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Oral Sex and Syphilis
Syphilis is a highly contagious STD. Transmission usually occurs during vaginal, anal or oral sex when syphilitic sores or patches come into contact with slightly abraded skin or mucous membranes. Left untreated, syphilis can progress from painless ulcers to a rash, heart disease or memory loss, and death. While penicillin is a highly effective treatment, it cannot reverse damage already done by the disease. Oral sex is an efficient way to transmit syphilis, and has played an important role in a number of recent syphilis outbreaks.6,7,8

Oral Sex and Gonorrhea
Gonorrhea is a very common, highly contagious STD that is passed through contact with infectious fluids. Gonorrhea can cause pelvic inflammatory disease (PID) in women, which can lead to abdominal pain and infertility. Infected pregnant women are at increased risk for miscarriage and premature births, and their infants can have serious eye infections. Gonorrhea survives well in the throat, and gonorrhea throat infections from oral sex are relatively common.9 Most people with throat infections have vaginal or penile infections as well. Although most throat infections from gonorrhea cause no symptoms, you can develop a sore throat, fever and swollen lymph nodes. 

Oral Sex and Genital Herpes
Herpes simplex-1 (HSV-1) and herpes simplex-2 (HSV-2) are very similar viruses that are transmitted by direct contact. In the past, most cold sores were caused by HSV-1 and most genital herpes was caused by HSV-2. Genital infections cause painful blisters, ulcers and difficulty while urinating and can recur for a whole lifetime. Although ongoing therapy can reduce the number and severity of recurrent infections, there is no cure. Genital infections acquired during pregnancy can cause encephalitis (brain swelling), retardation and death in newborns. Both HSV-1 and HSV-2 can be spread from an infected person to an uninfected person even if the infected person has no visible sores. Both viruses are easy to spread through oral sex. Oral sex appears to be changing how many people get herpes and where they get it. In one study of STD clinic attendees, those who had oral sex during the preceding two months were three times more likely to have genital HSV-1 than HSV-2.10 This is the opposite of what used to be seen, when most genital infections were caused by HSV-2.

Oral Sex & Chlamydia
Chlamydia is the most common bacterial STD in the U.S. It is particularly common among sexually active youth. In addition to vaginal sex, chlamydia appears to be transmissible through oral sex. In one study of persons in an STD clinic, one of every 30 patients had a throat culture positive for chlamydia. Women who practiced oral sex were three times more likely to have chlamydia in their throats than other women.11

Oral Sex & HPV
Human papillomavirus (HPV) is the most common viral STD and is transmitted by skin-to-skin contact. Genital warts are caused by some types of HPV and cervical cancer is caused by other types. Cervical cancer kills more than 4,000 women each year in the U.S.12 HPV appears to be transmissible by oral sex. Adults with recurrent respiratory papillomatosis (a throat condition that causes hoarseness) were more likely than uninfected adults to have practiced oral sex.13

Oral Sex & HIV

HIV is transmitted through contact with infected blood or body fluid. Infected pregnant women can pass it to their babies. The virus invades the immune system and destroys it over time. The destruction of the immune system reduces a person’s ability to fight off infections and cancer. People with HIV eventually develop AIDS, which is often fatal. When first infected, you may only have flu-like symptoms (feeling tired, feverish or achy) that last a little while. You may have no other symptoms for years. If you go on to get AIDS, you may get multiple infections that other people fight off easily, such as tuberculosis, pneumonia and yeast infections. Anal sex, multiple partners or shooting drugs are particularly high-risk activities. Transmission of the virus also occurs during vaginal and oral sex. Recent estimates of the proportion of new HIV cases attributable to oral sex range from less than 1 percent (14) to 7 percent.15

Despite widespread misconceptions, oral sex is risky sexual activity that puts participants at risk for a number of STDs.

If you’ve already been sexually active outside a lifelong mutually faithful relationship (as in marriage), talk to your healthcare provider about getting you and your partner tested for STDs. Abstinence from sexual activity—including oral sex—or lifetime faithfulness to one uninfected partner is the only certain way to avoid being infected.

1  Practices and preferences. In: Michael RT, Gagnon JH, Laumahn EO, Kolata G. Sex in America: A Definitive Survey. Boston, Ma: Little, Brown and Company; 1994:140-141.

2  Boekeloo BO, Howard DE. Oral sexual experience among young adolescents receiving general health examinations. Am J Health Behav. 2002;26:306-314.

3  Newcomer SF, Udry JR. Oral sex in an adolescent population. Arch Sex Behav. 1985;14:41-46.

4  Schuster MA, Bell RM, Kanouse DE. The sexual practices of adolescent virgins: Genital sexual activities of high school students who have never had vaginal intercourse. Am J Public Health. 1996;86:1570-1576.

5 Horan PF, Phillips J, Hagen NE. The meaning of abstinence for college students. Journal of HIV/AIDS Prevention and Education for Adolescents and Children. 1998;2:51-66.

6  Cook PA, Clark P, Bellis MA, et al. Re-emerging syphilis in the UK: A behavioural analysis of infected individuals. Commun Dis Public Health. 2001;4:253-258.

7  Poulton M, Dean GL, Williams DI, Carter P, Iversen A, Fisher M. Surfing with spirochaetes: An ongoing syphilis outbreak in Brighton. Sex Transm Infect. 2001;77:319-321.

8  Lacey HB, Higgins SP, Graham D. An outbreak of early syphilis: Cases from North Manchester General Hospital, UK. Sex Transm Infect. 2001;77:311-313.

9  Hook EW III, Handsfield HH. Gonococcal infections in the adult. In: Holmes KK, Mardh PA, Sparling PF, et al., eds. Sexually Transmitted Diseases. 3rd ed. New York, NY: McGraw-Hill; 1999:456.

10  Lafferty WE, Downey L, Celum C, Wald A. Herpes simplex virus type 1 as a cause of genital herpes: Impact on surveillance and prevention. J Infect Dis. 2000;181:1454-1457.

11  Jones RB, Rabinovitch RA, Katz BP, et al. Chlamydia trachomatis in the pharynx and rectum of heterosexual patients at risk for genital infection. Ann Intern Med. 1985;102:757-762.

12  Sanders GD, Taira AV. Potential cost-effectiveness of a HPV vaccine. Emerging Infectious Diseases 2003; 9(1): 37-48.

13  Kashima HK, Shah F, Lyles A. A comparison of risk factors in juvenile-onset and adult-onset recurrent respiratory papillomatosis. Laryngoscope. 1992;102:9-13.

14  Page-Shafer K, Shiboski CH, Osmond DH, et al. Risk of HIV infection attributable to oral sex among men who have sex with men and in the population of men who have sex with men. AIDS. 2002;16:2350-2352.

15  Gottlieb S. Oral sex may be important risk factor for HIV infection. BMJ. 2000;320:400.