The Short Answer: Yes, You Can
Let's be direct: oral sex is not risk-free. While the transmission risk for some STIs is lower through oral sex than through vaginal or anal sex, several infections spread readily through oral-genital contact.
If you've been told that oral sex is "safe sex," that's not entirely accurate. Let's look at the evidence.
STIs That Can Spread Through Oral Sex
Herpes (HSV-1 and HSV-2)
Risk level: HIGH
Herpes is perhaps the most commonly transmitted STI through oral sex:
- Oral herpes (cold sores, typically HSV-1) can spread to genitals
- Genital herpes can spread to the mouth
- Transmission can occur even without visible sores
- HSV-1 now causes a majority of new genital herpes cases in young people
Important: Many people with oral herpes don't realise they have it or don't connect cold sores with STI risk.
Gonorrhoea
Risk level: MODERATE TO HIGH
The throat is a common site of gonorrhoea infection:
- Spreads through giving oral sex to someone with genital gonorrhoea
- Can also spread from an infected throat to a partner's genitals
- Throat infections are usually completely asymptomatic
- Contributes to antibiotic resistance (the throat is a reservoir)
Syphilis
Risk level: MODERATE
Syphilis spreads through contact with sores:
- Primary sores (chancres) can appear on lips, mouth, throat, or genitals
- Oral sex with someone who has a sore can transmit infection
- Sores are often painless and easily missed
- Secondary syphilis rashes can also transmit infection
HPV (Human Papillomavirus)
Risk level: MODERATE
HPV can infect the mouth and throat:
- Transmitted through oral-genital contact
- Usually causes no symptoms
- High-risk oral HPV can lead to throat cancer (oropharyngeal cancer)
- HPV vaccination provides protection
Chlamydia
Risk level: LOW BUT POSSIBLE
Chlamydia can infect the throat:
- Less efficient transmission than gonorrhoea
- Throat chlamydia is usually asymptomatic
- May be under-diagnosed
HIV
Risk level: VERY LOW
HIV transmission through oral sex is rare but documented:
- Estimated at 0.04% per act (receiving oral sex with ejaculation)
- Risk increases with mouth sores, bleeding gums, or other STIs present
- Giving oral sex to someone with HIV poses minimal risk
- Still worth considering in overall risk assessment
Hepatitis A
Risk level: MODERATE (for oral-anal contact)
- Primarily spreads through oral-anal contact (rimming)
- Faecal-oral transmission route
- Vaccination is highly effective
Hepatitis B
Risk level: LOW
- Can be present in saliva but oral transmission is uncommon
- Risk increases if blood is present (mouth sores, dental work)
- Vaccination provides excellent protection
Why Does Oral Sex Get Overlooked?
Several factors contribute to underestimating oral sex risks:
Cultural Perception
- Often seen as "not real sex"
- May be treated as a safer alternative to penetrative sex
- Rarely discussed in sex education
Testing Gaps
- Routine STI screens may not include throat swabs
- You need to specifically request throat testing
- Many oral infections go undiagnosed
Symptom Absence
- Throat infections rarely cause noticeable symptoms
- People don't connect sore throats with STI exposure
- "If it doesn't hurt, it must be fine" – not true
Who Should Be Concerned?
Everyone who has oral sex should be aware of the risks, but some factors increase concern:
Higher Risk Situations
- Giving oral sex to multiple partners
- Oral sex with partners whose STI status is unknown
- Not using barrier protection
- Having mouth sores, recent dental work, or bleeding gums
Specific Populations
- Men who have sex with men (MSM) – higher rates of throat gonorrhoea
- People with HIV or other immunocompromising conditions
- Sex workers
- Anyone with multiple casual partners
Protecting Yourself
Use Barrier Methods
- Condoms reduce risk when giving oral sex to a penis
- Dental dams create a barrier for oral sex on a vulva or anus
- Flavoured condoms and dams can make this more pleasant
Get Tested Regularly
- Request throat swabs if you give oral sex
- Standard screens may only test genital sites
- Testing catches asymptomatic infections
Get Vaccinated
- HPV vaccine protects against cancer-causing and wart-causing strains
- Hepatitis A and B vaccines are highly effective
- Ask your clinician about vaccination
Know Your Partner's Status
- Open communication about STI testing
- Consider testing together before starting a new relationship
- No test is a guarantee, but knowledge helps
Avoid High-Risk Timing
- Don't give oral sex if you have mouth sores or cuts
- Avoid brushing teeth immediately before (can cause micro-cuts)
- Wait until any dental procedures have healed
Getting Tested for Oral STIs
If you give oral sex, comprehensive testing should include:
Throat Swab Testing
- Tests for gonorrhoea (and chlamydia if requested)
- Quick, non-invasive swab of the back of the throat
- Should be part of regular screening for those who give oral sex
Blood Tests
- HIV, syphilis, hepatitis B (and A if relevant)
- Detect systemic infections regardless of site of entry
Genital Testing
- Even if you only have oral sex, test all relevant sites
- Complete picture of your sexual health
The Bottom Line
Oral sex carries real STI risks that are often underestimated. This doesn't mean you need to avoid oral sex entirely – but it does mean being informed, considering protection, and including oral sites in your STI testing.
The most important thing is awareness: knowing the risks allows you to make informed choices about your sexual health.
Get Comprehensive Testing
Our full STI screens include throat swabs for those who give oral sex, ensuring you have a complete picture of your health. Book your confidential test today.
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