From the Guidelines
Oral sex involving the vagina can transmit human papillomavirus (HPV). HPV is primarily spread through skin-to-skin contact during sexual activity, including vaginal, anal, and oral sex 1. During oral-vaginal contact, the virus can be transmitted from the vagina to the mouth or throat of the partner performing oral sex, or vice versa. HPV is the most common sexually transmitted infection and has many different strains. Some strains can cause genital warts, while others can lead to various cancers, including cervical, vulvar, vaginal, penile, anal, and oropharyngeal (throat) cancers.
To reduce transmission risk, barrier methods like dental dams can be used during oral sex. HPV vaccination is highly recommended for eligible individuals before becoming sexually active, as it protects against the most high-risk HPV strains 1. The vaccines (Gardasil 9) are typically given as a series of two or three doses depending on age at first vaccination. Regular screening, such as Pap tests for women, remains important even after vaccination since vaccines don't protect against all HPV strains.
Key points to consider:
- HPV is transmitted through skin-to-skin contact during sexual activity, including vaginal, anal, and oral sex 1
- Barrier methods like dental dams can reduce transmission risk during oral sex
- HPV vaccination is highly recommended for eligible individuals before becoming sexually active 1
- Regular screening, such as Pap tests for women, remains important even after vaccination 1
From the Research
Vaginal Oral Sex and HPV
- Vaginal oral sex is a potential route of transmission for human papillomavirus (HPV) 2, 3, 4.
- HPV is a common sexually transmitted infection that can cause infections of the skin and mucosa, and is associated with various types of cancer, including cervical, anal, vaginal, vulvar, penile, and oropharyngeal cancers 2, 4, 5.
- The risk of HPV transmission through oral sex is increased with a higher number of sexual partners, early initiation of sexual activity, and not using barrier protection such as condoms and dental dams 2, 3.
Risk Factors for HPV Infection
- A history of multiple sex partners, initiation of sexual activity at an early age, and not using barrier protection are identified as risk factors for persistent HPV infections 2.
- Other risk factors include other sexually transmitted infections, including HIV, an immunocompromised state, alcohol use, and smoking 2.
- Oral sex is also a significant risk factor for oral HPV infections, with a study finding that women with genital HPV infection were more likely to have oral HPV infection if they had engaged in oral sex 3.
Prevention and Screening
- Vaccination is the primary method of prevention for HPV infection, with the nonavalent HPV vaccine effective in preventing the development of high-grade precancerous cervical lesions in noninfected patients 2.
- Screening for HPV infection is effective in identifying precancerous lesions and allows for interventions that can prevent the development of cancer 2, 5.
- Early detection and treatment of cervical and anal precancerous lesions is integral to secondary prevention, with molecular HPV testing, cytology, and tissue biopsy allowing for triaging of patients 5.