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How Risky is Oral Sex?

A CDC report reminds that it can be dangerous -- but the risks are more complicated than we think.

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The other leading risk through oral sex is gonorrhea, says Hurt. STD clinics  have reported that 5 to 10 percent of patients have gonorrhea of the throat. Scarier still: Cases of antibiotic-resistant oral gonorrhea are  on the rise (meaning these cases are harder to treat but  not incurable).

Chlamydia and syphilis are in the second tier of risk through oral sex. A  Chicago study found that 13.7 percent of syphilis cases were attributed to oral sex. Generally, though, it’s believed to be uncommon. As for syphilis, that seemingly antiquated infection, it’s “easily transmitted” during oral sex — “if a person’s mouth comes into contact with an open sore or a skin rash caused by the infection,” according to AVERT.

As for HPV, Hurt says, “We really don’t know what the risk is … but it clearly can infect in and around the mouth, as well as in the genital tract.”  One study described the risk as “small.” You’ve probably seen the scary headlines about oral sex causing cancer, but as I reported in the past, oral cancers linked to HPV are very rare: Approximately five per 100,000 people. (And most oral cancers are tied to HPV 16, and we have a vaccine for that now).

Further down the list of risk are Hepatitis A, gastrointestinal infections, and parasites, among others — fun times, y’all!

One takeaway is that — sorry, fellatio fans — blow jobs tends to be riskier than cunnilingus. “Across all STIs and all sex acts, generally the receptive partner is the one at greater risk for STI and HIV acquisition, the idea being that wherever ejaculate winds up, that’s also where the greatest burden of infectious material will also wind up,” says Hurt. But that hardly means that cunnilinguists are in the clear: He also says that the risk of contracting syphilis, herpes or HPV by performing oral sex on a woman is “arguably just as high” as with fellatio “since these infections can occur both inside the vagina and on the skin surface.”

There’s a yawning gap between sexual health experts’ recommendations and people’s actual behaviors: A  2004 surveyof U.S. adults found that 82 percent of sexually active participants never used a condom or dental dam during oral sex. A U.K.  survey of 16 to 18 year olds found that only 2 percent of those who had experienced fellatio consistently used condoms. “It’s pretty uncommon for people to actually use condoms or dental dams when performing oral sex,” says Hurt. Flavored condoms and dental dams help to encourage the practice, but “they can only go so far towards making [oral sex] through latex or polyurethane a pleasurable experience for either partner.”

So, you see, it’s hard to nail down the exact risk of unprotected oral sex, but Hurt says, “The most important point is that it’s all relative, and oral sex isn’t risk-free.”


Tracy Clark-Flory is a staff writer at Salon. Follow@tracyclarkflory on Twitter.

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