sexual contact. For example, receiving oral sex from a partner with herpes on the lips, mouth, or in the throat can result in contracting herpes on the genital area, anus, buttocks, or in the rectum. Likewise, HSV-2 can be spread from the genitals to other areas. Giving oral sex to a partner with herpes on the genital area, anus, buttocks, or in the rectum may result in contracting herpes on the lips, mouth, or in the throat.¹

Many people with herpes are often asymptomatic, meaning they do not experience any symptoms.³ Individuals can contract herpes regardless if sores are present; however, the risk of transmission is highest in the presence of sores. Although there is no known cure for herpes at this time, treatments can help individuals relieve the symptoms.¹

Chlamydia

Chlamydia is a bacterial infection caused by the bacterium Chlamydia trachomatis. Chlamydia is transmitted through direct contact with an infected throat, genitals, urinary tract, or rectum. Although most often asymptomatic, chlamydia can appear through a number of symptoms dependent on the site of the infection:

• Infection of the throat: sore throat
• Infection of the genitals or urinary tract: abnormal discharge or blood from the vagina or penis, burning sensation when urinating, painful or swollen testicles
• Infection of the rectum: rectal pain or discharge

Chlamydia can be easily spread through oral sex. Luckily, there are antibiotics that cure chlamydia. The sexual partners of someone with chlamydia should always be tested for the infection, and those who test positive for chlamydia should not have sex until they and their sexual partners have completed their antibiotic treatment as well.

Gonorrhea

Gonorrhea is a bacterial infection caused by the bacterium Neisseria gonorrhoeae. Gonorrhea is transmitted through direct contact with infected areas such as the throat, genitals, urinary tract, and rectum. Symptoms of gonorrhea are similar to chlamydia and vary depending on the site of infection:

• Infection of the throat: sore throat, most often asymptomatic
• Infection of the genitals or urinary tract: abnormal discharge or blood from the vagina or penis, burning sensation when urinating, painful or swollen testicles
• Infection of the rectum: rectal pain or discharge

Gonorrhea can be easily spread through oral sex. Fortunately, there are antibiotics that cure gonorrhea. However, there are certain strains of gonorrhea that are harder to cure than others. The sexual partners of someone with gonorrhea should always be tested for the infection, and those who test positive for gonorrhea should not have sex until they and their sexual partners have completed their antibiotic treatment as well.

Syphilis

Syphilis is a bacterial infection caused by the bacterium Treponema pallidum. Syphilis is transmitted through direct contact with a syphilis sore or rash on the genitals, lips, mouth, throat, or anus. A few symptoms of syphilis include:

• Ulcers of the skin, lips, mouth, throat, genitals, or anus
• Rash on body, palms of hands, or soles of feet
• Flu-like symptoms

Syphilis can also be asymptomatic, and can be easily spread through oral sex. There are several antibiotic treatments for syphilis that pertain to the STI’s stage of development. The sexual partners of someone with syphilis should always be tested for the infection, and those who test positive for syphilis should not have sex until they and their sexual partners have completed their antibiotic treatment as well. 

Human papillomavirus 

Human papillomavirus (HPV) is a viral infection. HPV can be transmitted through direct contact with infected areas such as the throat, genitals, mouth, cervix, anus, or rectum. HPV is often asymptomatic, and the body’s immune system is able to fight off the infection without treatment. If one does show HPV symptoms, they may include:  

• Warts on the throat, genitals, or anus
• Increase in chance of penile, head, neck, vaginal or cervical cancers (depending on the HPV strain)

According to a survey conducted by BMC Public Health, 34.5% of people surveyed believe that oral sex is an activity with no or low risk for the transmission of HPV. However, oral sex is an activity that can facilitate the transmission of the HPV virus. Although there is no cure for this infection, there are vaccines proven to be extremely effective at reducing the risk of cancer-causing HPV strains.¹

Human immunodeficiency virus (HIV)

Human immunodeficiency virus (HIV) is a viral infection. HIV is transmitted through direct contact with an infected person’s genitals, anus, or bodily fluids. HIV affects the entire immune system. While HIV can be asymptomatic for years, symptoms of HIV show during the later stages and include:

• Flu-like symptoms
• Immune system lowered and susceptible to opportunistic illnesses 
• Fatigue, weight loss, fever, and sores

HIV is primarily spread through sexual activities including oral sex. Although there is currently no permanent cure for HIV, there are antiviral medications and preventative medications, such as PrEP and PEP, that can improve the life of people with HIV.¹ 

While many of the STIs listed above are treatable and unharmful during their early transmission phases, leaving STIs untreated can cause many dangerous health problems such as infertility and pelvic inflammatory disease (PID). For further information on STI symptoms, treatment, and transmission, please explore our other STI articles or contact your health provider. 

STI Prevention During Oral Sex

When engaging in oral sex, there are many steps one can take to prevent the possible transmission of STIs. 

Barrier Methods

The most effective prevention of STI transmission is by using a barrier method. Barrier methods prevent the STI from transferring from the infected person to their partner by creating a non-permeable wall that allows sexual pleasure without direct skin contact. When used properly, barrier methods are highly effective for STI prevention as well as easy to use.²

Male condoms are an accessible and easy barrier method for those engaging in oral sex with a penis. Male condoms are placed onto the entire shaft of the penis and prevent direct mouth to penis contact by using a thin, non-permeable wall typically made of latex or other synthetic materials. Oftentimes, male condoms are available in several flavors and colors to experiment with if so desired; flavored lubricants may also be incorporated into oral sex in order to help reduce unwanted friction and intensify a sexual experience. Male condoms can be purchased at most local convenience stores as well as online. 

Female condoms are a form-fitting pouch with flexible rings at each end which are inserted into the vagina. This barrier method is less accessible to those who want to engage in oral sex with a vulva, as they are difficult to find in store and are more expensive than most barrier methods. Although female condoms can be used during oral sex, dental dams are more accessible. Female condoms can typically be purchased online. 

Dental dams are made of a thin piece of latex or silicone rubber that is positioned over the vulva before oral sex begins and acts as a barrier between the mouth and genitals. Oftentimes, dental dams are available in different flavors. This barrier method may also be used for anilingus. Dental dams can be purchased at local sex shops as well as online.

Communication

Although most STIs are quite common and treatable, STIs are still heavily stigmatized in today’s society. There should be no shame surrounding an individual with an STI, yet it is important that those with an STI disclose this information to their sexual partner(s). Using effective communication by discussing a partner’s preference for STI protection before engaging in oral sex can be a very rewarding and important experience. 

STI Testing

Getting tested for STIs is an important method in order to maintain one’s knowledge about their sexual health and body. It is recommended to get tested for STIs every three months when sexually active, which includes engaging in oral sex. STI results will not be accurate right after a sexual experience, so it is also recommended to communicate with your health provider about the typical time they require before they can administer an accurate STI test. Be sure to mention that you want to be tested for orally-transmitted STIs, as many health professionals will not administer mouth and throat testing unless it is specifically asked for. 

Concluding Remarks

Oral sex, just like any other form of sex, offers the possibility of STI transmission. Being aware of the possible STIs that can be transmitted via oral sex as well as being aware of the barrier method options for protection can provide an individual with helpful knowledge in regards to their sexual health and sexual experiences. Clear communication with sexual partners as well as regular STI testing are also important. 

References

1. “STD Risk and Oral Sex.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 1 Dec. 2016.
2. “Sexually Transmitted Infections (STIs).” World Health Organization, World Health Organization, 14 June 2019.
3. Levay, Simon, John Baldwin, and Janice Baldwin. “Chapter 15 – STIs.” Discovering Human Sexuality. 3rd ed. N.p.: Sinauer Associates, 2016. 485-87. Print.
4. Brondani, Mario A., et al. “Exploring Lay Public and Dental Professional Knowledge around HPV Transmission via Oral Sex and Oral Cancer Development.” BMC Public Health, vol. 19, no. 1, Nov. 2019. 
5. Goldstein, Rachel et al. “Adolescent Oral Sex and Condom Use: How Much Should We Worry and What Can We Do? “Journal of Adolescent Health, Volume 62, Issue 4, 363 – 364, April 2018. 
6. Syme, Maggie L., et al. “A Comparison of Actual and Perceived Sexual Risk Among Older Adults.” Journal of Sex Research, vol. 54, no. 2, Feb. 2017, pp. 149–160.

Last Updated: 3 March 2020.