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Back to Section One | Back to Arts & Entertainment
posted Friday, February 4, 2011 - Volume 39 Issue 05
Oral sex: how safe is it?
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Oral sex: how safe is it?

by Dr. Joanne Stekler - Special to the SGN

Joanne Stekler, MD, MPH, is deputy director of community services for the HIV/STD Program at Public Health - Seattle & King County. She is also an internal medicine and infectious disease physician at Harborview Medical Center, and assistant professor of medicine and epidemiology at the University of Washington.

This is the third in a series of articles focusing on HIV and other STD prevention and care topics for Gay/Bisexual men and Transgender individuals in Seattle and King County.


I recently heard someone say that most guys didn't know they could get gonorrhea in their throats from oral sex.

Well, you can & because gonorrhea is a sexually transmitted infection and oral sex is sex. Which means that oral sex can lead to STDs and other things that can really, well, suck.

You may have decided at one point or another to have oral sex with someone instead of anal sex because there's a lower risk of getting HIV. You can get HIV from giving oral sex, but the chance is small - it's thought to be about one in 10,000. But I know a few guys who were definitely infected through oral sex, so the risk could actually be higher. It may be more likely if someone has a high HIV level or if you have a cut in your mouth or a cold sore.

It's much easier to get syphilis from oral sex - about one in seven guys who have syphilis got it from oral sex. We are seeing more and more syphilis among Gay and Bi guys in Seattle. And although syphilis has increased, HIV rates have stayed the same. This could be because more guys may be using condoms for anal sex, but they're having lots of oral sex.

Like syphilis, gonorrhea has increased in Gay and Bi men in Seattle. Gonorrhea of the throat can feel just like strep throat, or you may have no symptoms at all. Both gonorrhea and syphilis can be cured, but gonorrhea may be more difficult to treat when it's in your throat. Also, some gonorrhea are becoming less sensitive to the antibiotics we have always used.

Last but definitely not least, you can get herpes from oral sex - both giving and receiving. Herpes simplex virus-1 (HSV-1), the virus that typically causes cold sores, can also cause genital herpes. Not only does herpes lead to genital ulcers, but getting infected with herpes increases your risk of getting infected with HIV even if you never have an outbreak.

Some possible ways to decrease getting or giving an STD through oral sex:

1) Have fewer partners.

2) Get tested regularly for HIV and other STDs. Make sure you get your throat swabbed for gonorrhea!

3) Ask your partners what STDs they've tested for and when they last tested.

4) Don't brush and floss your teeth right before giving head. Don't give head if you have bleeding gums, cold sores, or other sores in your mouth. Take care of your teeth and gums, especially if you use meth.

Use condoms for oral sex. Don't laugh. I know that using condoms for oral sex isn't fun for many reasons, but the fact is that condoms will decrease your chance of getting one of those STDs I just told you about.

Most Gay and Bi guys tell me that they've tried it, but flavored condoms taste horrible. So what do you think about making it tasty with jam or honey? Just remember not to use oil-based products that could damage the condom.

Give it a try & it might be more fun and scrumptious than you thought.

If you're a guy who has sex with other guys, you can get tested for HIV and other STDs at Public Health's STD Clinic, Gay City, the baths, and at your doctor's office. For hours and locations, call 206-296-4649 or go to www.kingcounty.gov/health/hiv. You can read more about the risks of oral sex at www.cdc.gov/hiv/resources/factsheets/PDF/oralsex.pdf.

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