Protection against STDs during oral sex low among youngsters

Adolescents and young adults regularly engage in oral sex but seldom use condoms to prevent the spread of sexually transmitted diseases, new research shows.

That didn’t surprise the researcher who headed the study. “Many studies show that adolescents and young adults are unaware of the health risks associated with oral sex,” said Giuseppina Valle Holway, a sociology professor at The University of Tampa in Florida, in an email.

As reported in the Journal of Adolescent Health, Holway and her coauthor Stephanie Hernandez examined reports of heterosexual oral sex and condom use in a nationally representative sample of more than 7,000 US youth between ages 15 and 24. More than half reported engaging in fellatio within the past year, but only 8 percent of females and 9 percent of males said they used a condom.

“Many young adults do not perceive they are at risk of contracting a sexually transmitted infection,” said Erin Moore, a professor of human sexuality at Stetson University in DeLand, Florida, who was not involved with the study.

Oral sex is less likely to spread sexually transmitted infections than vaginal or anal intercourse, she said, but the risk remains.

“If people are not going to use condoms consistently, then the most important thing they should do is get tested for sexually transmitted infections and make sure their partners get tested before engaging in oral, vaginal or anal sex,” Moore said in an email.

Holway and Hernandez suggest that doctors discuss the potential for sexually transmitted infections with young patients. Interactive workshops about safe-sex practices on college campuses are also valuable education tools, the authors write.

Many American schools provide no sex education or just abstinence-only sex education, discouraging all sexual contact until marriage without teaching prevention of sexually transmitted diseases, Moore said.

“Keep in mind that, less than 20 years ago, some states still had ‘sodomy laws’ that made engaging in oral sex illegal,” Moore said. The U.S. Supreme Court ruled sodomy laws unconstitutional in a Texas case in 2003.

Though the main findings of the study were expected, results about race and maternal education sparked interest in additional research.

Black youth were less likely to engage in oral sex, the study found, but they were significantly more likely to use a condom. Previous studies have shown that black youth also are more likely to use condoms during intercourse, according to the report.

Females whose mothers had higher levels of education were more likely to have performed or received oral sex - and were more likely to have had two or more oral sex partners in the past year. The finding led researchers to speculate that “higher goals may lead young women to engage in oral sex in place of vaginal sex, particularly if they view intercourse as a riskier sexual activity with more severe consequences (e.g., pregnancy) that could derail future plans.”

Moore was intrigued by the researchers’ hypothesis that maternal education could be related to young women having a goal-oriented mindset that may lead to oral sex instead of vaginal sex.

“Previous research highlights that college students tend to be more concerned about experiencing pregnancy than contracting a sexually transmitted infection,” she said. “A child is viewed as a much more life-changing event.”

The study focused exclusively on condoms and fellatio and did not examine the recommended use of dental dams during cunnilingus. But prior research shows that people rarely, if ever, use dental dams.

Increasing the use of barrier methods during cunnilingus could help to decrease the rate of oral human papillomavirus (HPV) infection and possibly the incidence of HPV-related cancers. Roughly one in nine U.S. men have oral infections of cancer-causing HPV.

HPV is among the most common sexually transmitted diseases. Most infections don’t cause symptoms and go away on their own. But the virus can cause cancers of the throat, anus, penis, cervix, vagina and vulva, as well as genital warts and lesions in the upper respiratory tract.

Other STDs that can be passed on from oral sex include gonorrhea, syphilis, herpes, and HIV, the virus that causes AIDS.