Many teenagers in the US do not regard oral sex as sex and one in five say they have experience of it.
A survey by Bonnie Halpern-Felsher, a paediatrician at the University of California, San Francisco of 580 teens, average 14, has found that oral sex is seen as less risky than intercourse and 20% of the group had engaged in it compared to 14% who'd had sexual intercourse.
Of the multi-ethnic 9th grade group surveyed, one third intended to have oral sex within the next six months and nearly one-fourth planned to have intercourse.
It was found more common for boys to have performed oral sex on girls, but condoms or dental dams were rarely used even though herpes, hepatitis, gonorrhoea, chlamydia, syphilis as well as the virus that causes AIDS can all be transmitted orally.
Campaigns aimed at deterring teenage sex have almost always focused on intercourse, but as many as half of adolescents experience oral sex first, says Halpern-Felsher, and given that adolescents do not appear to view oral sex as sex and see it as a way of preserving their virginity while still gaining intimacy and sexual pleasure, they are likely to interpret sexual health messages as referring to vaginal sex.
They also believed oral sex to be more acceptable than vaginal sex for adolescents their own age in both dating and non-dating situations, less of a threat to their values and beliefs, and it can be expected that more of their peers will have oral sex than vaginal sex in the future.
Although the risk of transmitting infections, including HIV, is significantly less with oral sex than with intercourse it is probably underestimated by teenagers.
The report is published in the journal Paediatrics.