3 questions

[quazzar]

Thanks in advance for your attention, doc!

1.  How likely is HIV transmission from a human bite?  I was bitten once, during sex, and I couldn't even tell if the bite had broken the skin or not.  I thought it maybe had, just a little.  I showed it to a doc who wrinkled her nose and said, "no, not likely for disease transmission," but still, I freaked out, got an HIV test 10 weeks later (negative), and put the matter to rest.  Should it stay rested?  When I spoke to CDC phone people about this they simply said that bite is possible but unlikely--and that there must be blood present in biter's mouth.  And of course, from a freaked-out person's perspective, there could always be that lil' drop of blood from someone's mouth cut...flossing...whatever. But I'm holding on to the 10 week result as though it is almost perfectly conclusive.

2.  Do the few people who have HSV-2 orally have frequent recurrences and asymptomatic oral shedding?  

3.  Simplyconfused posted a day or so ago about her HSV-2 leg infection--which has, of course, gotten me so re-freaked out about having gotten HSV-2 from a woman who rubbed her stockinged leg/thigh against my penis, maybe against the head. She rubbed her leg up and down a bit on my penis, which would perhaps create that "massaged into the body" trait that you mention is often necessary for HSV-2 transmission. You answered once, and confirmed again that there is "ZERO chance you were infected by the exposure you describe."  Does Simplyconfused's case prove otherwise?  (I hope not.)

I honestly am very sorry if this last question gets under your skin (sorry for the ill-placed pun).  I don't want to go against your suggestions/posting rules or bug anybody, but I DO want to be really certain about facts and possibilities.  I'd go to med school, but I'd probably learn to much stuff and get really, really freaked....knowing that the stocking-situation was not the source of my infection makes a huge difference in my life--only for me, only for my knowlege of my personal history....Thanks Doc.  This is the best site for med-learning, no question.

[H. Hunter Handsfield, M.D.]

I appreciate your desire to be "certain about facts and possibilities", but there are no certain answers to the questions you ask.  There is a theoretical risk of HIV through biting, but it's probably low since most HIV infected persons do not have infectious virus in saliva.  To my knowledge, nobody has been documented to have caught HIV from a bite, but I'm not sure.

People with oral HSV-2 generally have few or no symptomatic recurrences and little or no asymptomatic shedding, but there probably are exceptions.  It is not known why the infection behaves differently in the mouth than the genitals.

Transmitting HSV probably requires exposure to large amounts of the virus; that the virus be placed on a moist mucous membrane (e.g., inside the mouth, vagina, etc); or that it be massaged into the skin, as occurs during sex.  Brushing against an infected person's lesion probably is not sufficient for transmission.

Just choose your partners wisely and use condoms for genital or anal intercourse outside permanent, committed relationships.  Those are the only recommendations worth worrying about to prevent HIV or other STDs; after that, don't lose sleep over the risks.  They are too low to be worthy anybody's energy and worry.

HHH, MD

[Alisa W]

I thought it might reassure you some to know that I have not even passed this to my husband from my leg infection.We have been together for years now. We don't use any protection and have a normal active sex life. So, I would think, it would be a really slim chance that a one time encounter with a person rubbing their stocking covered leg on your body would infect you.  I feel badly that my post scared you again. I hope this helps calm you a bit. I also think, as the doctor stated, that it is very rare to have the breakouts in the leg location.

[quazzar]

Doc, is my 10 week HIV (negative) conclusive though?

And do you still stick to your earlier response that there is pretty much zero chance I was HSV-2 infected from a leg through stockings?  I do, apparently, have the virus....via blood test.

[H. Hunter Handsfield, M.D.]

You undoubtedly have seen many threads on this forum that tell you my views about timing of HIV tests.  A negative test at 6 weeks is conclusive, let alone 10 weeks.

If you have HSV-2, you did not get it by contact with a leg lesion through someone's stocking.  You got it by genital intercourse with an infected partner.  Period.

HHH, MD

[quazzar]

Doc,  thanks for your answers.  Oh, by the way, are those only your views on HIV time to testing, or are they commonly held by other docs at your level of expertise??  I'm sure tons of us are worried by that 12 week CDC suggestion.

Simplyconfused, believe me, this is my problem, and not yours.  Your post/question was helpful and informative--and I wish you the best.  I simply have annoying anxiety issues that I can't seem to get over.  I've never dealt with issues like this before, and I'm not handling hsv-2 diagnosis well at all.  I don't seem to have symptoms, and I worry about infecting others, and..well, to suddenly find out one has something is, as you know, a real kick in the wherever.  Clearly, if anyone is to blame for my freaking out it is me....But I thank you and the doc for your concern.  Happy holidays!

[H. Hunter Handsfield, M.D.]

I can't keep answering the same questions.  Search the threads for "time to positive HIV test" for many, many discussions about this.

HHH, MD

[HJL413]

"massages into the skin" I had a similar fear and I am trying to convince myself the fear isn't real. My concern is herpes exposure from a series of lap dances. Is it possible to contract herpes while clothed if vaginal fluid passes through pants. Dr said no on my post 11/5 and I am still scared as I had a return of ithcy red spots on right butock and I rubbed one itchy spot into a raw red area which looks like a scrape. I want to think it is something like exczema (eczema), however, fear and emotions are causing me to worry. Any thoughts, I also wonder why it would have first appeared on my buttock. Thanks.

[H. Hunter Handsfield, M.D.]

Your symptoms are not at all like herpes and as I said before, you could not have acquired herpes in the way you describe.  Follow-up questions on this, in this thread or elsewhere, will be deleted without response.

HHH, MD

[HJL413]

Dr HHH:

Thank you for taking the time to respond to my comment. I KNOW I am having an emotional reaction and not one based on facts. Your pointed comments are most appreciated and will help me realize that fear and emotions are causing my concerns. Stay well