Letters Condoms in preventing STIs

Not used in oral sex

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39479.509329.3A (Published 07 February 2008) Cite this as: BMJ 2008;336:292
  1. Ravindra Gokhale, lead clinician
  1. 1Department of GU Medicine and Sexual Health, Wirral University Teaching Hospital NHS Foundation Trust, Wirral CH49 5PE
  1. ravindragokhale{at}doctors.org.uk

    Despite widespread availability of condoms, people are still having unprotected sex, which is reflected in increased sexually transmitted infections (STIs) and unintended pregnancies.1

    People simply don’t use condoms for oral sex. We have had outbreaks of syphilis in gay men in London followed by Manchester, and the enhanced surveillance that followed suggested transmission of syphilis through oral sex. I have also seen several cases of gonorrhoea acquired through unprotected oral sex both in men and women. Many GUM clinics now routinely take oral swabs for culture of gonorrhoea in all suspected cases of gonorrhoea. We have seen rises in genital herpes predominantly caused by herpes simplex virus (HSV) type 1, or the “cold sore” virus, again owing to increases in oral sex.

    Young people consider it “uncool” to carry condoms. The condoms available in vending machines in clubs are expensive, and many people simply hate condoms. We must look at other issues such as change in behaviour and use of alcohol and drugs, in addition to sex education and safe sexual practices.


    • Competing interests: None declared.


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