Ask Bish - Your Sex and Relationships Questions Answered

Ask Bish Oral Sex Risks in an Open Relationship

I’m in an open relationship, and am a little confused about STI testing and how careful to be.

What advice there is regarding multiple partner relationships seems to either be “wear a full length latex suit AT ALL TIMES” to “don’t use any protection or get tested; it’ll all be fine, man, it’s free love”. So, a few issues:

  • I don’t particularly want to catch anything, or spread STIs between partners. How careful, realistically, should I be? How often should I/ partners get tested? *
  • I’m happy to use condoms for PIV/oral and dental dams but I’ve encountered a lot of bad reactions to discussing barrier methods for oral as they don’t seem that commonly used.
  • I’ve also had a lot of angry reactions to asking people to get tested before we are sexually active. Am I being particularly cautious or is testing just not that common?

Bit of a long one, I apologise!



Hi V

Thanks for your question.

The short answer to your question is somewhere between the full latex body suit and going for regular check ups! I’ll give you, and other readers. some more information about the various risks and how to reduce them, but the key message of this response is that you can minimise your risks, but you can’t eliminate them. Ok let’s get started.

If you use condoms for penis in vagina sex (or penis in anus sex) then you are vastly reducing your risk of picking up a sexually transmitted infection. There are some risks of picking up an STI from unprotected oral sex, but those risks are much lower than from unprotected penis in vagina or anal sex. Risks are greater from having semen in the mouth. However there are risks for the person being licked or sucked: if someone has (or is about to get) a coldsore (very common) or a syphilis sore (rare) on their lip. Condoms and dams can reduce that risk hugely, however lots of people prefer not to use them for oral sex. This is probably because people aren’t aware of the risks. Or they are aware that there are some risks but weigh up that risk against the pleasure of not using barriers and decide it’s worth it.

However even using condoms and dams isn’t going to offer 100% protection from infections and viruses that can be caught from having sex. There are some which can be passed on from close physical contact (such as genital warts or herpes – which are only checked for if someone has an outbreak, which are often so mild people don’t notice).

Going for a check up is not going to prevent you from getting an infection but it will give you the information you need about your health to keep your partners safe. If your partner/s have check ups before you have sex with them, and they get the all clear, then you won’t get anything. However an all clear from a clinic only gives you assurance that they probably don’t have an STI at that time. Remember that all infections are treatable. The most common are curable. Mostly symptoms of STIs are not present or not noticeable. In the UK you can visit a sexual health service free and confidentially, click on the yellow box or here You could go just for advice and maybe talk to a health adviser about frequency of check ups and reducing your risks. (Where you may also be offered a vaccination for Hepatitis A or B, particularly if you are having sex with males or are having sex with males who have sex with males).

Your partners might not want to go for a STI screen before every new sexual contact simply because it might take up a lot of time. They might not think it necessary if they have lowered their risks by using condoms for penis in vagina/anus sex. They might also not like the idea of getting a screen because they don’t know what it involves. It’s not my call to tell you how often you should get a STI screen, it’s up to you, just as it’s up to your prospective partners and your choice about whether you have sex with them or not.

[and now for the key message….!]

There are risks to almost all kinds of sex: you can eliminate most of these risks by using condoms for penis in vagina sex, even more for using barriers for oral sex and even more from having sex with people who get tested regularly and do the above with their other partners too. However even then you won’t be able to have 100% safe sex. You can get pretty close to 100% and the chances are (if you do all this) that you won’t ever get an infection. However sometimes shit happens. We can only have safer sex. This is true for everyone, no matter what kind of relationship we have. I can’t tell you how often you ‘should’ get tested or how ‘safe’ you are from infection. But remember there are always risks. Just make sure the risks are worth taking by having enjoyable sex that you want.

Big thanks to Dr Stuart Flanagan for checking this over for me.