In some states and territories, the use of prophylactics (condoms, dams and sometimes gloves) for oral, full service and other activities is legally mandated. It is a good idea to contact your local sex worker organisation to have a clear understanding of what your legal obligations are in your jurisdiction.
STIs are most likely to pass from one person to another during unprotected sexual activity.
Unprotected Oral Sex
Unprotected oral is considered a very low-risk activity for HIV transmission. However, HIV is present in pre-cum and ejaculate and the risk of transmission increases if there are sores, tiny cuts, inflammation or wounds in your mouth which allow the virus to enter your bloodstream. Oral conditions such as gum disease, STIs in the throat, sores or blisters in the mouth increase the risk of contracting HIV through unprotected oral. Additionally, unprotected oral can transmit STIs such as gonorrhoea, chlamydia, syphilis and herpes.
Safer Unprotected Oral Sex Tips
- Flush your mouth with salt water and if it stings, this is an indication that you have tiny cuts in your mouth and you should avoid unprotected oral.
- Research indicates that, in regards to HIV transmission risk, it is safer to swallow pre-cum and/or ejaculate rather than spit it out, as the gums are more likely to have damage and therefore entry points for HIV to enter your bloodstream than your throat and tube to your stomach. Additionally, stomach acid will kill any STIs or HIV in pre-cum and/or ejaculate that is swallowed. However, for chlamydia and gonorrhoea of the throat, the risk of transmission is high and the risk is the same whether you spit or swallow. Syphilis can affect any area of the mouth and again the risk is the same whether you spit or swallow.
- Do not floss or brush your teeth two hours before or after performing unprotected oral, as it increases your risk of causing inflammation or tiny scratches in your mouth, creating an entry point for STIs and HIV to enter your bloodstream.
- There is some preliminary research that suggests that gargling Listerine zero could inhibit the growth of the bacteria responsible for pharyngeal gonorrhoea (gonorrhoea of the throat). The results of this research are not yet definitive, but gargling with Listerine zero does not increase risk and will not do any harm. Have regular sexual health checkups and ask for an STI check of your mouth.
- Using a condom while performing oral sex eliminates the risk of bodily fluids carrying STIs and HIV entering your body.
Unprotected Anal Sex
Unprotected anal sex is considered a high-risk activity for transmitting STIs and HIV. This is because the lining of the anus is delicate, produces very little natural lubricant and is easily damaged during penetrative anal sex, allowing access points for infections to enter your body.
Unprotected Anal Sex Tips
- Some research suggests that being the insertive partner (top) is safer than being a receptive (bottom). However, the risk of HIV transmission is increased for the insertive (top) if you have blisters, sores, tiny scratches or tears on your penis for the virus to enter your bloodstream.
- If you are regularly practising unprotected anal sex with multiple casual partners, it is recommended you look into Pre Exposure Prophylaxis (PrEP). PrEP is only effective with people who are currently HIV negative and can greatly decrease your risk of contracting HIV. For information on accessing PrEP see Accessing PrEP.
- If you have recently had unprotected anal sex with a person living with HIV you should take Post Exposure Prophylaxis (PEP). PEP is only effective if you are HIV negative and take the medication within 72 hours of exposure. Contact your local sexual health clinic or the hospital accident and emergency department for more information.
- PEP and PrEP do not protect you from STIs. The best method for protecting yourself against STIs and BBVs is using a condom.
- Rimming is considered very low risk for HIV transmission. However, rectal mucous does contain HIV and can be transmitted if your mouth has been ‘breached’ (contains inflammation, tears, cuts, blisters or other STIs).
- For more information, see Anal Health.
Some research suggests kissing may be a pathway of transmission for pharyngeal gonorrhoea (gonorrhoea in the throat). Scarlet Alliance will continue to monitor the research and notify sex workers if facts and recommendations change.
- Limiting kissing partners and the time/depth of kissing may reduce associated risks.
- There is some preliminary research that suggests that gargling Listerine Zero could inhibit the growth of the bacteria responsible for pharyngeal gonorrhoea. The results of this research are not yet definitive, but gargling with Listerine Zero does not increase risk and will not do any harm.
Ensure your sexual health checkups include an STI check of your mouth & throat.