How Do I Lower the Risk of Getting an STI During Oral Sex?
When people talk about sexually transmitted infections, penetrative vaginal sex usually takes center stage. But the risk of STIs with oral sex is real, too. Yes, you can get STIs from oral sex, and yes, you can take measures to protect yourself as much as possible.
“People should definitely be concerned about contracting STIs from oral sex,” Peter Leone, M.D., adjunct associate professor of epidemiology for the Gillings School of Global Public Health and professor of medicine for the School of Medicine at the University of North Carolina, tells SELF. “It’s a really common mode of transmission.” OK, that sounds pretty foreboding, but let’s remember that there are ways to reduce your risk that don’t include abstaining, and we’ll get to those in a bit.
There are several sexually transmitted infections you can pass or contract through oral sex, from chlamydia to trichomoniasis.
Here are the STIs people can spread via oral, according to the Centers for Disease Control and Prevention (CDC).
Chlamydia: This is one of those potentially stealthy STIs that you can have with precisely zero symptoms. However, if you have symptomatic throat chlamydia, it’ll likely present with a sore throat. If your chlamydia is affecting your genitals, you might experience white, green, or yellow vaginal discharge (it might smell bad, too), random bleeding between periods, itching or burning in or around your vagina, and burning when you pee, among other signs. If left untreated, chlamydia can lead to pelvic inflammatory disease, which happens when an infection spreads to your reproductive organs, potentially leading to infertilty.
If your partner has throat chlamydia, they can spread it to your genitals or anus through oral sex. You can also get it in your own throat from performing oral on your partner’s penis, vagina, or anus, according to the CDC.
Gonorrhea: Gonorrhea is really similar to chlamydia in a few ways, including its ability to fly under the radar without causing many (or any) symptoms. If it does make itself known, it’s often through white or yellow vaginal discharge, burning when you pee, rectal pain or discharge, or a sore throat. It can also lead to pelvic inflammatory disease if the genital infection is left untreated.
Like chlamydia, gonorrhea can be passed to your genitals if your partner has the infection in their throat. Conversely, if they have gonorrhea on their genitals or anus, you can wind up with throat gonorrhea after oral sex.
Syphilis: Syphilis doesn’t always cause symptoms, but when it does, you might experience painfree ulcers or sores on your lips, mouth, throat, genitals, or rectum, the CDC says. It can also cause a rash on your midsection, the palms of your hands, and the soles of your feet, as well as flu-like symptoms.
If your partner has a syphilis sore or rash that you can come into contact with during oral sex, you can wind up with this STI, and vice versa.
Herpes: So, here’s an STI detail a lot of people don’t realize: There are actually two herpes viruses. Herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) can both cause oral and genital herpes, according to the CDC. With that in mind, HSV-1 is most often linked with the virus that pops up around your mouth as cold sores, and HSV-2 is usually behind genital herpes, which can cause painful blisters in that area, along with a headache, muscle aches, fever, and swollen lymph nodes in your groin.
If your partner has either type of herpes on their lips, mouth, or in their throat, they can pass it on to you when they give you oral. If your partner has either type on their genitals, you can get it when when you give them oral.
HPV: You can have HPV, also known as human papillomavirus, without realizing it, and without it harming your body at all before your system eventually clears it. (Yes, this is a thing that happens!) But in rarer cases, some strains of the virus can cause warts in your throat, on your genitals, or on your anus. Those throat warts can lead to symptoms like vocal changes, difficulty speaking, or shortness of breath, according to the CDC. Other types of HPV can potentially cause cancer of the cervix, vagina, anus, penis, head, or neck.
If someone has HPV in their throat, they can give it to you via your genitals and anus during oral or, if they have HPV in their genitals or anus, you might get it in your throat.
Trichomoniasis: This mouthful of an STI might not cause symptoms, like the others on this list. If you have trichomoniasis affecting your sexual organs, you might experience discharge, vaginal redness and itching, and a burning feeling when you pee.
The CDC notes that there have been no reports of someone contracting genital trichomoniasis after receiving oral sex. However, there are a few reports that performing oral sex on someone who has trichomoniasis can result in getting this STI in your throat. In that case, it might cause a sore throat, if any symptoms at all.
HIV: Huge disclaimer here: The CDC lists human immunodeficiency virus (HIV) as an STI that can technically be transmitted through oral sex, but the risk is very low. Receptive anal sex is the most common mode of sexual HIV transmission by far. The risk drops starkly when you talk about vaginal intercourse, which is still a more likely way to transmit HIV than oral sex. As it stands, oral is the least common way to spread HIV through sex—whether you’re giving or receiving—to the point where the CDC says the chance of this happening is “extremely low.” With that said, the organization still includes HIV on its list of STIs that can theoretically be transmitted via oral, so it’s worth a quick primer.
HIV kills the T cells that help your body fight off infections. If you contract HIV, about a month afterward you might start feeling like you’ve come down with the flu due to symptoms like a fever, headache, muscle aches and joint pain, rash, sore throat, and swollen lymph glands, according to the Mayo Clinic. (It’s also possible to go without symptoms for years, the CDC notes.)
How you protect yourself during oral sex depends in part on whether your partner has a penis or vagina.
Of course, the CDC points out that the only real way to avoid STIs is to...just not have sex. Another super-safe option is to only have oral sex if you’re in a mutually monogamous relationship and you and your partner have both been recently tested since being with any other partners.
Those are nice and all, but if the thought of either of those makes you cackle, you’ve got to have a plan of action.
If your partner has a penis, use a condom.
We know a lot of people don’t use condoms during oral sex, and it’s easy to see why: It can feel unnecessary, or like a hassle, or like it’ll interrupt the moment. But if you really do want to be as safe as possible during oral sex, this condoms-are-just-for-vaginal-penetration thing won’t fly.
The CDC specifically recommends using a non-lubricated latex condom for protection during oral sex. If you or your partner is allergic to latex, go for a plastic (polyurethane) condom, and if you can’t stand the taste of regular condoms, look for a flavored variety, Dr. Leone says.
Condoms are essentially “semen catchers” that prevent STIs by blocking the spread of genital fluids, Dr. Leone explains. Though some STIs, like herpes and HPV, can also be transmitted through skin-to-skin contact, condoms are still an excellent way to lower your overall STI risk.
It’s not just about using a condom, though—it’s about using it correctly, sex therapist Debra Laino, D.H.S. (doctor of health science), tells SELF. That means using a condom that isn’t expired, putting it on before any sexual action takes place but after your partner’s penis is erect, not ripping into the package with your teeth—all the basics.
If you're receiving oral sex—or if you're performing oral sex and your partner has a vagina—you should use a dental dam.
You’ve probably heard of dental dams—those square sheets of thin material (usually latex) that act as a barrier between one person’s genitals or anus and another’s mouth. But have you ever seen one out in the drugstore-aisle wild? They can be pretty hard to find, Dr. Leone says.
If you know in advance that oral is in your future, you can order dental dams online or call around to see which drugstores, sexual health clinics, or sex shops near you might have them. If you’re in a pinch because sex is about to happen, like, now, you can MacGyver a dental dam with a condom. Cut off the top, bottom, and down the side so it unfolds into a square shape, the CDC says.
A latex glove can also do the trick, sex therapist Jessica O’Reilly, Ph.D., host of the Sex With Dr. Jess Podcast, tell SELF. She recommends cutting off all the fingers except the thumb. Then, cut down the pinky side of the glove (opposite from the thumb) to create a dental dam. You or your partner can put a thumb or portion of another finger into the intact part of the glove for safe manual penetration, if that’s your thing.
Don’t have any of that stuff handy? Use non-microwavable plastic wrap, as long as you’re positive it’s not damaged in any way. “It doesn’t have holes in it, so you have a solid barrier,” Dr. Leone says. “It’s a cheap and easy way to protect yourself.” Though, it should be noted that this is not an FDA-approved way of reducing your risk of STIs. Still, it could be better than nothing.
What about oral anal, you say?
We thought you’d never ask. If you’re giving or receiving analingus and either of you are unsure of your STI status down there, you can use the same barrier methods mentioned above for oral-vaginal protection.
Having good oral hygiene is a surprising—but necessary—part of having the safest possible oral sex.
This seems random, but bear with us: Having poor oral health can lead to tooth decay, gum disease, or bleeding gums, the CDC points out, and that can create an even easier pathway for STI transmission.
Of course, using some kind of barrier method is the most important part of lowering your STI risk during oral sex, but brushing and flossing regularly help, too.
These tips protect you best if you use them every time when you’re giving or receiving oral sex.
You should also make sure you’re getting tested regularly. You can find a testing site here. And make sure to ask the providers there if they also check for STIs in your mouth or throat.
Ideally, you and your sexual partner could talk about everything from when you last got tested (and the results) to which kind of condom or dental dam you want to try next. It sucks that this can be tremendously hard to actually do, especially if you’re not in a relationship with the person, which is why getting tested often is so important.
That said, wouldn’t you rather be able to 100 percent enjoy oral sex than have nagging worries about compromising your health? Safe sex is really the way to go. Anyone who acts weird because you want to do what’s right for your body probably shouldn’t get to enjoy it, TBH.
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