Gave unprotected oral to a woman with genital herpes...

[freakingOut36]

Hi Doctor,

I recently performed unprotected oral sex on a woman who has genital herpes.  There were no signs of any breakout, yet I know that you don't necessarily need a breakout to contract the disease.  I don't know if she has type 1 or 2 but I am wondering what the likelyhood of me getting herpes (type 1 or 2) are from this incident, and if so when would I know or be able to find out definitively.

Thanks for your time

[Edward W Hook, MD]

There is no way to put a number on your risk.  Let me give you a few facts which I hope will help you:

1.  Transmission is far more likely if you had contact with lesions than if she did not have lesions. This is in your favor
2.  Most exposures, even if virus is present usually don't lead to transmission
3.  If you do not notice oral lesions, you probably did not get it from the exposure.  Most of the time lesions appear within 3-5 days of exposure.  You did not say how long it has been since your exposure but once you are more than a week out, you have little to be concerned about.

If you are wondering about blood tests, they can take months to become positive after acquiring infection and, if you had a positive blood test you would not know if your infection was recently acquired or not unless you have been tested in the past.

My advice.  Once you're out a week, don't worry about it. Hope this helps.  EWH

  

[freakingOut36]

  First off thank you for your prompt and informative reply.  I just wanted to ask a few more quick questions and give a little more info.  The experience I had was only a couple of days ago and so far no lesions, although I feel like my lips are dry but probably only a psychosomatic symptom.  However, I called a local STD clinic and they said there was a moderate risk and said I had around a 40-60% chance of infection.  Does this seem accurate?  Also, I talked to the woman a little more and she says she doesn't remember if it was type I or II, shes sure she wasn't having a breakout at the time, and she takes medicine when she does have a breakout.  Would her taking medicine at times of breakout lower the risk of transmission when shes not breaking out and taking anything?  Thanks again for your time, and for working on this website.  It really helps to be able to get some facts, and not just possible fiction.

[gracefromHHP]

The risk of contracting herpes orally thru performing oral sex on someone with genital herpes is very low.  We don't have decent stats on it because it doesn't happen enough for us to get those sorts of stats.  It's certainly not a 40-60% chance of infection orally from performing oral sex.  if it happened that often - we'd have the info we needed to get better stats. You can contract hsv2 orally but it doesn't happen very often.  

Treating ob's when you have them has no effect on the shedding rates in between ob's.

grace

[freakingOut36]

Thanks for the info grace.  One more question.  If I were to contract hsv2 orally would it affect me orally or genitally and when you say it doesn't happen very often what kind of percentage are we talking about (for some reason a percentage makes me feel better).  I had no open sores or cuts that I was aware of on my mouth, and thankfully still no noticeable lesions or symptoms.  Thanks again.

[Edward W Hook, MD]

Thanks to Grace for her spot on comments.  To elaborate a bit on the issue of therapy, it is known that taking daily suppressive therapy will both reduce the frequency of recurrences and likelyhood of transmission.  On the other hand, as pointed out, treating only at the time of symptomatic recurrences does not reduce the risk of transmission to others.

Observation number 2.  If your partner has regular recurrences, it is more likely than not that she has HSV-2.  genital HSV-1 rarely recurs.

Regarding your question for risk of oral vs genital, should you acquire it, if your only expsoure was oral, then your risk for acquisition would be oral as well. Hope this helps.  EWH

[freakingOut36]

A related discussion, Gave unprotected oral sex to a woman with genital herpes (follow-up) was started.