STI Risks with Oral Sex: What People Get Wrong

Most people think oral sex is “low risk.” Some think it is “no risk.” Both ideas are wrong. Oral sex absolutely transmits sexually transmitted infections, and in the United States it is quietly responsible for a huge percentage of infections that people never realize they have. The reason is simple. Most doctors never test the mouth.

At Shameless Care, 80 percent of our gonorrhea infections are oral, and that statistic alone shows that oral sex is a major vector of transmission. If you want accurate results, you have to test every site that was actually exposed. That includes the throat.

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Why Oral Sex Transmits STIs So Easily

Infections like gonorrhea, chlamydia, mycoplasma genitalium, syphilis, herpes, and HPV are transmitted through contact with mucous membranes or skin. The throat is a mucous membrane. The tonsils are mucous membranes. The mouth contains tiny abrasions and microtears that you never feel. Add saliva, body fluids, and friction, and transmission becomes easy.

This is why people who consistently test negative at the genitals suddenly test positive when they add a throat swab. The infection was never down below. It was living quietly in the mouth.

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Which STIs Spread Through Oral Sex

Gonorrhea

Oral gonorrhea is extremely common. Many infections live quietly in the throat without symptoms and spread easily through oral sex or even kissing.

Chlamydia

Less common in the throat than gonorrhea but absolutely possible. Most people have no symptoms if it occurs orally.

Mycoplasma Genitalium

Can live in the throat and be transmitted through oral sex.

Syphilis

Syphilis spreads through direct contact with a syphilis sore, which may occur on the lips, tongue, oral mucosa, genitals, or anus. These sores are often painless and go unnoticed, so oral sex can transmit syphilis even when no one realizes a lesion is present.

Herpes

Oral HSV-1 frequently spreads to partners during oral sex and has become one of the most common causes of genital herpes. HSV-2 can also be transmitted orally, though less often.

HPV

HPV spreads through skin to skin and skin to mucosa contact. Penetration is not required. Oral HPV is usually acquired from giving oral sex or from deep kissing and is a known cause of oropharyngeal cancers. This is one of the reasons HPV vaccination is so important.

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Why Oral STIs Are Usually Missed

Most people assume a negative test means they are “clean.” But if you tested only the genitals, you may have skipped the place where the infection actually lives. Many clinicians still use outdated protocols that focus on urine or genital swabs and ignore the throat.

Oral sex is now a primary transmission route for several STIs. If you give or receive oral sex, you can have an oral infection. This is why so many people clear a genital infection, feel relieved, and then unknowingly reinfect partners from an untreated throat infection.

Symptoms Are Rare, Which Makes It Worse

Oral STIs often cause no symptoms at all. Occasionally someone may notice a sore throat, mild irritation, or swollen glands, but most people feel nothing. Silence is the problem. You cannot feel your way to a diagnosis.

Only testing solves that.

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How to Protect Yourself

Barriers reduce risk, but the overwhelming majority of people do not use them during oral sex. HPV vaccination helps protect against high risk HPV strains. For bacterial infections like gonorrhea, chlamydia, and mycoplasma genitalium, the most effective protection is site specific testing.

If you test only the genitals, you may be missing the real infection.

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Why Shameless Care Tests the Way We Do

Shameless Care built its testing platform around how people actually have sex. Our panels include oral and anal swabs because infections are site specific. A throat infection stays in the throat. A genital infection stays in the genitals. If you do not test each site, you cannot know your true status.

This is why our positivity rates are high. We look where the infections actually are.

If you want accurate STI results, get tested the right way. Shameless Care offers comprehensive site specific testing that includes oral and anal swabs with no subscriptions and discreet shipping.

Your health matters. Your partners matter. Accurate testing protects both.