Oral Sex and STIs
Yes, STIs can be transmitted during unprotected oral sex. Oral sex is a much lower risk activity than intercourse, but there's still a possibility for transmission. Not using a condom, dental dam, or other barrier puts both partners at risk. This means that performing and receiving oral sex puts you at risk. Some STIs are more likely to be transmitted during oral sex than others, including:
Herpes is transmitted by skin-to-skin contact with a developing or existing sore. The virus can be transmitted from genitals to mouth if the person giving oral sex has or is developing a cold sore. It can also be transmitted from mouth to genitals if the person receiving oral sex has or is developing a genital sore.
Gonorrhea is transmitted when bacteria are present in body fluids. A person giving oral sex can get a gonorrhea infection of the throat if their partner has gonorrhea.
For the person receiving oral sex, there's little chance of contracting HIV, although it's difficult to pinpoint when HIV has been transmitted because people rarely engage in only one type of sexual activity. In the case of fellatio (oral sex on a man), the HIV theoretically could gain entry from the mouth to the opening on the tip of the penis, or through an open cut or lesion on the penis. If you receive oral sex, however, you mainly expose yourself to saliva, which has negligible concentrations of HIV.
The risk of HIV infection is greater for the partner who performs oral sex. A person performing oral sex on a woman should avoid it during her period, for menstrual blood can carry the HIV. Research presented at the 7th Conference on Retroviruses and Opportunistic Infections in February of 2000 concluded that 8 of 122 cases in an HIV-transmission study were possibly attributable to performing oral sex on a man. Of these 8 infected people, some reported having had recent dental work or having cuts in their mouths, suggesting that HIV transmission by oral sex is associated with cuts, lesions, or irritation of the tissues in the mouth.
Other STIs that can be transmitted through oral sex, although less commonly, include:
HPV/ Genital Warts
In the US, HPV is considered to be the most common STI. Approximately 5.5 million people are newly infected with genital HPV each year and about 20 million people are currently infected. Some studies estimate that 50% to 75% of the sexually active population are exposed to at least 1 strain of HPV, although most people don't develop symptoms. Because HPV is so common, a person can have very few sexual partners and still come into contact with this virus.
How is it transmitted?
HPV is transmitted through vaginal, anal, and oral sex and can be transmitted by skin-to-skin genital contact or rubbing. HPV can spread whether warts are visible. Because genital HPV infections are often unseen, they can be transmitted by sex partners who do not know they're infected. A pregnant mother who is infected with HPV can also transmit the virus to her infant during vaginal childbirth.
What are the symptoms?
A majority of HPV infections have no signs or symptoms and so most people that are infected are completely unaware but can continue to transmit the virus to sex partner(s).
Depending on the type of HPV, some women have infections that cause abnormal cell growth (dysplasia) on the female cervix. A woman may only find out she has HPV when her annual Pap smear results indicate abnormal cervical cell changes.
Other types of HPV cause visible genital warts. In women, these growths may develop inside the vagina, where they are hard to detect.
You can reduce your risk of transmitting HPV to a sexual partner by abstaining from sex, by finding other ways to express intimacy, by avoiding contact with any wart, and/or by using condoms correctly and consistently every time you have sex. Like all safer sex methods (with the exception of abstinence) using condoms is not 100% safe -- genital warts not covered by a condom can still transmit the virus, but condoms are still a crucial step to minimize risk for people who continue to be sexually active.