Oral sex: varied behaviors and perceptions in a college population

Journal of Sex Research, Feb, 2007 by Wendy C. Chambers

Historically, fellatio or cunnilingus, hereto referred to as oral sex, were perceived among heterosexual couples as not only more intimate than intercourse but also to be reserved for those who were married (Michael, Gagnon, Laumann, & Kolata, 1994). It took Kinsey's studies to reveal the greater prevalence of oral sex; though it was not until the 1970s that societal attitudes began to perceive it as acceptable for unmarried couples as well (Michael et al., 1994).

Thus it is a historical reversal that oral sex has become more common than intercourse among heterosexual, White, and better educated samples as well as a precursor to intercourse (Billy & Tanfer, 1993; Michael et al., 1994; Prinstein, Meade, & Cohen, 2003; Schwartz, 1999). In addition, oral sex and other noncoital activities have made the definition of "sex" variable. One study indicated that roughly 60% of a undergraduate sample (N = 599) did not regard oral sex as "sex" (Sanders & Reinisch, 1999), though a younger sample (ages 13-16) indicated that as much as 77% of a national sample endorsed oral sex as "sex" (NBC News/People, 2005). Other studies have indicated that a range of 10-30% of virgin samples (defined as having not engaged in intercourse) had engaged in oral sex or perceived oral sex as allowing one to maintain virginity (Herold & Way, 1983; Schuster, Bell, & Kanouse, 1996; Woody, Russell, D'Souza, & Woody, 2000; see studies summarized in Bruckner & Bearman, 2005; NBC News/People Magazine, 2005; Remez, 2000; Sanders & Reinisch, 1999).

The major viral and bacterial sexually transmitted infections (STIs) can also be transmitted via oral sex--these include human papillomavirus (HPV), herpes simplex virus, hepatitis B, gonorrhea, syphilis, Chlamydia, and chancroid, respectively (Edwards & Carne, 1998a, 1998b; Hawkins, 2001). The Centers for Disease Control (CDC; 2004a, 2004b, 2004c, 2004d) also validates transmission via oral sex for Chlamydia, herpes, gonorrhea, and syphilis. In addition, whereas herpes simplex virus type 2 has historically been found to infect the genital region, herpes simplex virus type 1, most commonly found in the region of the mouth, is now appearing in the genital region, with oral sex identified as the significant culprit (Cherpes, Meyn, & Hiller, 2005). Finally, Remez (2000) cited communication with Penelope Hitchcock, chief of the Sexually Transmitted Diseases Branch of the National Institute of Allergy and Infectious Diseases, who stated that HIV transmission was possible via oral sex, but that it is rare. Barrier methods, such as the male condom, dental dams, and plastic food wrap such as Saran[TM] wrap have been endorsed as protection during oral sex, though typically any type of sexual contact is strongly discouraged if any type of lesion or sore is evident (CDC, 2000; Palo Alto Medical Foundation, 2005; University Health Center, 2005).

Yet, despite the likelihood of STI-transmission via oral sex, the national survey of teens by NBC News/People Magazine (2005) found that only 30% used protection (such as a condom) all of the time. Forty-two percent never used any protection. Nonetheless, this is in great contrast to a previous study of youth aged 12-15 in which very few participants used any protection, though the samples were extremely small (Boekeloo & Howard, 2002).

In terms of incidence and frequency, earlier studies indicated a rise in oral sex among adolescents (Newcomer & Udry, 1985), university students (Woody et al., 2000; Grunseit, Richters, Crawford, Song, & Kippax, 2005), and adults in general (Laumann, Gagnon, Michael, & Michaels, 1994). Other research has indicated greater acceptability of oral sex among adolescents in comparison to intercourse (Halpern-Felsher, Cornell, Kropp, & Tschann, 2005). In the NBC News/People Magazine (2005) study, 12% of the teen respondents indicated that they had engaged in oral sex.

Regarding gender differences in frequency of oral sex behavior, studies from the 1980s and the early 1990s revealed no significant differences in the giving/receiving of oral sex between men and women overall (Michael et al., 1994), greater activity for cunnilingus (Haas, 1979, as cited in Newcomer & Udry, 1985; Newcomer & Udry, 1985; Schwartz, 1999), or greater activity for fellatio in the past month (Herold & Way, 1983). Are there currently gender differences in giving/receiving oral sex? Although the evidence is meager or anecdotal (McKay, 2004), it does indicate a potential trend of women giving oral sex more frequently to men as opposed to an equal interchange (Remez, 2000). The reasons for any of these trends, however, are purely speculative.

Few studies have addressed the motivations for engaging in oral sex, though others have addressed predicting oral sex behavior (Herold & Way, 1983). The NBC News/People Magazine (2005) study found that between 40-47% of their young sample felt that not needing to worry about pregnancy, meeting the right person, and the desire of the partner to engage in oral sex were major reasons for engaging in oral sex the first time. Anecdotal evidence, based on speaking with a number of high school classes (Barrett, 2004), has included motivations of curiosity, pleasure, pleasing one's partner, intimacy, pregnancy/intercourse avoidance, drunkenness, and as a means to reduce STI/HIV risk.