Safer sex

Safer oral sex: the low down on going down

Oral sex (also called "going down") is the act of sucking or licking someone's external genitals (penis or vulva) or anus. While most experts agree that unprotected oral sex is not as risky as unprotected anal or vaginal intercourse, oral sex is not without risk.

What makes oral sex less risky than unprotected intercourse? Because the skin inside the mouth is stronger and thicker than the skin inside the vagina or anus, it is less likely to tear during oral sex. This means there is less of a chance HIV will enter your bloodstream. In addition, it's believed there is a substance in saliva that may actually inhibit HIV.

Although the risk for HIV transmission is low during oral sex with an HIV-positive partner or with a partner whose HIV status isn't known, many other sexually transmitted infections—including chlamydia, gonorrhea and herpes simplex virus—can be spread through unprotected oral sex.

Body fluids that can transmit HIV and sexually transmitted infections include pre-ejaculatory fluid ("pre-cum"), semen, vaginal secretions, and blood (including menstrual blood). The person performing the oral sex act (referred to as the receptive partner) is at higher risk that the person being stimulated orally (also called the insertive partner). This is because the receptive partner comes into contact with more potentially infectious fluids.

This risk of contracting HIV or another sexually transmitted infection increases if:

• you have a throat infection or other sexually transmitted infection
• you have any cuts or sores—even unnoticeable ones—in your mouth caused by disease, dental work, flossing, brushing or from eating "sharp" foods like chips
• the skin in your mouth or on your partner's genitals is torn—even unnoticeably—during rough, very penetrative, or prolonged oral sex.

To reduce the risk of contracting HIV or another sexually transmitted infection during acts of oral sex:

• use a dental dam (or a condom, cut lengthwise) for oral sex on a woman (cunnilingus).
• use an unlubricated latex condom (try flavoured condoms) for oral sex on a man (fellatio or "blow job").
• don't have oral sex right after brushing or flossing your teeth; wait at least 30 minutes
• try to avoid getting body fluids in your mouth
• after oral sex, rinse with water or an anti-bacterial mouthwash

Oral sex on a woman (cunnilingus)

So named because it is used during dental surgery such as root canals, a dental dam is a small sheet of latex that acts as a barrier between the vagina or anus and the mouth. Due to the possible infectious secretions from both the vagina and the anus, the dental dam is becoming a popular safer sex tool. When used properly, a latex dental dam offers effective protection against HIV infection and other sexually transmitted infections (STIs).

How to properly use a dental dam

Use a dental dam each time you perform oral sex. Use a new dental dam before each sex act and ensure the dam is free of holes or breakage. You can check the dam by holding it up to the light or by seeing whether water will pass through it.

Avoid using oil- or petroleum-based lubricants such as Vaseline, baby oil, vegetable oil, mineral oil, or petroleum jelly: these products can break down the latex and may cause leaks. Use a water-based lubricant such as KY Jelly instead.

Finally, be sure that only one side of the dam comes in contact with the genitals and that the dam is used only once. Use a new dental dam each time you engage in cunnilingus or other similar intimate relations.

To use the dental dam, hold it over the vulva or anus during oral stimulation, making sure the latex remains in place. Always keep the same side against the body. Never share or reuse a dental dam.

Dental dams are best stored at room temperature. Never use a dental dam if it appears brittle.

No condom or prophylactic is 100% effective, but when used properly, dental dams help reduce the risk of HIV infection and many other sexually transmitted infections (STIs).

Oral sex on a man (fellatio or "blow job")

If you're wondering about fellatio (commonly known as a "blow job"), a latex male condom may be used.

Use a new condom each time.

To put the condom on, squeeze the tip to remove any air. Before any sexual act and while the penis is erect, place the condom on the tip and gently roll it all the way down to the base of the penis.

To remove the condom, hold onto the rim to ensure nothing spills out. Tie the end of the condom in a knot and dispose of it in a wastebasket.

As with dental dams, avoid the use of oil- or petroleum-based lubricants.

Store condoms at room temperature and avoid using a condom if it appears brittle.

As with dental dams, male condoms are not guaranteed to be 100% effective, but when used properly, they will help reduce the risk of HIV infection and many other sexually transmitted infections (STIs).