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Can I transmit herpes if I have never had an outbreak? Coldsores?
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Can I transmit herpes if I have never had an outbreak? Coldsores?

I have had cold sores since I was a child, but have not had one in several years.  I have never had any sign of genital herpes.  I recently had unprotected oral sex with a man and vaginal sex using a condom.  Within 2 days he said he came down with genital herpes and that I transmitted it to him.  He described the outbreak as a small bump that tingled on his penis.  I suggested we get tested and he resisted the idea, stating I would test positive no mater what due to my history of cold sores and that it would take at least 3 months before it could show up in his blood test.  He said he had a blood test for the virus about 2 years ago and it was negative.  I suggested he get the lesion tested.  He said it was already almost healed (2 days after he said he first had the outbreak) and that at that point it could not be swabbed.  I thought typically the initial outbreak is more severe and am surprised it only lasted 2 days.  How probable is that I transmitted genital herpes to this person?  Should I be tested, or does the fact I have had cold sores make this pointless?
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It is theoretically possible to spread herpes without an active outbreak.  However, this is very uncommon.  More important, if he's never had herpes before, the incubation period after contact is generally 3-5 days, not 2, and a first attack is likely to be much more severe--swelling, swollen glands, blisters--not just a single small tingling bump.  Even if this bump were herpes--I doubt it--it would represent a "recurrent-type" outbreak, which means that he was exposed long before he met you and the outbreak was a coincidence.  (Just as when you get a cold sore, you get it regardless of whether you kissed someone lately.)

Blood tests won;t be of value.  He'll either take your word for this or he's already made up his mind otherwise, in which case there's not much you can say.  If so, that's too bad for him.  If he was so sure it was herpes, he should have seen a doctor right away.

Good luck.

Dr. Rockoff
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