Oral sex and the transmission of viral STIs

Objective: To review the literature on the role of oral sex in the transmission of viral sexually transmitted infections (STIs). Method: A Medline search was performed using the keywords ore-genital sex, and those specific to each infection. Further references from each article identified by Medline were also included, as were relevant references from "Current contents" Conclusions: Oral sex is a common sexual practice among both heterosexual and homosexual couples. The evidence suggests that HIV transmission can take place through ore-genital sex from penis to mouth and vagina to mouth. Case reports describe apparent transmission from mouth to penis although this appears less likely. The risk of ore-genital transmission of HIV is substantially less than from vaginal and anal intercourse. Receptive ore-genital sex carries a small risk of human papillomavirus infection and possibly hepatitis C, while insertive ore-genital contact is an important risk factor for acquisition of HSV 1. Ore-anal transmission can occur with hepatitis A and B. The transmission of other viruses may occur but is unproved. The relative importance of oral sex as a route for the transmission of viruses is likely to increase as other, higher risk sexual practices are avoided for fear of acquiring HIV infection.