Afraid of Herpes

Dear Dr-
I am a 35 yr old healthy female who has been monogamous for 15 yrs.  (married)  I have recently had two brief encounters with a man that I seem to have an extreme sexual chemistry with. Definitely not planned. It just fell into my lap (I know, please do not judge me)  I have never done anything or ever considered doing anything like this in my life before.  Mid life crisis?? I don't know. Anyway, we had unprotected oral sex and then about 10 seconds of unprotected sex.
I have a good life, a great husband and family, however I am planning on seeing this person again infrequently. It is not emotional ; it is just good sex.  I want to protect myself completely.  I do not have any STD nor have I ever.  Herpes seems to be my main concern because of its ease of transmission.
This is where my confusion lies.  Next time I see this person, I plan to use a condom for oral sex on him and saran wrap or some kind of a barrier for me.  I also plan on using a condom for vaginal sex and the idea came to me that maybe that this in addition to wearing his boxers or briefs during the act(with access through the slit) might lessen skin to skin contact with the scrotal area etc.  I want to protect myself from herpes as best I can.  This person says he does not have herpes or anything, by the way, but since this is not an exclusive relationship, I can't be too cautious.  I have never in my life even had a cold sore so I am very nervous about exposure.  Due to my situation, if I were to catch herpes, (even type 1) It would seriously impact my life.  

1. Would the precautions I listed help to eliminate risk?  Are they needed?

2.  Also, how come when I go online to herpes sites they say that it can be transmitted from hand to hand or hand to genital contact?  I see pictures of herpes blisters on things like elbows etc.  What about herpetic whitlow?  Yet, when I read your forum, you say that it is not transmitted in that way.  The reason I ask is because perhaps using latex gloves for manual contact and fingering would be something to consider, but between all the latex I was planning on using as precautions, this is becoming not so much fun anymore.  I don't want to be two people bumping around in plastic bubbles to avoid herpes if I don't have to.  Whtt is the real deal?  Can I safely stroke his penis and can he touch me?  Does washing before and after help?

Thank you, Dr H.  I'd be very interested in your advice.

[H. Hunter Handsfield, M.D.]

I'll try to help.  Since herpes is the STD on your mind, my response will focus on that STD; but be aware of other risks, particularly chlamydia and HPV, especially if your new partner has and will continue to have other partners.

The first thing to do is be tested, and ideallly for your new partner to be tested, for type 1 and 2 herpes simplex virus (HSV-2) with a type-specific blood test (see numerous other threads about the proper herpes blood tests, since not all providers and labs use the newer reliable tests).  The results will tell which of you is infected with which virus(es) and their likely anatomic sites.  You cannot safely assume you have not already been infected, regardless of your or your husband's monogamy.

To respond to your specific questions:

1) The precautions you describe are a bit extreme.  The risk of performing oral sex on each other is very low, as long as you both take precautions to avoid contact if there are oral lesions that could be herpetic (cold sores, etc).  Most STD experts don't routinely recommend condoms (or saran wrap) for oral-genital sex.  If you use condoms for genital intercourse, you will be very safe, although not 100% for HSV or HPV.

2) To my knowledge, hand-to-genital HSV transmission has never been documented.  Very few people have herpetic whitlows, and common sense would say to avoid had-genital contact if there are pus-filled sores on the fingers (duh).  You need to understand that diseases-specific websites are heavily populated by people with special concerns, anxieties, or social or political agendas and they typically are not monitored by science-based experts.  So outlandish stories are easily maintained and propagated.  Trust the experts, not the herpes-specific websites.

In addition to condom use, I suggest you have a frank conversation with your lover; it is important that you know what his sexual lifestyle is going to be aside from your relationship, how and where he selects other partners, and the like.  But if this is someone whose background is pretty much like yours, you probably are going to be safe.

Good luck--  HHH, MD

[concernedinsf]

Dr H will can probably offer better advice than I, but here's my two cents as someone who has both HSV1 & HSV2:

1. If you're going to continue in your affair, please use condoms.  It doesn't totally eliminate the risk of HSV2, especially if an infected partner is having an outbreak (in which case you should avoid sex altogether), but condoms will vastly reduce the risk of transmission of HSV2.

2. Have you been tested for HSV-1?  Chances are, you already have it (like 80% of the rest of us), even if you don't have active cold sores.  The easiest way it's transmitted is by kissing.

3.  To my knowledge, HSV-2 cannot be transmitted by mutual masturbation (correct me if I'm wrong, Doc?).

4.  If you continue in your affair, I think you and your partner have an obligation to get tested for STD's regularly, so as to reduce the chance that they are spread back to your family.

-CSF

[gracefromHHP]

How about instead of taking all the fun/intimacy/eroticism out of sex by using latex gloves and keeping half your clothes on you both get tested for herpes? You can order it up yourself thru www.healthcheckusa.com or thru www.tstd.org if either of them have a participating lab near you.  Both of you need to know your herpes status. If he is going to be having other partners too then he should be getting tested for all std's on a regular basis - not just herpes. It's still best to use a condom for sex but why worry about herpes transmission if it's not an issue? If you need help with your lab test results feel free to post them here and someone will help you ( or you can post them on the herpes homepage and someone there will help you - not sure how easy it is to post here without a charge ). BTW even if you've never had a cold sore you are still probably hsv1+ - over 60% the population has it but only 20-40% of them have ever noticed an obvious cold sore. It's quite common and chances are good that if you don't have it yet your husband at least does.  

Herpes isn't easily transmited to the hand thru manual stimulation but it can happen. if there are any open cuts on the hands or fingers ( including if they bite their nails! ) then avoid touching the genital area if you know your partner has genital herpes until the skin has healed. Otherwise the skin on the hand is usually too thick for the virus to penetrate. It happens but not all that often.  Manually stimulating each other is pretty low risk.

grace

[Christie2004]

Though I'm not judging you for what you did (things happen), I do just have to wonder what is going to happen if you continue as you are planning.

You say you have a great life, great husband, and family.  You seem very well educated and are wondering if the elaborate protective measures you are contemplating are enough.  You state it would seriously impact your life (you bet it would) if you were to contract an STD.  Even if you use a condom your risk would not be zero--it would be low, even very low...but not zero.  

I don't know--when you weigh the pros and cons of continuing this relationship, are "infrequent" bouts of good sex really worth what may happen?  You may have recurrent episodes of concerns (just read the archives!) and worry constantly if this or that minor irritation is herpes or other STDs--having to make plans to get a symptom checked out without your husband finding out.  Again, not judging, just making you think about whether the worry, precautions, secrecy, and perhaps guilt feelings are worth some infrequent good sex.  

If he's worth it...great.  I think your risk is low, at least of herpes if you use condoms.  But your risk to your family, your family's emotional life, and your marriage?  Perhaps much greater.

[concernedinsf]

Dr H.,

Where are the "good" websites that offer the quality of information you're giving here (specifically, on herpes)?  Any recommendations?

-CSF

[H. Hunter Handsfield, M.D.]

Good herpes information sources are the American Social Health Association (www.ashastd.org), CDC (www.cdc.gov/std), and the website of the Westover Heights Clinic in Portland, OR (www.westoverheghts.com).  The National Institutes of Health (www.niaid.nih.gov/factsheets/stdinfo.htm) website used to be excellent and probably still is; I just haven't checked it out in a while.  And, or course, the one from my own (former) institution, Public Health - Seattle & King County; you can it out through the link at the top of the STD Forum, "STD Quick Facts and Information".

HHH, MD

[Arroused]

Thank you everyone and Dr H for your comments.  I will use your information to decide upon how and "if" I continue in this sexual situation.

[bluebird05]

Why not sit down with your husband and tell him that although he's a "great husband" you're thinking about having an affair because sex with him is terrible....and give him a chance to make things better before you go putting him at risk for HIV or any other disease.