A study published in the Journal of Infectious Diseases suggests oral sex and deep kissing are risks for acquiring oral HPV infections.
Gypsyamber D’Souza, Ph.D., and colleagues previously demonstrated that oral sex is a risk for cancers of the oropharynx (tongue, soft palate, and tonsils). The American Cancer Society estimates there are about 34,000 cases of oropharyngeal cancer each year in the U.S. Heavy tobacco and alcohol use is strongly linked to these diseases, but “high risk” HPV plays a role with half or more of oropharyngeal cancers.
Does this mean that sexual behaviors are a risk for acquiring oral HPV infections? To examine the potential link, the investigators collected demographic and sexual behavior information from two cohorts: Patients with no history of cancer who were part of a control group in head and neck cancer research, and college-age men. Oral samples were collected and tested for HPV DNA.
Oral HPV prevalence was low in both groups, 4.8% in the control and 2.9% in the young men, respectively. With the controls, the risk of oral HPV infection was greater as the number of lifetime oral and vaginal sex partners increased (10 or more oral sex partners or 25 or more vaginal sex partners).
Among the young men, the risks were elevated as the number of oral sex and open-mouth kissing partners increased (vaginal sex was not a risk for oral HPV in this group). Oral HPV was detected most often among those who, in the last 12 months, had six or more oral sex or open-mouth kissing partners. In a subset of men with no reported history of oral sex, higher rates of oral HPV infection were found among those with 10 or more lifetime or five or more recent deep-kissing partners.
The investigators conclude that oral sexual behaviors associated with oropharyngeal cancers are also linked with oral HPV infections, and that deep kissing is also a risk.
Studies such as this inevitably lead some partners of those diagnosed with genital HPV to wonder if it’s safe to engage in oral sex. It should be pointed out that the vast majority of cases of HPV don’t lead to cancer. Cancers of the oropharynx–while they occur more often than cervical cancer–are still not common and don’t develop quickly, usually taking 10 years or longer.
There are few guidelines regarding oral sex and HPV, apart from common sense precautions of abstaining while skin lesions related to the virus are present (including cervical cell changes detected on Pap tests). The effectiveness of latex barriers (condoms, dental dams, and even household plastic wrap) in reducing oral HPV transmission hasn’t been studied, but some experts say they have value in protecting against other STIs when performing oral sex and may also reduce the risk of acquiring HPV.
References
G D’Souza, Y Agrawal, J Halpern, S Bodison, M Gillison. Oral Sexual Behaviors Associated with Prevalent Oral Human Papillomavirus Infection. Journal of Infectious Diseases, 2009. 199 (9): 1263-69.
G D’Souza, A Kreimer,R Viscidi, M Pawlita, C Fakhry, Wayne M. Koch, W Westra, M Gillison. Case–Control Study of Human Papillomavirus and Oropharyngeal Cancer. New England Journal of Medicine, 2007.
Cervical Intraepithelial Neoplasia. www.clinicaltrials.gov (study NCT00303823) http://clinicaltrials.gov/ct2/show/study/NCT00303823