Ask The Sexpert

Dear Sexpert,

Is there any danger in kissing? I know you can get mono and maybe catch a cold, but is there any chance of catching any real STIs? Kind of along these same lines, I'm very confused about the differences between oral herpes, genital herpes (is it the same virus in just a different location?) and canker sores. Please help me out.

— Anonymous '08

Dear Anonymous '08,

If you're swapping spit with a partner, pretty much the only STI you're at risk for is herpes.

The herpes simplex virus comes in two strains: type-1 (HSV-1) and type-2 (HSV-2). The former causes the majority of oral herpes cases and the latter the majority of genital herpes, but both can technically show up in either region. Both type-1 and type-2 are transmitted through direct contact between broken skin and sensitive mucous membrane tissue, such as that of the mouth or genitals. But both types can also be transmitted from one orifice to another by mouth-genital contact, even when there are no obvious sores or other signs of herpes.

Genital herpes lesions vary quite a lot and often look like small blisters or pimples; they most frequently appear on the genitals, buttocks and thighs. Oral herpes (commonly called "cold sores") looks like small fluid-filled blisters that usually appear on the lips but can also appear inside the nose or on the chin or cheek. Symptoms for both types of herpes can often go unnoticed, since they can easily be mistaken for pimples, blisters, insect bites or cracked skin.

Herpes are not to be confused with canker sores. Those are shallow ulcers of the mouth that can occur on the soft palate, tongue, inside the cheeks or lips, or at the base of the gums. While oral herpes almost always starts at the lips and rarely spreads inward, canker sores usually appear in the soft tissues of the mouth. Further, canker sores are not contagious, while the cold sores caused by the herpes virus are highly contagious. In fact, about 50 to 80 percent of adult Americans have oral herpes (!), usually contracted during childhood due to a kiss from a friend or relative.

You should be aware, however, that even though most STIs cannot usually be transmitted through saliva, if you kiss someone with an open sore on their mouth and come into contact with their blood, you are at risk for several STIs, including HIV. Scientific literature documents at least one case of possible HIV transmission this way, and several likely cases of both HIV and Hepatitis B transmission through biting while kissing.

In general, kiss away — but avoid settings where you could come into contact with blood, and if you're into the occasional nibble, make sure not to break your partner's skin!

— The Sexpert

Dear Sexpert,

So how much does anal sex really hurt? And are the gains worth the pain?

— Just Ass-king

Dear Just Ass-king,

If you have a medical condition such as hemorrhoids or an anal fissure (a tear in the lining of the anus), it's better to wait and get treatment rather than indulge anally. Otherwise, pain is really a personal thing. Follow these guidelines to ANAL satisfaction:

Ask.

Make sure your partner is absolutely comfortable with any sexual act you are about to perform. The ground rule has to be that as soon as one person wants to stop, the activity will stop. Anal sex will only be pleasurable if both parties are completely at ease and comfortable together.

No-risk.

According to the Centers for Disease Control and Prevention and the World Health Organization, unprotected anal sex carries more risk of STI transmission than vaginal or oral sex do. That means, as with any other sexual activity involving bodily fluids, it's absolutely imperative to use condoms. For anilingus (is any explanation necessary?), use a dental dam, because the presence of bacteria on or in the anus or rectum can mean serious risks. 'Nuff said.

Alternatives.

To get used to the sensation of anal sex and allow the internal anal sphincter (the ringlike muscle inside the anus) to relax, try starting off with fingers (with very clean and short nails, obviously!) or small sex toys. If something is uncomfortable, slow down and take a deep breath.

Lubricate.

I can't stress this enough. Use water-based lube, because saliva or vaginal fluids can transfer infections. In the same vein, remember to always change condoms or wash your penis when moving from the anus to the vagina — you don't want to be spreading bacteria around!

As to whether the gains are worth the pain, the Sexpert can't help you there! This all depends on personal preference. Many sexually active people of all sexual preferences enjoy anal sex, and many others choose not to engage in it. The one thing the Sexpert does feel certain about is that if you do choose to try it out, your enjoyment will be related to how comfortable you feel with your partner. The first step in anal sex should always be talk, talk, talk.

—The Sexpert "Sexpert" is written by a team of peer sexual health advisors and fact-checked by University health professionals. You can submit questions, to be published anonymously every Thursday, to sexpert@dailyprincetonian.com. Don't be shy.