James W. Hicks, M.D.

Condoms for Oral Sex

In Ask the Doctor* on January 16, 2011 at 10:07 am

Q: What percentage of people wear a condom for a blowjob? I’ve seen it advised everywhere, but I’ve only met one person who actually does it, and zie [he/she?] does it for sex work. How important is it in terms of STD’s? How dangerous is it for the reciving and giving partner? Can you give me the skinny? THANKS!

A: Medical professionals urge condom use during oral sex, because potentially infectious fluids are exchanged. Even though the risk of transmitting HIV is low, you can catch gonorhea, syphilis, chlamydia, and herpes. If you have a cut in your mouth, or a sore, then you could also conceivably get HIV. In some anonymous sexual settings (such as a bathhouse or video store), your partner could pass on hepatitis, an intestinal bug, or even the common cold, if he hasn’t washed between sexual acts. Who knows where that penis has been?

Some people try to limit the risk by not letting a partner ejaculate in their mouth, but that can be difficult to control, and you may still be exposed to unclean skin and pre-ejaculatory fluids. If someone has ejaculated in your mouth, it may be relatively safe to swallow, since the acidic juices in your stomach should kill HIV and most bacteria, but spitting out is probably the safer course. It might help to gargle with an antiseptic mouthwash immediately after giving a blowjob, though the practice hasn’t been studied.

If you use a condom during oral sex, you may prefer one that is unlubricated, or one that is flavored. Though you asked about a blowjob, most of the risks described above also apply to cunnilingus. You can use a dental dam, which is a sheet of latex that you lay across the woman’s clitoris, vulva, and vaginal opening.

Returning to your original question, I suspect that condoms are not widely used for oral sex. A condom changes the experience of oral sex, though perhaps more for the one giving the blowjob than the recipient. Some people make it a rule to always use a condom themselves or on their partners, but others make an exception for oral sex. Condoms are almost never worn for oral sex in pornographic movies, but that’s probably not a good place to turn for guidance. Sex workers protect their health (and their clients) by using a condom regardless of the act.

The bottom line: The risks are lower than with unprotected vaginal or anal intercourse. You need to consider what level of risk, if any, is acceptable to you.

[You can e-mail your questions about sex, sexuality, and sexual relationships to me at flexuality@hotmail.com, or post a question anonymously as a comment. The answers I post are for informational purposes only and do not constitute individual treatment.]

  1. HPVs (Human papilloma viruses) can be transmitted via oral.
    Most people with HPV do not develop symptoms or health problems from it. In 90% of cases, the body’s immune system clears HPV naturally within two years.
    But sometimes, certain types of HPV can cause genital warts in males and females. Rarely, these types can also cause warts in the throat — a condition called recurrent respiratory papillomatosis or RRP.
    Other HPV types can cause cervical cancer. These types can also cause other, less common but serious cancers, including cancers of the vulva, vagina, penis, anus, and head and neck (tongue, tonsils and throat).

    The types of HPV that can cause genital warts are not the same as the types that can cause cancer. There is no way to know which people who get HPV will go on to develop cancer or other health problems.

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