Can You Get an STI From Kissing? Here's What You Should Know - Health.com

Although the risk is low, you can get a sexually transmitted infection (STI)—often used instead of a sexually transmitted disease (STD)—from kissing.

Herpes, cytomegalovirus (CMV), human papillomavirus (HPV), and syphilis may spread through active lesions (i.e., cold sores) or saliva. In contrast, you cannot get STIs like chlamydia, hepatitis, human immunodeficiency virus (HIV), or trichomoniasis from kissing.

Read on to learn about STIs that may pass through kissing and their symptoms and treatments. 

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It's possible to spread certain STIs—including herpes, HMV, HPV, and syphilis—through kissing.

"There are STIs that can be spread through non-sexual contact [like kissing] that are also spread through sexual contact," Martha Rac, MD, an assistant professor of obstetrics and gynecology at the Baylor College of Medicine, told Health.

Still, kissing is generally a low-risk activity compared to anal, oral, and vaginal sex.

"This is definitely a possibility, and there are some [STIs] that we worry about more than others when it comes to kissing," Michael Angarone, DO, an associate professor of infectious diseases at the Northwestern Feinberg School of Medicine, told Health.

Mouth-to-mouth kissing increases the risk of certain STIs, but some may pass on by kissing someone's cheek, eyes, and head, Christine Greves, MD, an OB-GYN at the Winnie Palmer Hospital for Women & Babies, told Health.

Herpes

Two similar viruses—herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2)—cause herpes. You may contract herpes through skin-to-skin contact, such as during anal, oral, or vaginal sex and while kissing. Most people contract HSV-1 by age 20.

HSV-1 typically causes cold sores, or fever blisters, on your gums, lips, mouth, or throat, also known as oral herpes. Cold sores may be red or yellow and crusty. They may break open and leak a clear or yellow fluid. You may have many small cold sores that grow into one large cold sore.

Other oral herpes symptoms include:

• Burning, itching, or tingling near your lips or mouth
• Fever
• Pain while swallowing
• Sore throat
• Swollen glands

HSV-2 typically causes genital herpes but may cause cold sores around or on your mouth if you practice oral sex, said Dr. Greves. You may then spread HSV-2 through mouth-to-mouth contact. 

Cytomegalovirus (CMV)

CMV is a herpes virus that may spread through saliva while kissing. About 50% to 80% of people in the United States have CMV by age 40. Many people with CMV do not know they have the infection since CMV often causes no symptoms.

CMV sometimes causes flu-related symptoms like:

• Fatigue
• Fever
• Loss of appetite
• Malaise, or generally feeling unwell
• Muscle aches
• Rash
• Sore throat
• Swollen glands

HPV

There are over 200 types of HPV, some of which spread through deep tongue kissing and oral sex.

Oral HPV often causes no symptoms, so many people do not know they have the infection. As a result, oral HPV may easily pass from person to person. HPV may cause oral cancer in some people.

Syphilis

Syphilis is spread by direct contact with a sore, typically found on or around the anus, lips, mouth, penis, rectum, or vagina.

Syphilis symptoms may include:

• A skin rash
• Fever
• Firm, round, and painless sores at the infection site
• Swollen lymph nodes

The risk of contracting syphilis from kissing is low, said Dr. Greves.

Gonorrhea

Gonorrhea is a common STI among adolescents. Gonorrhea typically spreads through unprotected anal, oral, or vaginal sex and may transmit from mother to fetus during pregnancy. You may contract gonorrhea if you touch your eyes with infected fluids.

Research has found that oral gonorrhea might spread through kissing. Oral gonorrhea usually does not cause symptoms, and most cases subside within seven days.

Some STIs do not transmit through casual contact, including kissing, such as:

• Chlamydia: The bacteria Chlamydia trachomatis causes this common STI. You may contract chlamydia through unprotected anal, oral, or vaginal sex. Pre-ejaculatory fluids, semen, and vaginal fluids may carry C. trachomatis. You may contract chlamydia if you touch your eyes with infected fluids. Chlamydia may spread from mother to fetus during pregnancy.
• Hepatitis: This causes inflammation of your liver. There are several types of hepatitis, such as hepatitis B and D, which may spread through unprotected sexual contact. Saliva does not carry hepatitis B, so you cannot contract it through kissing. You also cannot get hepatitis D through kissing.
• Human immunodeficiency virus (HIV): This virus may spread through blood, breast milk, rectal fluids, pre-ejaculatory fluids, semen, and vaginal fluids. You may contract HIV by having unprotected anal or vaginal sex or sharing drug paraphernalia like needles. HIV does not spread through saliva, sweat, or urine. Rarely does HIV spread through kissing if both people have bleeding gums or sores.
• Trichomoniasis: Pre-ejaculatory fluids, semen, and vaginal fluids may carry the parasite that causes trichomoniasis, or "trich." Trich often spreads through unprotected vaginal sex and vulva-to-vulva contact. You may also contract trich by touching your eyes or using sex toys with infected fluids.

Treatment depends on the cause of oral STIs. 

For example, cold sores caused by oral herpes often go away on their own within one to weeks.

At-home treatments that may help reduce symptoms include:

• Applying ice or a warm washcloth to the affected area to alleviate pain
• Cleansing cold sores with antiseptic soap and water
• Eating fruit-flavored popsicles
• Gargling cool water or rinsing with salt water
• Not consuming citrus, hot drinks, or salty and spicy foods
• Using Tylenol (acetaminophen) to reduce pain

You may take antiviral medicines, including acyclovir, famciclovir, and valacyclovir, to reduce the frequency of cold sore outbreaks. Still, oral herpes is a chronic infection, so antivirals cannot cure it. You may need to take antivirals continuously if you often get cold sores.

Like oral herpes, CMV and oral HPV often resolve without medicine. You may take pain relievers or gargle salt water to help treat CMV. People with weak immune systems may require antibody therapy or antivirals.

Penicillin, an antibiotic, helps treat syphilis. You may take doxycycline if you are allergic to penicillin.

Preventing oral STIs may be difficult. People are often unlikely to ask for someone's complete sexual history before the first kiss.

Still, healthcare providers say there are a few ways to lower your risk, such as:

• Ask questions: Kissing tends to happen spontaneously, and it's unlikely that you'll have a conversation about sexual history before kissing someone. Still, it's more than OK to ask about and be open about sexual health before you kiss someone, noted Dr. Greves.
• Do not kiss someone with a cold sore: You are less likely to contract herpes or syphilis if someone does not have an outbreak than if they have an active lesion.
• Practice monogamy: Being monogamous with one partner who does not have STIs means you will not have exposure, said Dr. Greves.

Kissing is generally a low-risk activity compared to anal, oral, and vaginal sex. Still, STIs, such as herpes, HMV, HPV, and syphilis, may transmit through active lesions or saliva. 

Most oral STIs go away on their own. Taking pain relievers and gargling salt water may help treat oral herpes and CMV. Some people may require antibiotics or antivirals to treat oral STIs. Consult a healthcare provider if you develop symptoms of an oral STI or have had recent exposure to an STI.

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