indirect transmission of Oral HSV 1 to genital HSV 1...?

[intheskywithdiamonds]

I hope you don't think this is an annoying question, I have been through a great number of the previous postings on this subject before asking this question and while there was some overlap I'd really like some specific advice on the issue.

On Friday afternoon I had sex with my boyfriend - he gave me oral sex but I did NOT give him oral sex. We then had intercourse (without a condom as I am on the pill and we were both thoroughly tested before we slept together for the first time a year ago). The point I started to freak out was on saturday morning when I noticed that what I had thought looked like a spot on my lower chin was looking more like a cold sore (I have had cold sores (HSV 1) since I was a child, as has my partner, so this is not a concern - we always refrain from any sexual activity including kissing when one of us has one. However, every time previously I have gotten them on my bottom lip, never on my chin, which is why I think I did not recognise the symptoms properly). Anyway, my question is this - while I'm pretty sure he didn't directly kiss my chin (!), there would obviously have been some skin to skin contact with the area, after which he gave me oral sex - so could he have transmitted my oral HSV 1 to me genitally - and furthermore then have been infected genitally himself when we then had intercourse. Again, the contact with his chin and my genitals was probably negligible but I am aware the virus is highly infectious, and usually am careful about washing hands etc if I have touched a sore at all.

I'm sorry if this seems hysterical, I've just been having a bit of a meltdown all weekend about it. I'm going to the clinic tomorrow to talk to someone, and I imagine you might be unable to give a definite answer unless I have any symptoms (which I do not, but it's only been two days), but I just needed to do something proactive about this as it's been churning through my brain for 48 hours.

Many thanks.

[Edward W Hook, MD]

There is no evidence to suggest that STDs (including herpes) of any sort can be spread to others through transfer of secretions by other body parts.  I must admit, this question usually comes up when folks are concerned that their hands (as opposed to their chins) might have spread infection.  These diseases really require direct contact for tranmission of infection to occur.  

Take care EWH

[intheskywithdiamonds]

Thank you so much, that's quite reassuring - one last (promise) final clarification - I didn't think that I had been infected by my BF re: the lesion on my chin - it was already there and not to do with him, I just mistook what it was. So I suppose the gist of my concern was two part - one you've already addressed (i.e. auto-infection), and the second regarding the brevity and intermediary nature of the contact - there seem to be divergent views on whether it absolutely has to be prolonged and direct 'genital to genital, oral to oral or oral to genital', or if intermediary surfaces (i.e. chins!) could transmit it too (moot question I know given your thoughts on auto-infection, but if you wouldn't mind humouring me I'll shut up now). Many thanks and all best wishes.

[Edward W Hook, MD]

Your question is not annoying and I hope that my comments can help you to relax through the rest of the weekend.  When a person gets a herpes infection (HSV-1 or HSV-2), they develop an immune response. The affect of this immune response is that recurrences are briefer and less uncomfortable than the initial episode and to prevent spread to other parts of the body.  The same immune response also prevents you from getting "more" HSV from a partner who is infected with the herpes type or spreading your own HSV to other parts of your own body.  Thus, in your situation where both you and your partner have HSV-1 infections, it is most unlikely that either of you can pass your own infections to each other at any parts of your bodies (I say "most unlikely" because Dr. Handsfield and I have seen it happen once or twice in the past 60 or so years of practice (combined) taking care of thousands of patients and emphasize that the chances or you and your BF being an exception to the generalization are close to zero)  .  

Further evidence that the lesion on your chin is not HSV-1 from your BF is that it appeared less than 24 hours after your encounter.  HSV does not appear as new lesions that quickly, typically taking 4-10 days NEVER appearing within 24 hours of exposure.  

There are many other dermatologic processes which might be causing the lesion on your chin but I can promise you it is not due to herpes contracted from your BF and it has not been spread to your genitals.

I hope my comments bring you some peace of mind.  Let us know what folks at the clinic say.  EWH

[intheskywithdiamonds]

dear god, you're going to think I'm a crackpot but am new to this and just noticed my profile says I'm male - just in case it affects things, I'm def a girl! That's it, last post I promise.

[intheskywithdiamonds]

Sorry, just to add - the thing I read on this forum that especially worried me was that HSV is present in saliva. Is this at all times or just when one has an outbreak? It seems to make it more likely (as we kissed first and so my saliva would have been in his mouth) that there could have been a genital infection this way? On the other hand if it's present all the time I guess there's v little point worrying too much about it...