Oral Sexual Activity and the Associated Health Disparities in College Aged Females in the United States: A Systematic Review

Purpose: To explore the current level of understanding about oral sexual activity and the risk for sexually transmitted infections in the female college population, a systematic review was conducted to summarize scientific literature over the past decade.

Methodology: The following electronic databases were searched: PubMed, Google Scholar, CINAHL, MEDLINE, SCOPUS, SAGE, and ProQuest.  The publication dates searched were 2004 to 2014.  The keywords used in this search were as follows: oral sex, college females, adolescent sexual behaviors, sexual risk, and sexually transmitted infections.  Inclusion criteria included the following: English language only, academic peer reviewed journals, qualitative and quantitative studies, and domestic research.  The exclusion criteria consisted of international research, only vaginal sex studies, and pregnancy related studies.  A matrix method was utilized for organization of the review of literature.

Results: A total of 93 articles, publicly available at no charge, were selected for full-text evaluation, 38 of which were included.  These articles were organized into the following four categories: adolescent/teen sexual behaviors, female college students, oral sex, and college student’s sexual behaviors, with the matrix method.  Consistent findings were as follows: the prevalence of oral sexual activity among adolescents and young adults is increasing; a shift in attitudes with oral sex has occurred in regards to risk, classification as a sexual act and virginal status; and the existence of a distinct knowledge deficit on the transmission of sexually transmitted infections with oral sexual activity.  Specific findings for adolescent women have also revealed that females who engage in oral sex are more likely to have unprotected vaginal sex, placing them at greater risk overall. Gaps were identified regarding the need for further examination of the perceptions of risk with oral sexual behaviors due to the potential for sexually transmitted infections with college females, as well as the need for more educational interventions on oral sexual behaviors.  Another gap identified was the need for more research on the factors which influence the decision to have oral sex to help with educational efforts regarding sexually transmitted infections.

Conclusion: Despite some concern over the shift in attitudes and the increased prevalence of oral sexual activity, there is insufficient research performed in the United States which specifically addresses oral sex.  More research efforts are warranted to examine oral sexual activity and the associated health disparities specific for the female college population.