The risks of infections in each type of sex

Relevant STIs according to type of sexual practice

Having unprotected sex does not always imply having the same risk for the same infections or the same probability of contracting them. In this section we are going to try to explain the different risks to which you have been exposed depending on your sexual practice. We will also inform you of the percentage of cases that we see without symptoms, in addition to the tests that we offer at Open House for these specific situations.

What are the risks of STDs in oral sex?

Receiving or giving unprotected oral sex mainly carries a risk for gonorrhoea, chlamydia, and syphilis. It is only indicated to perform an HIV test in a few cases. Keep reading to learn more about the risks and about our rapid and sensitive tests.

Receiving or performing oral sex (mouth-to-penis) is the route of transmission for most of the gonorrhoea and chlamydia infections that we see at Open House and also for a large part of the syphilis infections. The risk of contracting these infections is 40 to 60% per contact, if the person with whom we have sex is infected.

If oral sex is mouth to vagina (cunnilingus) it is also a risk behavior for gonorrhoea, chlamydia and syphilis, but much less than in mouth to penis oral sex. The maximum risk in this type of sex is 5% for gonorrhea and chlamydia and 40% for syphilis.

There are many cases of these infections without symptoms, both in the throat and in the genitals.

Specifically:

• Cases without symptoms in the penis: 15-20% gonorrhoea and syphilis and up to 60% chlamydia.
• Cases without symptoms in the vagina: 40% gonorrhea and up to 60% chlamydia and syphilis.
• Cases without symptoms in the throat: Up to 90% of the cases of these three infections

Is there a risk of HIV and Hepatitis B in oral sex?

Oral sex is NOT a high frequency route of transmission for hepatitis B and HIV. The risk of hepatitis B in oral sex is around 1%. The risk of HIV in oral sex is practically zero, but there are certain circumstances that raise the risk from zero to levels that are still very low (from 0.01 to 0.05%).

We have performed almost 15,000 HIV tests on people whose only contact has been oral sex. To date, we have only confirmed two HIV positive cases and it was due to co-transmission of syphilis in the same contact simultaneously.

What are the risks of STDs in rimming?

Rimming (licking the ass) is a risk situation for syphilis, hepatitis B and hepatitis A. The risk of each of these infections having sex with someone infected is around 40% for syphilis, 1% for hepatitis B and up to 90%.for hepatitis A (for the active person).

STI Tests Relevant to Oral Sex

As you have seen from the risks, the relevant tests for unprotected oral sex practices would be gonorrhoea, chlamydia and syphilis. We do not advise doing an HIV test unless certain criteria are involved. These tests can be carried out three weeks after the risk contact you want to monitor (unless you have symptoms) and the result is available in just 90 minutes in our physical clinics with our urgent PCR system or in 24-72 hours after receiving your sample in our laboratory with our standard or online testing service.

Do you have questions or concerns? Open House specialist doctors are the best solution. Request an appointment at our clinics in Madrid or Valencia or purchase a remote consultation to receive expert advice.

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What are the risks of STDs in vaginal sex?

Having unprotected vaginal sex, like oral sex, mainly involves risk for gonorrhoea, chlamydia, syphilis and, in addition, another bacterium called mycoplasma genitalium. In these cases it is recommended to test for HIV and hepatitis B, but HIV has a low percentage of transmission and in Spain most people are vaccinated against hepatitis B.

Transmission and cases without symptoms in vaginal sex

 

Vaginal sex is a more frequent route of transmission of hepatitis B viral infections (10% in men and up to 60% women) and HIV (0.1 to 5% per contact) than oral sex, but both share a high percentage of transmission of gonorrhoea, chlamydia and syphilis (between 40 and 60% per contact). In addition, vaginal sex is also a potent route of transmission of mycoplasma genitalium (20% per contact). The risk of HIV decreases if the sex was not prolonged, if it was not traumatic or if there was no ejaculation.

There are many cases of these infections without symptoms, especially if they are present in a hidden site (inside the vagina or on the cervix).

Specifically:

• Cases without symptoms in the penis: 15-20% of gonorrhea and syphilis and up to 60% of chlamydia and M. Genitalium.
• Cases without symptoms in the vagina: 40% gonorrhea and up to 60% chlamydia, M. Genitalium and syphilis.
• Both sexes: up to 75% of HIV and hepatitis B

Mycoplasma hominis and ureaplasmas

These two bacteria are highly infectious in vaginal sex and are transmitted exclusively through this route, they have a transmission rate similar to that of gonorrhoea and chlamydia, but they are normally considered normal bacterial flora and are only considered pathogens, tested and treated, if they cause symptoms.

Trichomonas

This parasite is a minor cause of vaginal infections or urethritis in men and its route of transmission is exclusively through vaginal sex. We only look for this infection when you have symptoms.

Tests Relevant to Vaginal Sex

As you have seen from the risks, the relevant tests for unprotected vaginal sex practices would be gonorrhoea, chlamydia, mycoplasma genitalium, syphilis, HIV and hepatitis B. All tests can be performed four weeks after the risk contact you want to monitor (unless you have symptoms) and the result is available in just 2 hours in our physical clinics, with our urgent PCR system or in 24-48 hours after receiving your samples in our laboratory using the online testing service.

Do you have questions or concerns? Open House specialist doctors are the best solution. Request an appointment in our clinics in Madrid or Valencia or purchase a remote consultation to receive expert advice.

Do you have symptoms after having vaginal sex?

If you have urethral symptoms (in men) or vaginal symptoms after having unprotected vaginal sex, you can use our specific Open Plan tests available for these situations. In this plan we seek the detection of DNA (PCR technique) of Chlamydia, Gonorrhoea, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma and Trichomonas. The result is delivered in 1 to 3 business days and costs €130.

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What are the risks of STDs in anal sex?

Practicing unprotected anal sex is the most frequent route that exists for contagion of all sexually transmitted infections. As in other practices, the greatest risk is for gonorrhoea, chlamydia, syphilis and mycoplasma genitalium, but in these cases, especially for the passive person, it is also important to check for HIV and hepatitis. Visit each section to expand the information about the risks and our sensitive tests.

Transmission and cases without symptoms in anal sex

There are heterosexual patients who practice unprotected anal sex to avoid pregnancy, but who forget that this is the main route of HIV transmission. In addition, the rectum can be a source of infection where typical symptoms are not present and, therefore, these infections can be present but hidden. The risks of unprotected anal sex vary if you are the active or passive person:

• Active person: 40 to 60% for gonorrhoea, chlamydia, and syphilis, 20% for mycoplasma genitalium, 10% for hepatitis B, and 1 to 5% for HIV
• Passive person: 40 to 60% for gonorrhoea, chlamydia, and syphilis, 20% for mycoplasma genitalium, 60% for hepatitis B, and 10 to 50% for HIV

There are many cases of these infections without symptoms, both in the rectum and in the genitals.

Specifically:

• Cases without symptoms in the penis: 15-20% gonorrhoea and syphilis and up to 60% chlamydia and mycoplasma genitalium
• Cases without symptoms in the vagina: 40% gonorrhoea and up to 60% chlamydia, syphilis and mycoplasma genitalium
• Cases without symptoms in the rectum: Up to 90% of the cases of these four infections
• Blood infections: up to 75% HIV and hepatitis B

Tests relevant to anal sex

As you have seen from the risks, the relevant tests for unprotected anal sex practices would be gonorrhoea, chlamydia and mycoplasma genitalium (PCR) and syphilis, HIV and hepatitis B (serology or PCR). All the tests can be carried out four weeks after the risk contact you want to monitor (unless you have compatible symptoms) and the result is available in just 2 hours in our physical clinics, with our urgent PCR system or in 24-72 hours after receive your samples in our laboratory using the standard or online testing service.

Do you have questions or concerns? Open House specialist doctors are the best solution. Request an appointment in our clinics in Madrid or Valencia or purchase a remote consultation to receive expert advice.

What are the risks of STIs in other sexual practices?

Many of our patients ask us about the risks of sexually transmitted infections in other types of sexual practices, we have provided advice on the most common questions. This guide is not intended to be exhaustive. If you want personalised advice according to your specific situation, do not hesitate to consult our specialist doctors.

Sharing equipment to take drugs

At Open House, 50% of the people who tested positive for Hepatitis C had shared drug equipment, it was not due to risky sex for this infection. Its transmission is due to direct blood-to-blood contact by sharing this equipment.

Fisting

Group fisting without gloves is a very frequent route of transmission for all kinds of infections, especially Hepatitis C and Lymphogranuloma Venereum (an aggressive version of Chlamydia). To avoid infections, you must use different gloves for each partner with whom you practice fisting.

Sharing dildos

The risks of gonorrhoea, chlamydia, mycoplasma genitallium, and syphilis are similar to those we have seen with vaginal or anal sex. Transmission of hepatitis C has also been described in this type of sexual contact.

Exchange of bodily fluids in hangnails or small wounds

There is no specific data on the risk of transmission of HIV or another STI through hangnails or small cuts on the fingers in contact with pre-cum, semen or vaginal fluids. It is believed that the risk only exists if the wound is bleeding during sex, but it is a theoretical risk that has not been scientifically proven.

Group anal sex

Viruses and bacteria can pass from one person’s rectum to another through the penis that penetrates both people, even using a condom if it is not changed. If the time between one penetration and another is several minutes, HIV transmission may not occur, but the hepatitis B and C viruses and the bacteria gonorrhoea, chlamydia and syphilis can survive this time outside the body.

Dr. Atef Souied Espada

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