Background:
Recent findings suggest that oral sex behaviors are increasing among adolescents. Little is known about health behaviors or motives associated with oral sex.

Objective:
This study describes the prevalence and behaviors associated with oral sex (OS) in sexually-experienced, urban adolescent women.

Method:
All 13-22 year-old adolescent women attending an urban adolescent family planning clinic between 10/24/05 and 3/21/06 were approached to complete a self-administered survey. Exclusion criteria were being non-English speaking and using antibiotics within 30 days. 92 were approached; 80 (87%) participated. Data were analyzed descriptively.

Result:
Mean age of the sample was 17.3±1.6 years, 91% were African-American, and 69% were in high school. All had sexual intercourse (SI); 79% performed OS, and 94% received OS. While 73% had SI before age 16, only 25% performed OS before age 16. 46/63 (73%) were older on first OS versus first SI. While only 21% performed OS on >2 partners, 66% had SI with >2 partners. Among women who performed OS in the past 3 months, 11% (5/47) always used condoms with OS contrasted with 31% (21/67) who always used condoms with SI in the past 3 months. Two-thirds of women report initiating OS themselves or discussing initiation with their partners. Reasons chosen for performing OS: her partner likes it (49%); she likes it (25%); to avoid intercourse (21%); and to avoid pregnancy (16%).

Conclusion:
Our data suggest oral sex is prevalent among sexually active urban adolescent women. In this sample, oral sex often follows initiation of vaginal intercourse, is mutually agreed upon and appears more selective; however oral sex is less often protected with condoms.

Implications:
As oral sex poses risk for STI transmission, this behavior should be assessed during history-taking. Further studies are needed to understand the motivations for oral sex in other demographic groups as well as for non-sexually-experienced women.