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Updated 16 August 2013

A guide to safe oral sex

Is oral sex safe? Sexologist Dr Elna McIntosh answers a few crucial questions.

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Oral sex and sexually transmitted infections (STIs)
There are different levels of risk, depending on the STI and the type of oral sex.

  • Having a STI can increase your chances of getting infected with HIV.
  • STIs that cause sores and blisters (like syphilis and herpes) are easy to get from all types of oral sex – getting or giving.
  • With gonorrhoea, chlamydia and NGU, infections are possible from sucking and getting sucked.
  • Hepatitis A, intestinal parasites and herpes can be easily passed through rimming without a barrier.
  • It is easier to pass STIs on when sores, blisters or discharges (drip) are present.

Remember: “low risk” does not mean “no risk”.

Oral sex and HIV
There have been no studies measuring the risk of getting the Aids virus through oral sex alone. Until better scientific information is available, the actual risk from oral sex is still unknown. Meanwhile, available evidence suggest that:

  • HIV can be passed on from oral sex.
  • There have been well-documented cases of getting HIV from sucking or “giving head”.
  • Bleeding gums, gum disease and sores in the mouth can make it easier to get infected with HIV through oral sex.
  • There have been no well-documented cases of getting HIV from getting sucked.
  • There have been no recorded cases of getting HIV from rimming or getting rimmed.
  • It is much easier to get HIV from sucking than from getting sucked.
  • It is much easier to get HIV from anal or vaginal sex without a condom than from oral sex without a condom.

Only you can decide what you will or won’t do. Consider the following questions when making that decision.

How easy is it to get HIV and other STIs from oral sex?

  • Not all STIs are easily passed on through oral sex. Educate yourself on which diseases are more common and which are easier to spread through oral sex.
  • HIV is not easily passed on through oral sex. However, inflamed, bleeding gums, sores in the mouth or cum in the mouth can increase your chances of HIV infection. Be informed about what may increase the risk of infection.

What are my chances of having sex with someone infected with HIV or another STI?

  • To get HIV or an STI from oral sex, your partner must be infected with that disease.
  • Know what diseases you are likely to be exposed to and how they are passed on.

What can happen to me if I get the disease?

  • Even though the chance of getting HIV from oral sex is low, the consequences of HIV are life threatening. You may decide that it isn’t worth taking that chance and use protection. Or you may not feel that protection is necessary, because the chance of transmission is low. The decision is yours.
  • Some STIs have more serious consequences than others. Know what these are when determining the level of risk that is acceptable to you.

Once you’ve decided, talk to your partner.

How can I reduce my risk?
Any of these methods can reduce your risk of contracting STIs and HIV. Some are more effective than others.

For sucking and getting sucked:

  • For maximum protection, use non-lubricated latex condoms. If you don’t like the taste, try flavoured ones.
  • Use a barrier like plastic wrap (Jiffy) or a dental dam when getting sucked, or if sucking a woman.

If you don’t want to use a condom:

  • Avoid taking semen in your mouth or ejaculating in someone’s mouth. If you get semen in your mouth spit it out.
  • Avoid sucking or rimming if you have bleeding gums, sores, abscessed teeth, or have just gone to the dentist. These could make it easier for HIV and STIs to enter the body. Wait until they heal.
  • Do not brush or floss your teeth right before or after having sex. For fresh breath, try chewing gum or rinsing with mouthwash.
  • Look closely for sores or blisters on the genitals, mouth or lips. If sores or blisters are visible, avoid oral sex. Remember: It isn’t always possible to see sores and blisters.
  • Avoid deep throating. This may irritate the lining of the throat, making it easier for HIV and STIs to enter the body.

For rimming:

  • Use a barrier like plastic wrap or a dental dam to prevent faecal matter from getting into your mouth. This can protect you from intestinal parasites and hepatitis A.
  • Using a barrier may also protect you from herpes.

In this article, oral sex is defined as:
Sucking or getting sucked:
Mouth – penis contact
“Head”
Fellatio
Cunnilingus

Rimming
Mouth – anus contact
Analingus

Determining the risk: oral sex and HIV / STIs

HIV/Aids
How easy is it to transmit through oral sex?

Probably difficult:

  • There have been no published studies measuring the risk of HIV from oral sex.
  • There have been documented cases of men getting infected from sucking.
  • There have been no recorded cases of getting HIV from getting sucked.
  • There have been no reported cases of getting infected from rimming.

Although HIV is in precum and semen, the actual risk from oral sex is unknown. The chance from transmission is believed to be much lower than through unprotected anal or vaginal intercourse because:

  • Saliva may neutralise the virus
  • The lining of the mouth is tougher and stronger than the lining of the rectum and the vagina.
  • A penis is not as likely to cause the same trauma to the mouth as it will to the rectum or the vagina.

The following may increase your risk of HIV infection and / or transmission during oral sex:

  • Sores, cuts, abrasions, inflammation, gum disease and blood in the mouth can allow HIV to more easily enter the body.
  • Similarly, the presence of white blood cells at the site of STI infections may provide an easy entry point to HIV.
  • Prolonged deep throating may cause tears in the throat’s lining, making it easier for HIV to enter the body.

Any questions? Ask our sexologist

 
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