You know what the “S” in STD stands for, right? True to their name, the vast majority of sexually transmitted diseases stem from sexual contact. But there are non-sexual behaviors that can carry risks too.
“People are always asking me if the can get herpes from a hot tub or hotel sheets or toilet seats,” says herpes expert Christine Johnston, M.D., an associate professor of infectious disease at the University of Washington. “But herpes and some of these other bugs don’t live on surfaces.”
In fact, unlike cold and flu germs, most STD viruses “die immediately” once they leave the human body. For that reason, your risk of contracting an STD outside the bedroom (or backseat, or wherever you get it on) is low. But it’s not non-existent.
Here are all the ways you could end up with an STD that aren’t penetrative sex.
1. Oral Sex
“Oral sex is sex,” Johnston says. Herpes, syphilis, gonorrhea, and other STDs can all be transmitted during oral sex—whether you’re giving or receiving, she says. While it’s difficult to compare the risks of getting specific STDs from different types of sex, according to the Center for Disease Control, studies have shown that the risk of getting HIV from oral sex with an infected partner (either giving or getting oral sex) is much lower than the risk of getting HIV from anal or vaginal sex with an infected partner. Condoms or dental dams are effective ways to protect yourself, according to the CDC.
2. Sharing Razors
Blood-borne STD pathogens—including the viruses that cause AIDS and hepatitis C—can be transmitted via razor. “It’s extremely rare,” Johnston says. But it’s something to keep in mind if you ever think to borrow a buddy’s Mach 3.
3. Unregulated Tattoos
Nearly all tattoo parlors in the U.S. follow proper health regulations. In those cases, you’re not at risk for an STD. But if you’re getting inked by a friend or at an “unregulated” tattoo shop where needles are reused, you’re at risk for hepatitis C and HIV, Johnston says.
4. Sharing Needles
Intravenous drug users (or anyone who shares needles) is at risk of contracting STIs—even beyond HIV or hepatitis C Johnston says. One recent study from the University of Florida found injection drug users may be almost twice as likely to contract an STD than people who don’t use these drugs. According to the study, those who share needles tend to be bigger sexual risk-takers and have links to high-risk networks, which gives them a greater chance of sex with an infected partner. This in turn, increases their overall STD risk and their risk for HIV infection.
While herpes simplex 1 (oral herpes) is not strictly considered an STD, it can—and often is—passed via kissing, says Dr. Khalil Ghanem, M.D., Ph.D., an associate professor of medicine at Johns Hopkins University School of Medicine. If both you and your smooching partner have open cuts or sores around your mouths, that could potentially expose you to other STDs, he adds.
6. Dry humping
Even if you and your partner stop short of sex, rubbing your bare genitals together could lead to STD transmission, according to the CDC. For example, if your partner kept her underwear on but had an exposed, open syphilis sore, rubbing your penis on it could lead to an infection.