My boyfriend and I want to have oral sex. We’ve never had oral sex or vaginal sex or anal sex with anybody before. But I am afraid of STDs. Could we still get STDs through oral sex?

Great question! While it’s true that the risk of either of you having and passing on a sexually transmitted infection (STI, sometimes called a sexually transmitted disease or STD) is low, it’s not zero.

The only way to know for sure that you’re both STI-free is to get tested.

You can make a date out of it by going together to get tested. Try your local community health center or Planned Parenthood. If you’re 10-22 years old in NYC, you can call (212) 423-3000 to get an appointment for confidential STI testing at no cost to you at the Mount Sinai Adolescent Health Center. You can also get tested at your primary care provider’s office.

Here’s why you’re not completely risk-free, even though neither of you has had oral, anal or vaginal sex with anyone.

  • Cold sores (also called fever blisters) are dry, reddish sores on your lip or around your mouth. These sores are caused by oral herpes. Oral herpes is very common (around half of the United States’ population has it) and often transmitted to kids through non-sexual acts, like a kiss from grandma or sharing a straw with someone who has the virus. It’s not generally considered an STI. However, if one of you has a cold sore and performs oral sex on (goes down on, eats out, gives head to) the other, it could spread herpes to their genitals. Using a dental dam or condom for oral sex, and avoiding oral sex if you have or feel like you’re about to get a cold sore, can help prevent this. We talk more about herpes, including the difference between oral and genital herpes, here.
  • Certain STIs, like HPV and herpes, can be spread during manual sex (hand jobs, fingering), or rubbing genitals directly together without clothes (even if there’s no penetration). The risk of spreading STIs this way is much lower than with penis-in-vagina (PIV), anal or oral sex—but it’s not nonexistent.
  • Some STIs, including HIV, can spread from a mother to their child during birth.
  • Some infections like HIV are also spread through certain non-sexual behaviors, like sharing needles for injection drug use.

It sounds like you trust your boyfriend and there’s no reason to not believe him. However, getting tested and using barrier methods ultimately gives you more control over your sexual health.

It may also help you feel less anxious about STIs. We recommend using a condom or dental dam (a latex barrier used for oral sex performed on a vulva or anus) for oral sex, to help prevent the spread of STIs. You can learn how to use a condom here. Some people like to use flavored condoms for oral sex. Just be sure to avoid them if you have PIV or anal sex, though.

You’re definitely not the only person who feels anxious or scared about STIs. This is especially true if you’ve had abstinence-only sex education that emphasizes the risks of sex without discussing how to stay safe. Hopefully, understanding more about how to have safer sex (of all kinds!) will help you feel less afraid.

If you still feel deeply anxious or afraid about STIs though, take a step back.

Sometimes, anxiety about one part of sex or a relationship is actually a sign that you’re worried about something different (like feeling pressured to do something sexual, not trusting or feeling safe with your partner, or not feeling ready to have sex). Check in with yourself and consider talking to a medical provider or someone else you trust about what you’re feeling.

It’s great that you’re having these honest, open conversations with your boyfriend before getting physical.

If you haven’t already, it’s also a good idea to talk about boundaries. What do you want (and not want) out of the experience? This helps make sure you’re both on the same page and have the experience you want together. Make sure you both understand the importance of consent.

If you have any other questions about sexual health and are 10-22 years old near NYC, call the Mount Sinai Adolescent Health Center for confidential, comprehensive health care at no cost to you.