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For STD Awareness 2012, Infectious Diseases doctor Ricardo Arbulu, MD, will be setting the record straight regarding common STD myths. Check back throughout April 2012 for additional myths debunked by Dr. Arbulu!
Myth #1: Condoms are not necessary to prevent STDs when having oral sex.
They are! You can get HIV, gonorrhea, chlamydia or syphilis through oral sex. You can reduce the risk to virtually zero by using condoms appropriately.
It is true that HIV is NOT transmitted through saliva. The virus may be present in saliva, but human enzymes (substances in the saliva) inactivate it. That is why you do not risk being infected with HIV by kissing an infected person.
However, oral sex, like any other form of sex, causes microscopic tears in the surfaces that are in contact. This allows some blood from both persons to be exchanged. The amount exchanged is much less in oral sex than it is in other forms of sex, but it still happens.
The risk of transmission of HIV is as follows:
Anal sex >>> Vaginal sex >>> Oral sex
The risk of getting HIV from oral sex is higher if either of the following are true:
- There is ejaculation in the mouth
- Either person has sores on the genitals or in the mouth, which increase the risk of bleeding
Myth #2: I cannot get genital herpes from my partner if he/she has no sores on the genitals.
Yes you can! The risk is lower when there are no genital sores or blisters in your partner, but you can still catch herpes.
- Genital herpes is caused by the Herpes simplex 2 virus. Most people who have this virus do not experience any symptoms. Those who do, start within two weeks of catching the virus. Symptoms consist of painful blisters in the genitals, which break quickly, leaving sores. These sores last days, sometimes weeks if untreated. Once somebody starts having genital lesions from herpes, it is likely that they have repeated episodes. Episodes tend to be milder with time.
- Regardless of symptoms or not, the herpes virus never leaves a person’s body and it is always present to some degree in their genitals (penis/vagina/anus). Microscopic cracks on the skin allow it to be passed on to the partner.
- The load of virus is much higher when there are active lesions, i.e. sores or blisters.
So…How do I prevent herpes infection if my partner is infected with herpes?
- Do not have sex at all when your partner has sores on the penis, vagina or anus. Further, your partner may know well when the sores are about to show up, since he/she may be used to feeling some pain before that. If he/she reports that, do not have sex until you are sure this is not a flare up of the herpes.
- Consider using condoms every time you have sex. I say “consider” because, weighing the sacrifices versus benefits, some people do prefer the risk of getting herpes. Keep in mind that most people who do end up catching herpes do not develop symptoms or develop mild symptoms only. On the other hand, keep in mind that STDs tend to come in clusters, so you want to make sure your partner only has herpes and no other serious STD before you decide to not use condoms. Your physician should be able to assist you with this important decision.
- Regarding prescription drugs to prevent getting herpes:
- If your partner has frequent flare-ups of herpes, he/she can get a prescription for anti-viral medication. The primary goal is to reduce the frequency of these flare ups. A secondary benefit is that he/she reduces the shedding of the virus to you!
- You may be wondering now if you, the uninfected partner, can take antiviral drugs before or after sex to prevent herpes… This makes sense, but it has not been proven efficient yet, so I cannot recommend it.
More information about herpes: