STD Risk and Oral Sex – CDC Fact Sheet

Fast Facts

  • Many sexually transmitted diseases (STDs) spread through oral sex.
  • Using a condom, dental dam, or other barrier methods the right way every time you have oral sex can reduce the risk of giving or getting an STD.
  • There is little to no risk of getting or transmitting HIV from oral sex.

What is Oral Sex?

Oral sex involves using the mouth to stimulate the genitals or genital area of a sex partner. Types of oral sex include the penis (fellatio), vagina (cunnilingus), and anus (anilingus).

How common is oral sex?

Oral sex is commonly practiced by sexually active adults. More than 85% of sexually active adults aged 18-44 years reported having oral sex at least once with a partner of the opposite sex. A separate survey conducted during 2011 to 2015 found that 41% of teenagers aged 15-19 years reported having oral sex with a partner of the opposite sex.

Can STDs Spread During Oral Sex?

Illustration of microbes imagined from inside a mouth

Yes. Many STDs and other infections are spread through oral sex. Anyone exposed to an infected partner can get an STD in the mouth, throat, genitals, or rectum. The risk of getting an STD or spreading an STD to others through oral sex depends on several things, including the particular STD, type of sex, and number of sex acts performed.

In general:

  • It is possible to get some STDs in the mouth or throat after giving oral sex to a partner who has a genital or anal/rectal STD.
  • It is possible to get certain STDs on the genitals and genital areas after receiving oral sex from a partner with a mouth or throat infection.
  • It is possible to have an STD in more than one area at the same time. For example, you can have an STD in the throat and the genitals.
  • Several STDs (i.e., syphilis, gonorrhea, and intestinal infections) that are transmitted by oral sex can spread in the body.
  • Oral sex involving the anus (or anilingus) can transmit hepatitis A and B. It also can transmit intestinal parasites like Giardia and bacteria like E.coli and Shigella.
  • If you have an STD, you might not know it because many STDs are symptomless. It is possible to spread STDs even when you don’t have any signs or symptoms.

Which STDs Can Be Passed On from Oral Sex?

Chlamydia

Chlamydia
(Chlamydia trachomatis)

 

Risk of infection from oral sex:
  • Giving oral sex to a partner with an infected penis can cause chlamydia in the throat.
  • Giving oral sex to a partner with an infected vagina or urinary tract may cause chlamydia in the throat.*
  • Giving oral sex to a partner with an infected rectum might cause chlamydia in the throat.*
  • Getting oral sex on the penis from a partner with chlamydia in the throat can cause chlamydia of the penis.
  • Getting oral sex on the vagina from a partner with chlamydia in the throat might cause chlamydia of the vagina or urinary tract.*
  • Getting oral sex on the anus from a partner with chlamydia in the throat might cause chlamydia in the rectum.*

* Statements with an asterisk (*) need more research.

Areas of initial infection:
  • Throat
  • Genitals
  • Urinary tract
  • Rectum
Initial signs and symptoms of infection:
  • Most chlamydia infections in the throat have no symptoms. When symptoms are present, they can include a sore throat.
  • Many genital, urinary tract, or rectal chlamydia infections have no symptoms. When symptoms are present, they can include:
    • Discharge from the vagina or penis (discharge from the vagina may be bloody)
    • Burning feeling when peeing
    • Painful or swollen testicles
    • Rectal pain or discharge
Treatment:
  • The right medicine can cure chlamydia.
  • Sex partners of a person with chlamydia should also receive testing to ensure there is no infection. People with chlamydia should not have sex until 7 days after they and their sex partners receive and complete treatment.
If left untreated, throat infections:
  • Can spread to sex partners who do not have the infection, often by performing oral sex on a male partner’s penis.
If left untreated, genital, urinary and/or rectal infections:
      • chronic pelvic pain,
      • infertility, and
      • ectopic pregnancy (a pregnancy in the fallopian tube or outside of the womb)
  • In pregnant people:
    • Might result in premature birth or low birth weight in babies.
    • Can spread to the baby during delivery and cause infection in the eyes or respiratory tract.
  • In men:
    • Can cause epididymitis, a painful condition of the ducts attached to the testicles that may lead to ductal scarring.
  • In everyone:
    • May increase risk of getting HIV infection.
    • Might increase risk of spreading HIV to sex partners.
    • May cause a reaction throughout the body known as reactive arthritis. This can lead to:
      • arthritis (joint pain)
      • conjunctivitis (pink eye)
      • a rash on the soles of the feet or elsewhere

Gonorrhea

Gonorrhea
(Neisseria gonorrhoeae)

 

Risk of infection from oral sex:
  • Giving oral sex to a partner with an infected penis can cause gonorrhea in the throat.
  • Giving oral sex to a partner with an infected vagina or urinary tract might cause gonorrhea in the throat.*
  • Giving oral sex to a partner with an infected rectum might cause gonorrhea in the throat.*
  • Receiving oral sex on the penis from a partner with gonorrhea in the throat may cause gonorrhea of the penis.
  • Receiving oral sex on the vagina from a partner with gonorrhea in the throat might cause gonorrhea of the vagina or urinary tract.*
  • Receiving oral sex on the anus from a partner with gonorrhea in the throat might cause gonorrhea in the rectum.*

* Statements with an asterisk (*) need more research.

Areas of initial infection:
  • Throat
  • Genitals
  • Urinary tract
  • Rectum
Initial signs and symptoms of infection:
  • Most gonorrhea infections in the throat have no symptoms. When symptoms are present, they can include a sore throat.
  • Symptoms of genital, urinary tract, or rectal infection may include:
    • Discharge from vagina or penis (discharge from the vagina may be bloody)
    • Burning feeling when peeing
    • Painful or swollen testicles
    • Rectal pain or discharge
Treatment:
  • Gonorrhea infections in the throat are harder to cure than genital or rectal infections but are treatable with antibiotics.
  • Genital and rectal infections are curable with the right medicine.
  • Sex partners of a person with gonorrhea should also receive testing to ensure there is no infection. Those with gonorrhea should not have sex until 7 days after they and their sex partners receive and complete treatment.
If left untreated, throat infections:
  • Can be spread to sex partners who do not have the infection.
  • Might spread through the body causing a rash and joint pain. This condition is disseminated gonococcal infection. A heart infection can also occur, which is a serious and potentially life-threatening condition.
If left untreated, genital, urinary and/or rectal infections:
  • Can be spread to other sex partners.
  • In women:
  • In pregnant people:
    • Might result in premature birth or low birth weight in babies.
    • Can spread to the baby during delivery, and can cause blindness, joint infection, or a life-threatening blood infection in the baby.
  • In men:
    • Can cause epididymitis, a painful condition of the ducts attached to the testicles that may lead to ductal scarring.
  • In everyone:
    • May increase risk of getting HIV infection.
    • Might increase risk of spreading HIV to sex partners.
    • May spread through the body causing skin sores and joint pain. This condition is disseminated gonococcal infection. A heart infection can also occur, which is a serious and potentially life-threatening condition.

Syphilis

Syphilis
(Treponema pallidum)

 

Risk of infection from oral sex:
  • Giving oral sex to a partner with a syphilis sore or rash on the genitals or anus can cause syphilis.
  • Receiving oral sex from a partner with a syphilis sore or rash on the lips or mouth, or in the throat, can cause syphilis.
  • Another important factor that affects risk of spreading syphilis is how long your partner had syphilis.
Areas of initial infection:
  • Lips
  • Mouth
  • Throat
  • Genitals
  • Anus
  • Rectum
Initial signs and symptoms of infection:
  • May not have symptoms
  • One or more painless ulcers or sores on the
    • lips, mouth, or throat
    • skin
    • on or near the genitals or anus
  • Rash on trunk, palms of hands, and/or soles of feet
  • Flu-like symptoms
Treatment:
  • Syphilis is curable with the right medicine.
  • Some past and current sex partners of a person with syphilis also should be tested for infection. Even if their syphilis test results are negative, some of these partners should still receive treatment.
If left untreated, syphilis:
  • Can spread to others through contact with syphilis sores or rash.
  • In pregnant people:
    • Can spread to the baby during pregnancy
    • Can cause stillbirth (a baby born dead)
    • Babies that don’t receive treatment may have developmental delays, seizures, or die
  • In everyone:
    • Can increase risk of getting HIV infection
    • Can increase risk of spreading HIV to sex partners
    • May cause damage to internal organs, blindness, muscle weakness, dementia, and even death

Herpes

Herpes
(herpes simplex virus types 1 and 2)

 

Risk of infection from oral sex:
  • Giving oral sex to a partner with herpes on the genital area, anus, buttocks, or in the rectum may cause oral herpes.
  • Receiving oral sex from a partner with herpes on the lips, mouth, or in the throat can cause herpes on the genital area, anus, buttocks, or in the rectum.
Areas of infection:
  • Lips
  • Mouth
  • Throat
  • Genital area
  • Anus
  • Rectum
  • Buttocks
Signs and symptoms of infection:
  • May not have symptoms
  • Headache or fever (during initial infection)
  • Painful or itching sores at or near the area of infection
Treatment:
  • There is no cure for a herpes, but antiviral medicine can shorten symptoms and decrease outbreaks.
  • Daily antiviral medication can prevent or shorten herpes outbreaks.

Even with treatment, oral (lip, mouth and throat) infections:

  • Can spread to others, including sex partners.

Even with treatment, genital area, buttock, anal, and/or rectal infections:

  • Can spread to sex partners who do not have the infection.
  • In pregnant people:
    • May spread to the baby during delivery, causing damage to the brain and internal organs and even death.
  • In everyone:
    • Can increase risk of getting HIV infection.
    • Can increase risk of giving HIV to sex partners.

HPV

HPV
(human papillomavirus)

 

Risk of infection from oral sex:
  • Giving oral sex to a partner with an HPV-infected penis or genital area can cause HPV in the throat.
  • Giving oral sex to a partner with an HPV-infected vagina or genital area can cause HPV in the throat.
  • Giving oral sex to a partner with HPV on the anus or in the rectum may cause HPV in the throat.*
  • Receiving oral sex from a partner with HPV in the throat might cause HPV on the genital area, anus, or rectum.*

* Statements with by an asterisk (*) need more research.

Areas of infection:
  • Mouth
  • Throat
  • Genital area
  • Vagina
  • Cervix
  • Anus
  • Rectum
Signs and symptoms of infection:
  • May have no symptoms
  • Warts in the throat (laryngeal or respiratory papillomatosis):
    • May cause changes in the voice, difficulty speaking, or shortness of breath
  • Genital or anal warts
  • Abnormal changes in cells of vagina, cervix, or anus found by clinical exams and tests (Pap and/or HPV tests)
  • Some types of HPV can lead to vaginal or cervical, anal, penile, head, and neck cancers
Vaccine:
  • HPV vaccine protects against transmission of certain types of HPV. All boys and girls aged 11-12 should receive the vaccination, including everyone through age 26 if not vaccinated already. More details about HPV vaccination are available from CDC’s HPV website.
Treatment:
  • Warts in the mouth and throat:
    • May disappear, stay the same, or grow in size or number
    • Surgery can remove warts in the throat
    • Treatment may reduce warts but does not cure HPV infection
  • Genital and anal warts:
    • May go away on their own, stay the same, or grow in size or number
    • Treatments include medicines to apply on warts, freezing the warts (cryotherapy), or surgery to remove the warts
    • Treatment may reduce warts but does not cure HPV infection
  • Abnormal changes in cells of vagina, cervix, or anus:
    • May need more clinical exams and tests (Pap and/or HPV tests)
    • Other procedures include biopsy (taking a small sample of tissue) and/or removal of abnormal tissue, depending on age, pregnancy status, and test results

Even with treatment, warts in the throat:

  • Might be spread to sex partners who do not have the infection.
  • May have recurrences (recurrent respiratory papillomatosis).

Even with treatment, genital and anal warts:

  • Can spread to sex partners who do not have the infection.
  • May return but will not develop into cancer.

Mouth and throat infections by several types of HPV that do not cause warts may develop into head or neck cancer.

Abnormal changes in cells of vagina or anus:

  • Might develop into cancer. Although some women have abnormal Pap and/or HPV test results, few get cervical cancer if they get the right follow-up and treatment.

 

HIV

HIV
(human immunodeficiency virus)

 

Risk of infection from oral sex:
  • Giving oral sex on the penis of a partner with HIV can cause HIV. The risk of infection is lower than the risks from vaginal or anal sex.
  • Giving oral sex on the vagina of a partner with HIV may cause HIV. The risk of infection is thought to be very low.
  • Giving oral sex on the anus of a partner with HIV may cause HIV. There are few reports of transmission from this type of oral sex.
  • Receiving oral sex on the penis from a partner with HIV may cause HIV. This risk is thought to be very low and has not been well studied.
  • Receiving oral sex on the vagina from a partner with HIV might cause HIV. This risk is thought to be extremely low and has not been well studied.
  • Receiving oral sex on the anus from a partner with HIV might cause HIV. There are few reports of transmission from this type of oral sex.
  •  The virus level (or viral load) in an infected partner’s blood and other body fluids during a sexual encounter. An undetectable HIV viral load eliminates the risk of spreading HIV from oral sex.
Areas of infection:
  • Infection of the immune system throughout the body.
Initial signs and symptoms of infection:
  • May have no symptoms for many years
  • Flu-like symptoms
Treatment
  • There is no cure for HIV, but antiviral and other medicines can help people live longer with a better quality of life.

Even with treatment, HIV infection:

  • Can increase the risk of getting certain infections and cancers

Trichomoniasis

Trichomoniasis
(infection with T. vaginalis)

 

Risk of infection from oral sex:
  • Giving oral sex to a partner with the infection in their genitals might cause trichomoniasis of the throat. There are few reports of potential spread from oral sex.
  • Spread of trichomoniasis by other oral sex practices has not been reported.
Areas of initial infection
  • Vagina
  • Penis
  • Mouth/throat (possibly)
Initial signs and symptoms of infection
  • Infections of the genitals or urinary tract may have no symptoms, especially in men
  • Symptoms of genital or urinary tract infection can include:
    • Discharge from vagina or penis
    • Vaginal area redness
    • Vaginal itching
    • Burning feeling when peeing
Treatment
  • Is curable with right
  • The sex partners of people with trichomoniasis should receive testing to ensure there is no infection. Those with trichomoniasis should not have sex until they and their sex partners complete treatment.
If left untreated, genital or urinary infections:
  • Can spread to sex partners who do not have the infection

 

not exactly

Is Oral Sex Safer than Vaginal or Anal Sex?

  • It is difficult to compare the risks of getting specific STDs from specific types of sexual activity.
    • Most people who have oral sex also have vaginal or anal sex.
    • Few studies look at the risks of getting STDs, other than HIV, from giving oral sex on the vagina or anus, compared to the penis.
  • Studies show the risk of getting HIV from oral sex (giving or receiving) with a partner who has the infection is much lower than the risk of getting HIV from anal or vaginal sex. This may not be true for other STDs.
    • In a study of gay men with syphilis, 1 out of 5 reported having only oral sex.
    • Getting HIV from oral sex may be extremely low, but it is hard to know the exact risk. If you are having oral sex you should protect yourself.
  • It is possible that getting certain STDs in the throat like chlamydia or gonorrhea may not be as harmful as getting an STD in the genital area or rectum. Having these infections in the throat might increase the risk of getting HIV. Having gonorrhea in the throat also may might lead to the spread of disease throughout the body. In addition:
    • Having infections of chlamydia and gonorrhea in the throat may make it easier to spread these infections to others through oral sex. This is especially important for gonorrhea, since throat infections can be harder to treat.
    • Infections from certain STDs, such as syphilis and HIV, spread throughout the body. Therefore, infections acquired in the throat may lead to the same health problems as infections acquired in the genitals or rectum.
    • Mouth and throat infections by certain types of HPV may develop into oral or neck cancer.

What May Increase the Chances of Giving or Getting an STD through Oral Sex?

Certain factors may increase a person’s chances of getting HIV or other STDs during oral sex if exposed to an infected partner. Factors like:

  • Poor oral health, which can include tooth decay, gum disease or bleeding gums, and oral cancer.
  • Sores in the mouth or on the genitals.
  • Exposure to the “pre-cum” or “cum” (also known as pre-ejaculate or ejaculate).

However, there are no scientific studies that show whether these factors increase the risk of getting HIV or STDs from oral sex.

What Can You Do to Prevent STD Transmission During Oral Sex?

You can lower your chances of giving or getting STDs during oral sex. Use a condom, dental dam or other barrier methods every time you have oral sex.

  • For oral sex on the penis:
    • Cover the penis with a non-lubricated latex condom.
    • Use plastic (polyurethane) condoms if you or your partner is allergic to latex.
  • For oral sex on the vagina or anus:
    • Use a dental dam.
    • Cut open a condom to make a square and put it between your mouth and your partner’s vagina or anus.

The only way to avoid STDs is to not have vaginal, anal, or oral sex.

If you are having sex, you can lower your chances of getting an STD by:

  • Being in a long-term mutually monogamous relationship with a partner who does not have an STD (e.g., a partner with negative STD test results).
  • Using latex condoms the right way every time you have sex.

It’s important to remember that many people with an STD may be unaware of their infection. STDs often have no symptoms and are unrecognized.

If you are having sex, ask your healthcare provider to test you regularly for STDs and HIV. Talk openly with your provider about activities that might put you at risk for an STD, including oral sex. You also should talk to your partner(s) about STDs. Free and low-cost options for testing are available in your area. 

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