My Lips Are Sealed: How do I avoid contracting an STD from oral sex?

Dear Sexpert,

I recently learned that you can catch STDs from oral. I had no idea and now I need to know: how I can protect myself from them during oral sex?

— My Lips Are Sealed

Dear Lips Are Sealed,

Many people are not aware that oral sex of any kind increases risk for sexually transmitted infections (STIs) for both partners, so kudos to you for learning this and for thinking about reducing your risk. As you may know, STIs are types of bacteria, viruses or parasites that are transmitted during sexual contact.  They can be transmitted via bodily fluids or via skin-to-skin contact.  The bodily fluids include not just semen, vaginal fluids, and blood, but also saliva.   When giving or receiving unprotected fellatio (oral sex performed on the penis), cunnilingus (oral sex performed on the vulva), or anilingus (oral sex performed on the anus), you are exposed to one or more of these fluids.  Skin-to-skin contact also occurs during unprotected oral sex and can result in the transmission of some STIs.

Some of the most common STIs contracted during oral sex are Human papilloma virus (HPV), Herpes Simplex Virus (HSV), Syphilis, Gonorrhea and Chlamydia.  While you can lower your risk of HPV transmission by getting vaccinated, once contracted, HPV may go away on its own, or if untreated, could lead to other diseases such as genital warts, or in some extreme cases, cancer. Herpes HSV-1 and HSV-2 both cause blisters and sores, but HSV-1 is mostly present on and around the mouth, while HSV-2 causes sores on the genitals. However, both types can be present on either area. There is no cure for herpes, but there are medications to reduce the likelihood of transmission. Herpes can be contracted even when sores or blisters are not visible. Syphilis also appears as sores on the genitals or around the mouth, and can cause severe complications if untreated. Gonorrhea and Chlamydia can be contracted in the throat from a partner who is infected. Both could be asymptomatic, but gonorrhea can also cause strep throat-like symptoms. Finally, there is the risk of contracting human immunodeficiency virus (HIV) which travels in blood, ejaculate, vaginal secretions and other bodily fluids. The risk of catching HIV from oral sex is lower than for vaginal or anal sex, but is still possible.

Luckily, there are many options for reducing risk during oral sex and many of them come in a variety of flavors. When performing or receiving oral sex, use a barrier between the mouth and the genitals. For fellatio, use an external “male” condom on the penis.  For cunnilingus or anilingus, use an internal “female” condom (for anal use, take out the inner ring and let the end hang out of the anus), a dental dam, or you can cut open a non-lubricated latex condom and use it as you would a dental dam. Do not use the same side of a dental dam over multiple areas and do not flip the dental dam over and apply to other areas. You can write your name on one side so you use only use one side.  Each of these barriers should be used only once and then properly disposed. Dental dams and condoms are available from the front desk at McCosh Health Center as well as at the LGBT Center.

If you have any more questions about practicing safer oral sex, I encourage you to make an appointment with Sexual Health and Wellness (SHAW) at UHS. The clinicians there can provide you with more useful information and demonstrate how to use each barrier method effectively, so that you can reduce your risk.

~The Sexpert

Information included in this article and more information on STI’s retrieved from Bedsider

and The Center for Disease Control and Prevention.