The CSPH: Q&A Safer Oral Sex

25- Q&A safer oral sexMany (both teens and adults alike) believe oral sex to be the safe alternative to vaginal and anal intercourse. However, the truth is that although less risky, it certainly is not completely safe. STIs, like HPV and Herpes are the top risks when engaging in unprotected oral sex.

A little education goes a long way though, and it only takes a few necessary steps to keep yourself protected.

This article by The Center for Sexual Pleasure & Health (The CSPH) covers the following points:

  • HPV and Herpes are contracted through skin-to-skin contact.
  • HPV is the leading cause of throat cancer above even tobacco use.
  • Gonorrhea and chlamydia are common STIs transmitted during oral sex but are relatively easy to treat.
  • HIV can be transmitted during oral sex although it’s extremely rare. There are only a few proven cases of this mode of HIV transmission in the world.
  • A cut or sore in the mouth greatly increases the risks of infections passing during oral sex.
  • Many STIs show very few symptoms.
  • Condoms, internal condoms or dental dams can be used to prevent skin-to-skin contact. A dental dam can also be made form saran wrap or a condom.
  • According to studies, up to 82% of people practice oral sex without protection, meaning that unprotected oral sex is a societal norm.
  • Lack of knowledge and worry that sensation may be lessened could be the reason why unprotected oral sex is so highly practiced.
  • Flavored lubricants could be a good solution to cover the taste of latex.
  • Safe oral sex could increase sexual pleasure.

This article was originally published on The CSPH website.

BY The CSPH | theCSPH.org

What precautions one must take to enjoy oral sex healthily?

Ahh, the good ol’ Lewinski, giving dome, eating peaches, carpet munching, knob-polishing, and court-addressing.  Many of us are familiar with oral sex (and its various slang affiliates!), but considerably fewer of us have a comprehensive understanding of how to safely engage in mouth-led southern explorations.

Image from the CSPH

Image from the CSPH

The common perception of oral sex is that it is a risk-free sex act.  This belief is most accepted among young adults and adolescents, many of whom engage in oral sex before other forms of intercourse as a deliberately risk-preventative measure.  Indeed, while penis-in-vagina sex is often understood as potentially resulting in exposure to sexually transmitted infections and pregnancy, oral sex is mostly contextualized as wholly safe.  This results in people of all ages being less cautious in their oral sex forays by not utilizing safer sex materials, thereby putting them at greater risk for STI transmission.

With that said, it is in fact true that oral sex is less risky than other sexual activities insofar as pregnancy and STI transmission.  However, this doesn’t mean that we should all be giving and receiving oral sex without appropriate safety measures.  Unprotected oral sex can result in the contraction of a number of sexually transmitted infections, and while there has yet to be research published on the risk of all STIs during oral sex, a closer look at individual infections proves to be enlightening.

There are two primary STI risks in engaging in unprotected oral sex: herpes simplex and human papillomavirus, also known as HPV.  As I discussed in Q&A: Herpes, some 50 to 80% of adults have herpes simplex virus 1 (HSV-1), also known as cold sores.  Despite its colloquial framing as “oral herpes,” HSV-1 can also be transmitted to genitals, with up to half of new genital herpes contractions occurring as a result of HSV-1.  Unlike most STIs, herpes is not curable, and while there is no shame in contracting HSV, which is in many ways a simple skin condition that flares up occasionally, most individuals would prefer to not deal with it.

Like herpes, HPV is contracted through skin-to-skin contact as opposed to the sharing of bodily fluids, such as semen and vaginal secretions.  Oral HPV affects approximately one in 15 Americans, and is much more commonly contracted genitally, with a projected 80% of people having HPV in their lifetime.  While HPV generally doesn’t require treatment since the body’s immune system tends to be well-equipped in fighting the infection, it’s noteworthy that HPV is the leading cause of oral and throat cancers, more so than even tobacco use.

Other sexually transmitted infections that are more commonly contracted through oral sex are gonorrhea and chlamydia.  Unlike herpes, however, these STIs are usually fairly easy to treat with the use of antibiotics.  The human immunodeficiency virus (HIV), may also be transmitted during oral sex, although this is incredibly rare.  Furthermore, hepatitis and other bacterial infections may be transmitted during unprotected mouth-to-ass play.

Regardless of the STI in question, there is a greater risk of transmission when there is a cut and/or sore in the mouth, which allows these infections to pass into the bloodstream.

It’s important to note that many sexually transmitted infections are asymptomatic, meaning individuals who have contracted the STIs show extremely minor or no signs of the infections.  Furthermore, while annual STI testing should be a tool in everyone’s sexual health arsenal, the fact is that patients are not regularly tested for oral sexually transmitted infections unless the individual is experiencing symptoms.

With all that said, it should come as no surprise that using safer sex precautions when engaging in oral sex is integral in limiting the spread of sexually transmitted diseases.  This translates into using external condoms during fellatio (blowjobs), and dental dams during cunnilingus (good ol’ muff diving) and even analingus (anyone want to toss some salad?).  If you don’t have any dental dams on hand, use saran wrap or make one out of a condom!  These barrier methods allow individuals to engage in mouth-to-genital action without direct skin-to-skin contact, limiting the chances of STI transmission.

Unfortunately, the vast majority of individuals who engage in oral sex do not, in fact, use barrier methods.  One study found that 82% of adults do not utilize these protective tools when engaging in oral sex, while another study suggested the same for 70% of adolescents.  This is significant, not only from a public health perspective, but also because it leads to the conclusion that safer oral sex is something out of the norm, potentially making it especially difficult to have important conversations regarding barrier methods as people may often feel uncomfortable introducing such safety precautions into their sex lives.  Furthermore, many people are resistant to the idea of condoms and dental dams during oral sex specifically, even if they welcome their use in other activities.

Although I can’t make sweeping generalizations on the topic, I’d hasten to suggest that there are two main reasons why people may be contrary to using barrier methods during oral sex: a lack of knowledge on the issue and a worry that protection will limit sensation.  The former reason can be addressed by a casual conversation regarding the potential risk of STI transmission, and,  if you’re regularly in contact with said sexual partner, by directing them to resources such as this Q&A.

Though the concern that barrier methods will make oral sex less “worth it” due to decreased pleasure also tends to be a common argument against using condoms during penetrative sex, just as with penis-in-vagina and penis-in-anus intercourse, safer sex is important in empowering people to care for their bodies, their health, as well as the bodies and health of their sexytime partners.  Besides, what would the individual rather have: oral sex with a condom/dental dam, or no oral sex at all?  When framed as a non-negotiable safety measure, I’d bet the resistant party will find themselves suddenly amenable to using protection.

Of course, like I previously mentioned, due to how relatively rare safer oral sex is practiced, it can be uncomfortable to introduce such measures into one’s sex life.  Feeling unsure as to how to go about having such conversations?  Try out these nifty scripts:

“I think you’re unbelievably sexy and would love to give you head, but I want to you to know that I make it a point to have safer oral sex.”

“I want you in my mouth so bad. Do you have a condom?”

“Have you ever had someone put a condom on you with their mouth?”

Another common concern regarding safer oral sex is the taste of latex; after all, not many people like a mouthful of plastic.  Flavored condoms and lubricants can do wonders in addressing this issue.  With that said, a note about flavored lubes: many of them contain glycerin, which may trigger yeast infections in those prone to them.  For this reason, either opt for a flavored lube without glycerin, or make sure to not apply it directly to the vulva.  Some great glycerin-free flavored lubricants include Sliquid Naturals Swirl and Nature Lovin’.  You can also opt for flavorless silicone-based lubes such as Gun Oil and Uberlube.  For lubricant and other sexual aid reviews, visit The CSPH Blog’s Center Stage Sexual Aid feature.

When you’re ready to go down, keep in mind that, just as with other forms of sexual play, safer sex precautions can be used to not only protect yourself or your partner, but also help to increase the sexual excitement from discovering the oyster, chewing brown, or licking a popsicle.

csphThe CENTER for SEXUAL PLEASURE and HEALTH (The CSPH) is designed to provide adults with a safe, physical space to learn about sexual pleasure, health, and advocacy issues. Led by highly respected founder and director, Megan Andelloux, The CSPH is a sexuality training and education organization that works to reduce sexual shame, fight misinformation, & advance the sexuality field.