Oral sex and STIs: do you need a throat swab?

Which STIs pass through oral sex

Oral sex is a common way for gonorrhoea to reach the throat, and chlamydia can infect the throat too. Syphilis and herpes can also pass through oral sex, through contact with a sore. The risk of HIV from oral sex is very low.

It works both ways: an infection in a partner’s penis, vagina or anus can reach your throat, and an infection in your throat can pass to a partner’s genitals or anus.

Why throat infections are easy to miss

The guidelines note that throat gonorrhoea causes no symptoms in most people. You won’t usually have a sore throat, so the only way to find it is to test the throat itself. A urine test or a vaginal swab won’t pick it up.

Finding throat gonorrhoea matters for another reason too. The guidelines describe the throat as the most likely place for treatment to fail, because medicine reaches it less well and bacteria there can share resistance genes. That’s why a check that the treatment worked is recommended 2 weeks after treating a throat infection.

Who should have a throat swab

The Australian STI Management Guidelines (opens in new tab) recommend a throat swab for gonorrhoea and chlamydia for:

• All men who have sex with men, even without symptoms, as part of testing at three sites. See STI testing for gay, bi and other men who have sex with men.
• Anyone else with more than one sexual partner, for gonorrhoea.

If you’ve had oral sex and neither applies, a throat swab isn’t routinely recommended, but it’s reasonable to ask for one if you’re worried. A partner telling you they have gonorrhoea or chlamydia is also a reason to test the throat if you’ve had oral sex with them.

How a throat swab works

You wipe a soft swab over the tonsil area on both sides and the back of the throat for about 10 seconds, then put it back in its tube. It can make you gag a little, but it doesn’t hurt. The guidelines say people without symptoms can collect throat swabs themselves. The lab tests the same swab for gonorrhoea and chlamydia.

When to test

The window period for gonorrhoea and chlamydia is around 2 weeks, so a throat swab taken sooner after oral sex may miss an infection. See how soon after sex you can test. For routine testing, see how often to get STI testing.

Lowering your risk

• Use a condom for oral sex on a penis, and a dental dam for oral sex on a vagina or anus.
• Test regularly, including a throat swab if it’s recommended for you.
• Avoid oral sex with someone who has a sore on their genitals, anus or mouth, and see a clinic if you have one yourself.

How at-home testing works with Prickly

Prickly is an Australian at-home STI testing service for people without symptoms. When you request testing, you tell us whether you’ve used your mouth for sex, and a doctor confirms whether a throat swab suits you.

• Request online. Complete a five-minute online request, or book a short call with a doctor – bulk billed with Medicare. Either way, a doctor confirms that at-home STI testing is suitable for you.
• Receive your equipment. Collection equipment tailored to your exposures ships the same or next business day in an unmarked mailer box with Australia Post tracking.
• Collect at home. Follow the included STI testing self-collection guide – swabs and urine for the lab, and, if you’ve added HIV testing, a fingerprick HIV self-test you read at home in 15 minutes.
• Post to the lab. Post your lab samples back the same day using the included prepaid return label – at any Australia Post Office, red street posting box or Parcel Locker.
• Get your results. A doctor reviews every lab test result and emails you privately. Telehealth follow-up included – with help accessing treatment and telling partners, if needed.

The same steps are on the home page under How it works, and fees are under Pricing.

When at-home testing isn’t right

See someone in person at a sexual health clinic (opens in new tab), GP clinic (opens in new tab) or urgent care clinic (opens in new tab) instead if you have symptoms or if you’re under 16. And if you may have been exposed to HIV in the last 72 hours, don’t wait for a test – visit www.getpep.info (opens in new tab) or go to a sexual health clinic (opens in new tab) or emergency department (opens in new tab) as soon as you can. If something happened without your consent, 1800RESPECT (opens in new tab) is also available 24/7 for free, confidential support.