Risk of Transmission of HSV2 and my symptoms

[Btown75]

Close to 4 weeks ago I visited Thailand and engaged in some sexual activity.  I did have protected sex with a few different girls (sex workers) and received unprotected oral sex off 3 different girls.  I did not notice any herpes symptoms. I also had a body to body massage from a transexual.  Firstly,what is the likelihood that I contracted Herpes during that type of exposure? What degree of risk (high risk or low risk).  I do have oral HSV1 but have never tested positive to HSV2. To describe the interaction the Transexual was gently rubbing his genitals against my *** crack using baby oil but no penetration. He did not have a condom on.  I did not notice any sores or lesions and was only done for 5 minutes.  He also masturbated me, and performed unprotected oral sex for a couple of minutes before sticking his finger into my anus.  About a week after that I came down with a flu, coughing,chest infection and fever.  Upon returning home 2 weeks later I have noticed a slight irritation with the opening of my meatus, it feels slightly itchy. I have not noticed any sores or lesions appearing and no burning pain while urinating and no discharge that i can tell.  I have noticed that my *** crack seems inflamed and red, more towards the top of my *** under my tail bone and down to the upper part of my anus.  It doesnt feel itchy but just red and a bit sore.   I can see no lesions or blisters but am concerned that this still may be herpes as I have read alot of sites that state Herpes can sometimes present as just inflamation and this is where the transexual was rubbing his genitals.  I dont have any issues urinating or passing bowel movements and no other real pain has been experienced.  Wanting to know how common Herpes 2 would present as just a red inflamed rash and no other symptoms? Very concerned and anxious.

[Terri Warren, RN, Adult Nurse Practitioner]

The intercourse with a condom is low risk, the genital rubbing is also low risk and the oral sex is not a risk because you already have HSV 1.  The issue near the tailbone and anus is less clear about what might be going on.  Genital to genital rubbing, and this is sort of that, is usually risk free but it's hard to know exactly what transpired here.  If the first symptoms didn't show up for 2 weeks after the encounter, I think it is very unlikely to be genital herpes - the average time from infection to symptoms is 5.5 days.  Have you been in to see a health care provider about these symptoms?  If yes, what did they think was going on here?  

With first infection with herpes, I would expect if you were going to have symptoms, they might be more than just irritation.  With recurrences, that would be more common.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

Again, herpes would not likely present as a constant rash, it would be an evolving problem with various states of skin disruption.  This is not what you are describing to me.

Terri

[Btown75]

Thank you for your response.

Yes, there was just only rubbing on the outside of my anus and butt crack.

The rash or irritation is right in the crack. It's not spread out much but more within the crease. It doesnt seem to be getting worse, there is a little pain associated with it, which feels like nerve pain at the top where my coccyx is.

I am still concerned as everything I have read states hsv2 will show up usually where there was contact and this is where the contact was.  Is it common for HSV2 to only be a rash without the ulceration or blistering?  How common are atypical symptoms and will there usually be ulceration or blisters of some sort ?  

The doctor did put me on antibiotics when I returned to help with the cold/flu symptoms so am not sure if that has had an impact on this rash also.  I will re-test again in another 4 weeks to help put my mind at ease as this has been really making me anxious which is probably contributing to the sensations i am feeling also.  

Thank you

[Terri Warren, RN, Adult Nurse Practitioner]

The results cannot be definitive until 4 months have passed since the encounter.  Another negative result at 6 weeks would give you 70% reassurance about the negative, if it is negative, that the results would stay negative.  Also, if this was herpes, the red area would be changing over time, perhaps become more ulcerated then scabbing over on that kind of skin.  

If you had herpes inside the anus (I thought there was just rubbing on the outside), you would likely have pain with bowel movements and perhaps some bleeding or discharge.  

Terri

[Btown75]

Hi Terri

Thanks for your response.

I have seen a doctor and he doesn't seem overly concerned about the rash and inflamation in my *** crack.  In his opinion it doesn't look like HSV2.  

I guess what concerns me though is that some doctors don't seem as concerned if the 'typical' herpes symptoms aren't present.or are just looking for those kinds of signs  I suppose in my case I am worried that I may be displaying 'atypical' symptoms.  How common is atypical symptoms in your experience?

I did have a slight irritation in the meatus of my penis that seems to be a little itchy and was a bit red but its not constant, it seems to come and go and I have experienced no burning on urination and no blisters. The doctor did look at that and it looked ok to him.  My anus does feel a bit tender in one part and it seems to feel like it's just inside and of course the irritation on the outside and up between the cheeks.  There is no pain or bleeding on bowel movements and  I cannot see any blisters or fissures etc and I have shown the doctor also who didn't notice anything unusual other than that it was a bit inflamed. The fact that the person did rub his penis against my *** crack and also against my anus still has me concerned.  I'm not sure if I'm being overly paranoid?  If I had hsv2 inside my anus would I be experiencing worse or different symptoms?

I have tested negative for Chlamydia and Gonnorreae, I also took an IgG EIA test for HSV2 on 7 March 14, and this was approximately 23 days since the encounter I am describing. That result was negative.  I also received negative results for the other standard tests HIV, Syphliss, Hep B & C.  I have read that the HSV tests can sometimes display false negatives and positives and am worried if I haven't allowed enough time for the test?  How confident should I be with these results?  Any further advice or information you could provide me would be greatly appreciated!  Thanks so much Terri.