Oral Sex

Definitions

Oral sex is defined as using one’s mouth, tongue, and lips to stimulate a partner’s genitals or anus.^1,2,4,5
Common terms include:
- Oral-penile: fellatio, blowjob, giving head
- Oral-vaginal: cunnilingus, going down
- Oral-anal: annilingus, rimming, rimjob

Risks

Many sexually transmitted infections (STIs) such as herpes, syphilis, chlamydia, gonorrhea, genital warts (human papillomavirus, or HPV), intestinal parasites (amebiasis), or hepatitis A or B infection can be transmitted through oral sex.^1,2,3,4,5
It is difficult to determine exact rates of transmission of STIs through oral sex since many sexually active individuals practice oral sex in addition to other, higher risk activities, such as vaginal and/or anal sex.^1,3,4
For most STIs, transmission is greater for the person performing- rather than receiving- oral sex.^3,4
If a male ejaculates during oral sex (without wearing a condom), then the risk of transmission to his partner becomes higher for chlamydia, gonorrhea, hepatitis B and HIV.^1,4,5
Several co-factors can increase the risk of STI transmission through oral sex, including: oral ulcers or cuts, bleeding gums, genital or anal sores, and the presence of other STIs.^1,4,5

Precautions

Abstain from oral sex if a partner’s mouth has a sore.^2,4,5
If there is a sore or discharge on your partner’s genitals or an unusual odor, avoid any type of contact with the genitals including oral sex.^4,5
Abstain from all types of sex if you or your partner is currently being treated for a STI.^2,4,5
If a partner is diagnosed with an STI, consider making an appointment with a clinician to decide if you can/should be tested.^3,4,5
Sore throat, tonsillitis, oral lesions, or cold sores are potential symptoms of oral STI infection. However, many oral STIs are asymptomatic.^3,4
Do not brush or floss your teeth right before you have oral sex. Flossing and brushing can sometimes cause your gums to bleed.^4,5
If you wish to freshen your breath before oral sex, try mouthwash instead.⁵

Herpes

A person with oral Herpes can transmit Herpes to their partner’s genitals or anus.^3,4
Likewise, a person with genital Herpes (typically HSV-II) can transmit Herpes to the mouth, though this route of transmission is not as common.^3,4
The Herpes virus can be passed without visible sores, so many individuals may not be aware that they are placing themselves at risk.³

HIV

HIV may be transmitted through oral-genital contact when HIV in semen, pre-seminal fluid, vaginal secretions or blood enters the mucous membranes or abrasions in the mouth and throat.¹
HIV is not transmitted through saliva.^1,3,4
Exact rates of HIV transmission through oral sex are not known, but the risk is much less than with vaginal or anal sex.⁴
The risk of getting HIV from oral sex can be reduced by taking pre-exposure prophylaxis (PrEP) consistently and correctly.¹
If you or your partner has HIV, the risk of transmission is lowered by taking antiretroviral therapy (ART) consistently and correctly.¹

Barrier Methods

For oral sex on a vulva or anus, dental dams or plastic wrap can serve as a barrier to prevent the transmission of STIs.^1,2,3,4,5
Barrier methods are thin, flat sheaths placed over the vulva or anus during oral stimulation and held in place. They cannot be used for penetration.^2,4
Latex barriers, such as a dental dam or condoms cut open, are manufactured with flavors to cater to different tastes.^2,3,4,5
Dental dams may be difficult to find and expensive, but household plastic wrap (such as Saran or Cling Wrap) is readily accessible, cheap, tasteless, covers a larger area, and can be used with all kinds of lubricants.^2,5
For oral sex on a penis, using a flavored latex condom can reduce STI transmission.^2,5
Use a barrier method from start to finish.³
Use a new one each time you have oral sex. Never reuse a barrier method.^3,4,5
Never transfer a barrier method from an anus to vulva.⁴
Only use one side of a barrier method; never flip it over to use both sides.⁴
After stimulation, dispose of the barrier method properly. Do not flush.²

Lubricants

Using lubricant inside the condom or on the side of the barrier method touching the person receiving oral sex may increase sensation.^2,4,5
Oil-based lubricants (e.g., Vaseline, massage oil, baby oil) cannot be used with latex barrier methods because they can cause latex to break.^4,5
Avoid using sweetened food products like whip cream and chocolate syrup during oral sex. They contain sugar which can cause yeast infections and they can also be oil-based.^3,5

Is Oral Sex For Me?

The decision to engage in oral sex needs be made individually and as a couple.²
Communication with your partner is essential when exploring protection during oral sex.²
Talking with your partner about their feelings, the reason for those feelings, and the issue of risk can help both of you make appropriate decisions.²
A person’s feelings about oral sex can change over time and from one partner to another.
Ultimately, it is your right to decide what sexual behaviors you feel comfortable doing, and it is always okay to say no.⁵
If you have additional questions, concerns or suggestions, please email Katy Janousek, Sexual Health Coordinator, Health Promotion Department: kjanousek@uhs.uga.edu.

Sources