Human sexual expression encompasses an extraordinarily diverse array of behaviors, ranging from conventional reproductive acts to intricate sensory practices that engage diverse erogenous zones across the human body. Among these practices, anilingus—the oral stimulation of the anal margin and perianal anatomy—occupies a unique crossroad between anatomical physiology, epidemiological investigation, sexological inquiry, and socio-cultural taboo. Understanding anilingus requires a comprehensive, multidisciplinary lens that evaluates its physiological mechanisms of pleasure alongside its clinical significance, public health dimensions, and evolving cultural normative frameworks.
Anilingus
1. Concise Definition
Anilingus refers to the sexual act involving the oral stimulation, licking, kissing, or sucking of a partner’s anus, perineum, or perianal tissues for erotic pleasure. It serves as an intimate behavior practiced across various sexual orientations, gender identities, and relationship dynamics, functioning both as an autonomous sexual act and as a preparatory component of broader sexual repertoires.
In human sexology and biomedical literature, anilingus is recognized as an erogenous behavior enabled by the rich concentration of peripheral somatic and autonomic nerve endings distributed throughout the anal sphincter and perineal epithelium. While historically marginalized in clinical discourse due to pervasive cultural taboos regarding excretory anatomy, contemporary sexual medicine treats anilingus as a standard variant of consensual human intimacy, requiring precise assessment regarding both somatic gratification and infection control.
From a public health and epidemiological perspective, the behavior is identified as a direct mucosal contact vector capable of transmitting specific enteric and sexually transmitted pathogens. Consequently, scientific discussions of anilingus balance empirical explorations of sexual satisfaction and psychological bonding with rigorous clinical guidance on hygiene, prophylaxis, and risk mitigation.
2. Etymology & Linguistic Origin
The term anilingus originates directly from classical Latin roots, reflecting the standard nomenclatural conventions established within nineteenth-century biomedical and psychiatric sciences. It is a compound term derived from the Latin substantive anus, meaning “ring,” “fundament,” or the distal termination of the alimentary canal, combined with the Latin verb lingere, signifying “to lick” or “to lap up.”
The linguistic construction closely parallels related sexological terminology, such as cunnilingus (from cunnus, meaning pudenda or vulva, and lingere) and fellatio (from fellare, meaning to suck). The hybrid suffixation conforms to classical Latin noun declensions, creating a neologism that gained formal clinical traction in Western medical lexicons during the late nineteenth and early twentieth centuries, particularly within forensic psychopathology treatises such as those authored by Richard von Krafft-Ebing.
Colloquially, the practice has generated a vast lexicon within vernacular English, most prominently the slang terms “rimming,” “rim work,” or “anal-oral sex.” These informal expressions highlight the perimeter or “rim” of the external anal sphincter as the central focus of physical contact, transitioning the act from the formal classifications of forensic pathology into broader popular and subcultural discourse.
3. Pronunciation & Grammatical Form
In standard International Phonetic Alphabet (IPA) notation, the word is pronounced as /ˌheɪnɪˈlɪŋɡəs/ in General American English, or /ˌænɪˈlɪŋɡəs/ in standard Received Pronunciation. The primary stress falls consistently on the third syllable (“lin”), with a secondary stress occurring on the initial syllable.
Grammatically, anilingus is an uncountable noun. It functions primarily as the direct object or subject in clinical and sexological discourse (e.g., “Participants reported regular engagement in anilingus”). Variant orthographic representations appear occasionally across historical literature, including analingus, an etymologically irregular spelling that substitutes the thematic vowel ‘a’ to mimic the anatomical noun “anal.” Despite its relative prevalence in non-academic writing, standard lexicographical authorities recognize anilingus as the etymologically correct form.
Associated grammatical derivatives include the agent noun anilinguist (denoting an individual who performs the act) and the adjectival form anilingual (characterizing behaviors or stimuli pertaining to the practice). In vernacular syntax, the term is commonly substituted with the transitive verb phrase “to rim,” permitting standard conjugational flexibility unavailable to the Latin root.
4. Detailed Conceptual Explanation
Anilingus represents a complex intersection of neurosensory excitation, interpersonal vulnerability, and tactile exploration. The physiological basis for the pleasure derived from anilingus lies in the neuroanatomy of the human pelvis. The perianal skin and the mucocutaneous junction of the anus (the pectinate or dentate line) possess an exceptional density of sensory nerve receptors, mediated primarily by the pudendal nerve through the inferior rectal nerves. This somatic innervation confers acute sensitivity to light touch, thermal variation, friction, and pressure, rendering the external anal margin one of the most reactive secondary erogenous zones in the human body.
Beyond peripheral somatic innervation, the internal and external anal sphincters are regulated by complex autonomic pathways involving sympathetic fibers from the hypogastric plexuses and parasympathetic fibers from the pelvic splanchnic nerves. When stimulated during heightened states of sexual arousal, the reciprocal relaxation and rhythmic contraction of these muscular rings can induce potent central nervous system feedback. For many individuals, this neurochemical cascade produces intense sensations of erotic release, often synergizing with simultaneous genital stimulation to facilitate profound orgasmic states.
Psychologically, the practice carries profound symbolic weight. Because human cultures universally erect stringent taboos regarding the excretory functions of the gastrointestinal system, engaging in oral-anal contact requires an exceptional suspension of disgust sensitivity. In sexological theory, this phenomenon is often conceptualized through the lens of psychological disinhibition and intimate surrender. The willingness of an individual to perform or receive anilingus signifies high interpersonal trust, mutual acceptance, and the transgressive reclamation of a bodily zone historically codified as profane.
The experiential scope of anilingus varies widely across individuals. For the receiving partner, sensations range from delicate tickling and warmth to profound neuromuscular relaxation and deep muscular stimulation. For the performing partner, the act frequently serves as an expression of sensual devotion, dominant or submissive psychological fulfillment, or direct erotic arousal mediated by olfactory, gustatory, and tactile intimacy. Its practice spans heterosexual, homosexual, bisexual, and queer relationships, demonstrating that the underlying erotic potential of the perianal region is a universal aspect of human somatic architecture rather than an orientation-specific phenomenon.
5. Historical Development
The historical trajectory of anilingus reflects the broader historical evolution of human sexual attitudes, oscillating between ritualized esoteric practice, forensic criminalization, medical pathologization, and modern sex-positive normalization. In ancient civilizations, documentation of oral-anal contact appears intermittently in erotic art, mythological iconography, and satirical literature. Artifacts from the Moche civilization of ancient Peru, classical Greek black-figure pottery, and Roman erotic frescoes depict variations of anal intimacy, though scholarly consensus frequently debates whether these depictions represented normative behaviors, ritualized dominance, or exaggerated comedic tropes.
During the medieval and early modern periods in Europe, Christian theological doctrine, anchored by the writings of Augustine and Thomas Aquinas, classified any non-procreative sexual contact as contra naturam (crimes against nature). Under ecclesiastical and subsequently secular criminal codes, anilingus was subsumed under the expansive and severely penalized umbrella of sodomy. Because sodomy statutes prioritized anal penetration (coitus per anum), non-penetrative perianal oral contact received less distinct legal codification, yet remained deeply stigmatized as a mortal sin and an intolerable defilement of the Christian body.
The formal medicalization of anilingus emerged during the late nineteenth century with the advent of scientific sexology. Pioneers such as Richard von Krafft-Ebing, in his seminal 1886 work Psychopathia Sexualis, classified anilingus under the categories of “contrary sexual instinct” and “sexual perversion.” Krafft-Ebing viewed oral-anal behaviors as symptomatic of profound moral degeneration or hereditary neurosis, linking them to coprophilia and fetishistic obsessions. Early psychiatric models thus framed the act entirely through the taxonomy of disease and psychopathology.
A critical shift occurred mid-century through the work of Alfred Kinsey and his associates at the Institute for Sex Research. In their groundbreaking volumes on male (1948) and female (1953) sexual behavior, the Kinsey team systematically gathered statistical data on non-procreative practices. While Kinsey noted that anilingus remained heavily underreported due to social stigma, his documentation demonstrated that significant minorities of both heterosexual and homosexual adults engaged in diverse oral-anal acts, challenging the notion that the behavior was an idiosyncratic psychiatric aberration.
The gay liberation movement of the late 1960s and 1970s marked a pivotal transformation in the social visibility of anilingus. Within urban gay male enclaves, the act was actively embraced as an emblem of sexual freedom, intimacy, and resistance against heteronormative constraints. However, the onset of the HIV/AIDS epidemic in the early 1980s prompted intensive epidemiological investigations into all modes of sexual contact. While anilingus was quickly identified as an inefficient vector for HIV transmission compared to unprotected receptive anal intercourse, public health bodies highlighted its role in spreading hepatitis A, parasitic dysenteries, and bacterial gastroenteritis.
In the twenty-first century, broader access to diverse representations in digital adult media, comprehensive sex education, and sex-positive feminist movements has largely demarginalized anilingus. Contemporary empirical surveys indicate growing prevalence rates across diverse demographics, with contemporary sexual health discourse framing the practice not as a perversion, but as an ordinary, valid variation of somatic intimacy requiring informed hygiene and prophylactic management.
6. Theoretical Foundations
The academic examination of anilingus intersects several theoretical paradigms, most notably psychoanalysis, queer theory, evolutionary sociology, and behavioral health models.
In classical psychoanalysis, Sigmund Freud introduced the foundational concept of the “anal stage” of psychosexual development, occurring approximately between ages one and three, during which the child’s primary erogenous zone shifts to the bowel and bladder elimination mechanisms. Freud argued that unresolved conflicts during this stage could result in “anal fixation,” manifesting in adult character traits such as extreme orderliness (anal-retentive) or destructive carelessness (anal-expulsive). From a Freudian perspective, adult anilingus represents a regression to, or reactivation of, pregenital infantile sexuality, where libido remains fixated on non-genital zones before consolidating under genital primacy.
Conversely, queer theory and post-structuralist frameworks, heavily influenced by the work of Michel Foucault, critique psychoanalytic developmental models as inherently heteronormative and teleological. Foucault argued that the medical categorizations of non-procreative sexualities served as regulatory mechanisms of biopower, designed to monitor and discipline the human body. Queer theorists contend that anilingus operates as a subversion of the reproductive imperative. By severing physical pleasure entirely from biological reproduction and focusing eroticism upon an excretory aperture, the act destabilizes traditional hierarchies of bodily meaning, challenging patriarchal categorizations of “clean” versus “unclean” flesh.
Sociological theories of disgust, notably advanced by scholars such as Mary Douglas in her work on “purity and danger,” illuminate how societies establish moral order by marking bodily boundaries. Douglas posited that dirt is “matter out of place.” In this framework, the anus is socially designated as an internal exit point meant exclusively for waste removal; crossing that threshold with the mouth—the primary site of nourishment, communication, and social contact—disrupts deeply ingrained cultural taboos. Engaging in anilingus therefore represents a conscious transgression of boundary maintenance, transforming symbolic contamination into hyper-intimate devotion or somatic ecstasy.
7. Key Components, Types & Dimensions
Anilingus encompasses several structural, physiological, and behavioral configurations. Clinicians, sexologists, and educators differentiate these dynamics along distinct dimensions:
- Surface Contact (External Stimulation): Focuses exclusively on the external perianal epidermis, the median raphe of the perineum, and the outer margins of the external anal sphincter using gentle licking, breath work, or soft kissing without penetration.
- Deep/Penetrative Contact: Involves the insertion of the performing partner’s tongue through the anal verge into the anal canal, targeting the mucocutaneous dentate line and engaging the internal sphincter muscles directly.
- Unilateral vs. Reciprocal Dynamic: Unilateral anilingus occurs when one partner acts exclusively as the agent while the other receives. Reciprocal anilingus refers to simultaneous stimulation, frequently integrated into mutual oral-genital configurations (e.g., variations of the “sixty-nine” position adapted for oral-anal alignment).
- Preparatory vs. Autonomous Utility: Functionally, anilingus may serve as an autonomous sexual climax or act as an erotic precursor designed to relax the anal sphincters prior to receptive penetrative anal intercourse (dilatory utility).
- Unprotected vs. Protected Practice: Distinguishes between direct tissue-to-tissue contact and protected anilingus utilizing non-porous physical barriers, such as dental dams, modified non-lubricated latex condoms, or medical-grade plastic barriers, intended to block pathogen exchange.
- Sensory Integration: Often combined with complementary stimuli, such as manual prostate or vulvar stimulation, temperature play (using warm or chilled fluids), or the application of flavored, water-based lubricants to mediate tactile and gustatory sensations.
8. Examples & Illustrative Cases
To contextualize anilingus within real-world interpersonal and clinical scenarios, the following illustrative vignettes demonstrate its practical application across different life contexts:
- Vignette A (Overcoming Inhibitions in Heterosexual Intimacy): Mark (32) and Sarah (30) have been married for five years. Seeking to expand their sexual repertoire, Mark expresses interest in performing anilingus on Sarah. Sarah initially experiences intense anxiety rooted in internalized shame regarding bodily odors and traditional taboos regarding female anal cleanliness. Through open communication, pre-cleansing rituals using gentle showers, and an incremental approach starting with light touch along the perineum, Sarah reports achieving significant sexual arousal and intense orgasmic release, describing the experience as uniquely liberating and deeply validating of her bodily autonomy.
- Vignette B (Clinical Counseling and Prophylaxis in Men Who Have Sex with Men): Julian (26), a sexually active gay male, presents to a sexual health clinic for routine screening. During the behavioral history, Julian notes regular engagement in receptive and insertive anilingus with multiple partners. While he is adherent to daily HIV pre-exposure prophylaxis (PrEP), he expresses confusion regarding chronic episodes of non-viral gastroenteritis and pharyngeal discomfort. The clinician explains that while PrEP provides high protection against HIV, it offers zero defense against bacterial enteric pathogens such as Campylobacter or Shigella, nor does it prevent the oral acquisition of HPV or gonorrhea. The clinician counsels Julian on physical barrier implementation, immunization against hepatitis A and B, and routine mucosal swab screening.
- Vignette C (Psychosexual Exploration in Kink and BDSM Contexts): Elena and David participate in consensual power-exchange relationships. Within their structured dynamics, Elena positions David in acts of devotion where David performs anilingus on Elena. Here, the act functions not merely as physiological stimulation, but as a symbolic expression of submission, total acceptance, and erotic surrender, demonstrating how somatic behaviors acquire multifaceted meanings when framed by intentional psychological contracts.
9. Measurement & Assessment
In quantitative behavioral research and epidemiological inquiry, the assessment of anilingus requires validated psychometric scales and precise behavioral recall inventories. Because social desirability bias significantly distorts self-reporting on stigmatized sexual practices, researchers utilize computer-assisted self-interviewing (CASI) and audio computer-assisted self-interviewing (ACASI) to maximize report validity.
Empirical assessment tools frequently operationalize anilingus within broader survey batteries, such as:
- The Kinsey Scale & Sexual History Interviews: Broad historical instruments measuring the lifetime frequency of specific non-coital practices across diverse gender pairings.
- The Multidimensional Sexual Extensiveness Scale: A psychometric inventory that measures the breadth of an individual’s sexual repertoire, including non-procreative behaviors, oral-anal practices, and fetish explorations.
- CDC Behavioral Risk Factor Surveillance System (BRFSS): Integrates targeted queries regarding mucosal sexual exposures to map enteric disease outbreaks and monitor vaccine-preventable viral hepatitis transmission patterns.
- Derogatis Sexual Functioning Inventory (DSFI): Evaluates individual attitudes toward diverse sexual behaviors, assessing internal levels of drive, satisfaction, and psychological distress associated with specific intimate acts.
From a biomedical perspective, diagnostic assessment related to anilingus does not measure the act itself, but rather screens for clinical sequelae. This includes the application of pharyngeal nucleic acid amplification tests (NAAT) to detect Neisseria gonorrhoeae and Chlamydia trachomatis, serological testing for hepatitis A and B, stool cultures and multiplex PCR assays for gastrointestinal parasites (e.g., Giardia duodenalis, Entamoeba histolytica), and visual screening for perianal and oral lesions caused by the Human Papillomavirus (HPV) or Treponema pallidum (syphilis).
10. Applications & Practical Significance
The academic and clinical utility of analyzing anilingus spans clinical sexology, relationship therapy, and public health architecture. In sex-positive psychotherapy, normalizing desires surrounding anilingus assists clients in deconstructing deep-seated sexual guilt, overcoming bodily dysmorphia, and untangling performance-related anxieties. Clinicians use education regarding anilingus to help couples navigate asymmetric sexual desire, providing tools for non-coital intimacy when genital penetration is hindered by conditions such as erectile dysfunction, vaginismus, or pelvic floor hypertonicity.
In public health engineering, understanding anilingus is vital for managing infectious disease transmission. Because the act places the oral cavity into direct contact with fecal flora and rectal mucosa, health agencies design specialized educational campaigns promoting primary prevention. The most critical practical measures include:
- Barrier Prophylaxis: Promoting the correct application of dental dams—thin sheets of latex or polyurethane placed over the anus to prevent direct contact with infectious agents. In resource-limited settings, clinicians educate populations on fashioning makeshift dams by slitting non-lubricated male condoms down the side.
- Immunization Programs: Advocating for universal vaccination against hepatitis A and B among populations reporting regular oral-anal contact, notably men who have sex with men (MSM), who experience disproportionate rates of enteric viral transmission.
- Hygiene and Preparation: Developing pragmatic harm-reduction guidelines regarding pre-act hygiene. This involves gentle cleansing of the external perianal area with mild, non-irritating soaps while discouraging aggressive internal rectal douching immediately prior to contact, as mechanical trauma may disrupt the protective mucosal lining and elevate infection vulnerability.
- Clinical Vigilance for Foodborne and Enteric Outbreaks: Training physicians to recognize sexual transmission pathways for illnesses traditionally classified as strictly food- or waterborne, including shigellosis, salmonellosis, and cryptosporidiosis.
11. Research & Empirical Evidence
Epidemiological and sociological research confirms that anilingus is a common element of contemporary human sexuality, rather than a fringe practice. The landmark National Survey of Sexual Health and Behavior (NSSHB), conducted by the Center for Sexual Health Promotion at Indiana University, has generated substantial data regarding prevalence across the United States. Findings show that approximately 20% to 35% of adult heterosexual men and women report having engaged in anilingus at least once in their lifetimes, with prevalence rates exceeding 60% among gay and bisexual male cohorts.
Medical literature demonstrates distinct physiological transmission profiles linked to the behavior. Research by public health authorities has identified anilingus as a primary behavioral driver in sexually transmitted gastrointestinal infections, commonly referred to as the “gay bowel syndrome” in early literature, though modern epidemiology frames it more precisely as sexually transmitted enteric infection (STEI). Studies published in journals such as The Lancet Infectious Diseases demonstrate that multidrug-resistant strains of Shigella sonnei and Shigella flexneri circulate through direct oral-anal sexual networks, necessitating targeted antimicrobial stewardship.
Furthermore, oncological and virological research has underscored the relationship between anilingus and oncogenic HPV transmission. High-risk genotypes, notably HPV-16 and HPV-18, are strongly implicated in the pathogenesis of both oropharyngeal and anal squamous cell carcinomas. Studies evaluating viral concordance within couples suggest that oral-anal contact facilitates the bidirectional transfer of mucosal HPV variants, emphasizing the preventative value of widespread pediatric and adult HPV vaccination.
In the psychosexual domain, research published in the Journal of Sexual Medicine reveals a positive correlation between repertoire diversity—including oral-anal and non-coital acts—and subjective ratings of relationship satisfaction and orgasmic consistency. These empirical insights indicate that individuals who actively negotiate complex, non-traditional sexual behaviors often exhibit higher levels of dyadic communication and overall sexual self-efficacy.
12. Cultural & Cross-Cultural Considerations
Socio-cultural perceptions of anilingus are deeply heterogeneous, shaped by religious dogmas, regional hygiene standards, and traditional gender roles. In many Western, secularized societies, anilingus has increasingly been integrated into mainstream depictions of romance and erotica, losing much of its historical association with mental pathology. However, it still retains an aura of illicit transgression, serving as a boundary marker between “vanilla” and “kinky” sexual repertoires.
Conversely, in traditional Islamic, Orthodox Jewish, and strict Christian frameworks, anilingus is frequently categorized as impermissible (e.g., haram in Islamic jurisprudence or an infringement of tzniut and purity laws in traditional Judaism). In these theological paradigms, the body is treated as a sacred vessel governed by strict behavioral parameters separating clean aspects of creation from excremental waste. The deliberate placement of the mouth upon the excretory portal is seen as a violation of physical purity and spiritual dignity.
Cross-cultural anthropologists highlight that in cultures with deeply entrenched honor-shame systems or rigid patriarchal expectations, performing anilingus may be viewed as fundamentally humiliating or emasculating, particularly if performed by a male partner upon a female partner. Alternatively, within specific indigenous traditions and non-Western societies with expansive concepts of bodily energy—such as certain esoteric Tantric and Taoist practices—specific manipulations of the perineum and pelvic base are recognized as mechanisms for circulating vital life energy (such as prana or qi), though oral engagement with the anal aperture specifically remains relatively rare in traditional canonical texts.
13. Criticisms, Debates & Limitations
Despite its growing normalization, anilingus remains a subject of considerable controversy and scientific debate. One primary clinical critique revolves around the tension between harm reduction and epidemiological reality. Infectious disease specialists note that while sexual health organizations advocate for dental dams and latex barriers, real-world compliance rates are exceptionally low. Qualitative surveys suggest that the majority of individuals who practice anilingus reject physical barriers, citing diminished tactile sensitivity, chemical odors, and disruptions to spontaneous intimacy. Consequently, critics argue that public health messaging remains disconnected from actual human behavior, demanding more pragmatic harm-reduction frameworks that focus heavily on vaccination, prophylactic hygiene, and testing rather than idealistic barrier enforcement.
Another ongoing debate concerns the influence of modern pornography on sexual coercion and performance pressure. Sociological critics, particularly within certain feminist paradigms, argue that the widespread mainstreaming of anilingus within digital pornography has transformed an act that once required deep vulnerability and negotiation into an obligatory expectation for women. In this view, female performers and everyday women may feel implicit pressure to consent to oral-anal stimulation or perform it on male partners to validate their sexual adventurousness, potentially obscuring authentic personal boundaries.
Within biomedical research, limitations persist regarding exposure attribution. Because anilingus is rarely practiced in complete isolation from other sexual behaviors—such as vaginal intercourse, fellatio, cunnilingus, and manual-anal contact—isolating the precise transmission dynamics of specific pathogens (e.g., HPV, pharyngeal gonorrhea) presents methodological challenges. Observational studies frequently struggle with confounding variables, relying upon retrospective sexual recall that is prone to significant recall bias and social desirability distortions.
14. Related Terms & Distinctions
To avoid conceptual ambiguity, anilingus must be differentiated from closely associated anatomical, physiological, and clinical terms:
- Cunnilingus: The oral stimulation of the female external genitalia, including the clitoris, labia, and vaginal introitus. It differs from anilingus in its anatomical target, mucosal tissue characteristics, and primary association with genital-reproductive structures rather than the gastrointestinal tract.
- Fellatio: The oral stimulation of the male penis, encompassing the shaft, glans, and testicles. Unlike anilingus, fellatio involves direct contact with the external male urinary-reproductive tract.
- Anal Intercourse (Coitus per Anum): The penetrative insertion of the erect penis into a partner’s rectum. While anilingus involves superficial or lingual-muscular stimulation mediated by the oral cavity, anal intercourse involves mechanical thrusting that exerts greater friction and hydrostatic pressure, carrying significantly higher risks of mucosal tearing and HIV transmission.
- Coprophilia: A recognized paraphilic condition characterized by sexual arousal and gratification derived directly from contact with, consumption of, or interaction with human fecal matter. Anilingus is explicitly distinct from coprophilia; participants in anilingus generally demand meticulous hygiene to avoid fecal exposure, seeking erotic stimulation from the neurosensitive perianal epithelium rather than excretory matter.
- Anismus: A clinical gastrointestinal disorder marked by the failure of the pelvic floor muscles and external anal sphincter to relax during attempted defecation. While physiological, this is a neuromuscular pathology of elimination, whereas anilingus is a consensual behavioral act of erotic stimulation.
15. Summary / Key Takeaways
Anilingus is the oral stimulation of the perianal tissue and anal sphincter, representing a standard, increasingly documented variation of human sexual behavior. Driven by the dense somatic and autonomic innervation of the pelvic floor, the act provides potent physical and psychological pleasure. However, because it crosses the anatomical divide between the digestive and oral systems, it functions as a primary transmission vector for enteric bacteria, viral hepatitis, and various sexually transmitted pathogens.
Historically categorized as a moral sin and a psychiatric perversion, contemporary sexology and medicine treat anilingus as a valid intimate practice. Effective navigation of the act requires open interpersonal communication to build trust and mitigate bodily anxieties, alongside clear public health awareness encompassing routine testing, barrier methods, and prophylactic vaccinations against hepatitis A, B, and HPV.
References
American Sexual Health Association. (2020). Oral sex and sexually transmitted infections: Clinical considerations. American Sexual Health Association. https://www.ashasexualhealth.org
Centers for Disease Control and Prevention. (2021). Sexually transmitted infections treatment guidelines, 2021. U.S. Department of Health and Human Services. https://www.cdc.gov/std/treatment-guidelines/default.htm
Herbenick, D., Mullinax, M., & Mark, K. (2017). Sexual repertoire diversity and its relationship to sexual satisfaction and function among American adults. The Journal of Sexual Medicine, 14(6), 785-794. https://doi.org/10.1016/j.jsxm.2017.04.664
Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male. W. B. Saunders Company. https://kinseyinstitute.org
Krafft-Ebing, R. von. (1886). Psychopathia Sexualis: With especial reference to the antipathic sexual instinct: A medico-forensic study. F. A. Davis Company. https://archive.org/details/psychopathiasex00krafgoog