STD Awareness: “Can I Get an STD from Oral Sex?”

As tools to reduce risk for STD transmission, dental dams are not to be ignored.

Editor’s Note: Other posts of interest to readers include: “Gonorrhea of the Throat,” “Oral Herpes,” “Can Oral Herpes Be Spread to Genitals?,” and “Can Oral Sex Cause Throat Cancer?

Many consider oral sex to be a safer form of sexual activity compared to vaginal or anal intercourse. For this reason, they might put less emphasis on the use of latex barriers, such as dental dams and condoms, during oral sex. Unfortunately, this idea is misguided and can lead to the transmission of preventable infections.

It is generally true that oral sex presents less of a risk for contracting sexually transmitted diseases (STDs) — but this risk is not trivial, especially when people are under the impression that they don’t need to use barrier methods during oral sex. Most sexually transmitted diseases can be passed along by oral sex, including chlamydia, gonorrhea, syphilis, hepatitis B, herpes (which can be transmitted back and forth from the mouth, as cold sores, to the genital region, as genital herpes), human papillomavirus (HPV), and HIV. Even pubic lice can be transferred from the genital region to eyelashes and eyebrows! Additionally, intestinal parasites are more likely to be transmitted via oral sex than through vaginal sex. A microscopic amount of fecal matter containing parasites can be infectious, and can be unknowingly ingested when present on genitals.

Seventy percent of adolescents who reported engaging in oral sex had never used a barrier to protect themselves from STDs during oral sex.

Some bacterial STDs, such as gonorrhea and syphilis, can do permanent damage if not treated in time. Furthermore, gonorrhea of the throat is much more difficult to treat than gonorrhea in the genital or rectal areas. And some viral STDs can’t be cured (such as herpes and HIV), while others can cause chronic infections that have been linked to cancer (such as hepatitis, which is associated with liver cancer, and HPV, which is associated with throat cancer as well as cervical cancer and anal cancer).

According to a study published in Pediatrics, among California ninth graders oral sex was more prevalent than vaginal sex, and considered to pose much less of a risk than vaginal sex. A small but significant number of these students believed that the risk of STD transmission during oral sex was zero — not just low-risk, but no-risk. While these data were self-reported, they do point to an overarching trend, one in which people falsely believe that oral sex will protect them from acquiring STDs. Another study carried out in Washington, D.C., by researchers with the University of Maryland had similar findings — adolescents considered oral sex to be less risky than vaginal sex, they were unlikely to use protection if they engaged in it, and they were less likely to believe that oral sex could transmit HIV than they were to believe it could be transmitted via vaginal sex.

HIV, however, can indeed be transmitted orally, as the virus can be found in blood, vaginal fluids, seminal fluids, and pre-ejaculate. According to the researchers at the University of Maryland,

Cells in the mucous lining of the mouth may carry HIV into the lymph nodes or the bloodstream. Also, blood from the mouth may enter the urethra, the vagina, the anus, or directly into the body through small cuts or open sores.

Researchers have found that the majority of sexually active adolescents don’t use barrier methods, such as condoms, for oral sex. STDs, however, can be transmitted orally.

One study carried out by researchers at Yale University found that 70 percent of adolescents who reported engaging in oral sex had never used a barrier to protect themselves from STDs during oral sex — and only 17 percent reported using barriers every time. The same study found that only 9 percent never used protection during vaginal intercourse, and 61 percent reported using protection every time. These lopsided data indicate that there seems to be a prevailing view among young people that oral sex is low-risk or even risk-free, though they still recognize the importance of using barrier methods for vaginal intercourse.

Another study, which focused on teenagers who took “virginity pledges,” found that these adolescents were more likely to have oral or anal sex (ostensibly to “preserve their virginity”), and condom use during oral sex was “almost completely absent” among this population. This study found no difference in STD rates among pledgers versus nonpledgers, and this may be due to pledgers’ propensity toward unprotected oral sex as well as a greater reluctance to use barrier methods even after starting to engage in vaginal intercourse. Pledgers were also found to be less likely to be screened for STDs.

It is possible that many adolescents have been conditioned to think of oral sex as not “real” sex. Especially within a heterosexual context, sexually active people might be more likely to regard vaginal intercourse as “real” sex, with other activities ranking lower. Additionally, abstinence-only-until-marriage programs, intentionally or not, seem to be correlated with the idea among students that one’s virginity can be “preserved” by having oral or anal sex in lieu of vaginal intercourse. Because these programs are not likely to provide students with accurate information about barrier methods, those who engage in oral or anal sex to preserve their virginity are less likely to use condoms or dental dams.

These attitudes — that oral sex is not “real” sex and is therefore less risky, along with ignorance regarding STD transmission and methods of prevention — give rise to higher STD transmission rates among the sexually active population. It is important that sexually active people are able to know and evaluate the risks inherent to sexual activity, but when the belief that oral sex is “low-risk” persists, they cannot make decisions based on accurate information.

Click here to check out other installments of our monthly STD Awareness series!

11 thoughts on “STD Awareness: “Can I Get an STD from Oral Sex?”

  1. Pingback: STD Awareness: Gonorrhea of the Throat | Planned Parenthood Advocates of Arizona | Blog

  2. Pingback: STD Awareness: Antibiotic-Resistant Gonorrhea | Planned Parenthood Advocates of Arizona | Blog

  3. Pingback: STD Awareness: Antibiotic-Resistant Syphilis | Planned Parenthood Advocates of Arizona | Blog

  4. Pingback: STDs 101: An Introduction to Sexually Transmitted Diseases | Planned Parenthood Advocates of Arizona | Blog

  5. Pingback: Can Oral Herpes Be Spread to Genitals? | Planned Parenthood Advocates of Arizona | Blog

  6. Pingback: STD Awareness: HPV and Smoking | Planned Parenthood Advocates of Arizona | Blog

  7. Is it safe to use Saran Wrap as a barrier for oral sex? Is it toxic? Will it protect from STD and infections?

    • Hi Liz! This is a great question. I want to give you a quick preliminary answer, but when I have time I’d like to do some more research to address your question more thoroughly.

      First of all, PIanned Parenthood does recommend the use of plastic wrap (see here under the dental dam section). These sex educators say that Saran Wrap is the only kind that doesn’t contain microscopic holes. I don’t know if that’s true and would like to double-check that claim.

      Secondly, this Planned Parenthood white paper has some info on plastics and possible harmful chemicals, with recommendations for safer plastics. The focus here is on plastic as eating utensils, however. Also, this website lists the ingredients of Saran Wrap, with a lot of chemical information.

      The thing is, plastic wrap is not FDA-approved to prevent the transmission of viruses and bacteria during sexual activity, so it might not have ever been tested for that purpose. Furthermore, toxicity testing probably focused on things like microwaving food in plastic wrap, not on using it as a barrier for oral sex. So we might not have good data on its safety or efficacy in oral sex. But, as I said before, I’d like to revisit your question after doing more research into these matters. Stay tuned!

      This response was edited on February 8, 2014, to add information about the chemicals in Saran Wrap.

  8. Hi im jing. Can i ask if my partner has a gums problem is there any posibility for me to have an sti?

    • Hi Jing! Sexual activity can always pose a risk for a sexually transmitted infection, and it’s possible that gum disease can make someone more vulnerable to acquiring an infection in their mouth after performing oral sex. But this is a question for a doctor, who can get all the relevant details to your situation. It’s always a good idea for two partners to know one another’s STI status, and they can do this by getting tested (ideally together, to get the conversation started!). Good luck!

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