Herpes Risk Assesment

[steve45678]

Hi Doctor,  I am a married man and last Saturday evening, I strayed from my marriage with a friend.  This woman informed me upfront that she has genital HSV1 which she acquired about 9 months ago via receptive oral sex.  She said she has only had one outbreak and no reocurrences to date.  She told me that she does not think she has it orally since this one outbreak was genital and she has never had an oral outbreak and she was tested for all other STDs at that time.  She also informed me she has not had any other partners since her diagnosis and she does take valtrex and has only had one initial outbreak.  Of course, because I am married, I would like to know my exposure risk.  I also tested negative for all stds at my last doctor visit 6 months ago and had a blood test for Herpes 1 & II at that time which was negative along with all other tests.  During this encounter we did not have intercourse.  We both performed oral sex on each other several times to completion  and there was a lot of kissing, massaging and touching.  From this type of behavior, can you tell me my risk of acquiring her genital HSV infection?  I know you say the risk of oral sex is low but how low with a known positive partner?  How long should I wait to have relations with my wife and how long will it take for symptoms to occur?  If I continue to see her, what is the liklihood of exposure from comdom protected intercourse?  Thanks for a valuable site and hoping to gain some information from you since I seem to not be able to find much available on the web and from my doctor.  I also want to mention that I do not have any current symptoms.
Thanks again.

[steve45678]

Thanks so much.  I guess I'm just not that familiar with transmission and looks like if I got it, it would be orally and not genitally.  Kind of weird thinking but I was thinking that maybe with the mutual oral sex and saliva swapping, etc.  I could have somehow been exposed genitally.  Also, how effective is a codom against HSV 1?  I know it is not 100% for HSV II and just wondering if it's the same with HSV 1.  Thanks again.

[H. Hunter Handsfield, M.D.]

The comment from valtudo (below) is correct:  your only possible risk seems to be that you would have acquired or HSV-1 infection.  Half of all adults have oral herpes, with or without symptoms.  If it happened to you, even though you acquired it sexually, it would not be considered an STD.

Second, your partner probably is not shedding the virus without symptoms, at least not very often.  That happens a lot less frequently with genital HSV-1 than HSV-2.  Also, there is no reason to suspect she has an oral HSV-1 infection; probably she does not.

Third, if you had been infected, you probably would have known it.  Your lack of symptoms is reassuring and suggests you were not infected.

For these reasons, I see no reason for worry, and no risk of transmission to your wife.  Your risk is for oral HSV-1 infection, not genital.  And even if that occurred, there would be no reason for her to suppose (or for you to admit) that you acquired it sexually.  But if you want to sort things out with certainty, you can have another HSV-1 blood test 3-4 months after your extramarital adventure. If that result remains negative, you're home free.

Good luck--  HHH, MD

[valetudo]

kinda weird cuz you just said that she has hsv1 genitally and then you only performed oral sex on her


that means the worse case scenario is that you acquired oral hsv1 which the majority of the population has.


not to mention I think the doc will agree that in absence of a lesion, hsv 1 has a small chance of being acquired from a single sex exposure


so what are you worried about?