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Herpes Transmission Question
I have a question regarding transmission. I just recently had an outbreak and it appears as though the lesions have healed. But it still feels kinda sore in that area. I was with a girl who I told I had herpes and we did not have intercourse. But I did touch myself on my gentials (masturbation) and then performed mutual masterbation on her. She also touched my genital area directly by performing mutual masturbation on me. My fear is that I could have gotten some of the virus on my hand and then infected her from me performing mutual masterbation on her, or they she could have infected herself. I'm not a 100% certain my outbreak is over, it looks like the lesion has healed but it is still kinda red in the area and still feels alittle sore. I also shaved my genital area earlier in the day. I get my outbreaks on my scrotum. I don't know if that would make me more or less transmissable. I feel terrible. Can any of the doctors please provide me with their insight. I'm just concerned over the risk. I have heard hand-gential-hand transmission isn't likely, but it does happen in auto-inoculation. I don't see the difference between infecting another area of my body from getting virus on my hand or another person. Thanks for any help.
MEDICAL PROFESSIONAL
Your possibly neuropathic symptoms, in the area of your outbreaks, might indeed be due to your HSV-2 infection. But it does not necessarily correlate with transissibility. You cannot predict the concentration of virus during asymptomatic shedding. There is absolutely no basis for you to assume that you shed small versus large amounts of virus. You have an absolute ethical obligation to assume you can readily transmit HSV-2 to your susceptible sex partners. In other words, you are indeed overreacting with respect to hand-genital transmission. But you should assume you are always infectious for partners during genital sex.
That should end this thread. I won't have any further comments or advice.
That should end this thread. I won't have any further comments or advice.
Thanks again for your reply. I will look into suppressive therapy with my doctor. I examined my genital area again today, and where my last lesion was, and it has completely healed as I had suspected. However, I believe I have atypical symptoms. I get a weird sensation in the exact area where the outbreaks occur. They are always in the same spot. It is a weird sensation that I don't really know how to describe, sort of like very minor tingling pain in the skin area. So I assume this is probably related to my outbreak. I have it now even though my last outbreak has completely healed. The skin also looks kind of irriated, but there is no blistering or sores.
So I assume that even with these symptoms because there is no blistering or open sores that if there is any virus being shed, there isn't a very high concentration of it, and if I were to get the virus on my hands it still would be unlikely anything would happen given that the amount of virus that would be on my hands would be even less. I recall Dr. Hook stating that transmission depends on the amount of the virus you are exposed too. So going by this logic, and the fact you two haven't seen transmission like this in all your combined years of practice leads me to believe I'm over-reacting. But I just want to do all I can to prevent the spread of HSV-2. The more knowledge I have the better choices I will make.
So I assume that even with these symptoms because there is no blistering or open sores that if there is any virus being shed, there isn't a very high concentration of it, and if I were to get the virus on my hands it still would be unlikely anything would happen given that the amount of virus that would be on my hands would be even less. I recall Dr. Hook stating that transmission depends on the amount of the virus you are exposed too. So going by this logic, and the fact you two haven't seen transmission like this in all your combined years of practice leads me to believe I'm over-reacting. But I just want to do all I can to prevent the spread of HSV-2. The more knowledge I have the better choices I will make.
MEDICAL PROFESSIONAL
Note I did not say that hand-genital transmission cannot occur, and under the circumstance you describe, it probably is possible. If you wanted to transmit the virus intentionlly, you could undoubtedly do so by scratching an active, new HSV-2 lesion and then vigorously rubbing a partner's genitals. These facts don't mean that hand-genital transmission is actually worth worrying about.
Despite the infrequency of your outbreaks, you still should seriously consider suppressive therapy. If your rate of asymptomatic viral shedding is typical, you probably are potentially infectious (perhaps from your penis, not only the scrotum) 10% of the time or more. Most people with transmission anxieties like yours would benefit from suppressive therapy.
Despite the infrequency of your outbreaks, you still should seriously consider suppressive therapy. If your rate of asymptomatic viral shedding is typical, you probably are potentially infectious (perhaps from your penis, not only the scrotum) 10% of the time or more. Most people with transmission anxieties like yours would benefit from suppressive therapy.
This you so much for your prompt reply. I don't get alot of outbreaks. I get a couple a year at most, like 1-2. There is usually a large gap between like 5-6 months or more. I got my infection through intercourse with a condom on. The location is below the area where the condom covers. I was just a little bit freaked out as I felt I was be irresponsible by engaging in sexual activity when I wasn't sure if my outbreak was over. I hear you should wait 7 days after the sores have healed. Also it was feeling a bit sore and slightly red in the area, but the sore looked competley healed. I did tell her about my infection, and she expressed slight concern. She had stated what if after you touching yourself and you touch me you transmit the virus. I said that what we were doing was safe. But after I doubted myself and felt really guilty. I was thinking, how do you know your outbreak isn't over, it is still probably too soon. If you got virus on your hand and then masturbated her you could infect her. But what you're saying is that it is not a likely route for HSV-2 to take. Just one hypothetical questions, supposed I had an open sore, touched it and got the virus on my hand and then proceded to mutally masturbate her, that would still be highly unlikely because it is indirect contact?
MEDICAL PROFESSIONAL
Welcome back to the forum.
I reviewed your previous threads on this and the HIV prevention forum. In the first of those, you expressed a great deal of responsibility in your concern about the potential for transmission of your genital herpes and how to prevent it, on which Dr. Hook congratulated you. I add my support for that attitude. However, the subsequent discussions and this one suggest you are more concerned than necessary about the potential for HSV-2 transmission.
HSV-2 is rarely if ever transmitted except by insertive genital intercourse. Nobody can say the risk is zero from hand-genital transmission, but in our 30+ year careers in the STD business, neither I nor Dr. Hook has ever seen a patient with new HSV-2 infection who had not had genital intercourse, usually unprotected. You have a misunderstanding about autoinoculation, which occurs almost exclusively during the course of initial HSV infection; it is rarely a problem more than 3 months after acquiring the virus. Its rare occurrence has few if any implications for hand-genital transmission to partners. Further, with your recent outbreak pretty much healed, it is unlikely you were continuing to shed virus.
Apparently you are not on suppressive antiherpetic therapy or you would have mentioned it. As you may know, avoidance of transmission by depending on symptomatic outbreaks -- i.e. avoiding sex until healed -- is a largely ineffective way to prevent transmission of HSV-2. Most transmission events occur during asymptomatic shedding of the virus. Given your concern about transmission, I strongly recommend you talk to your provider about starting suppressive therapy with valacyclovir or one of the other antiherpetic drugs. It will reduce both the frequency of your symptomatic outbreaks (although you don't say how common they are) and will markedly reduce asymptomatic viral shedding and, therefore, the potential for transmission to sex partner. In addition, discuss your HSV-2 with any and all current, future, or potential sex partners before having sex with them, and use condoms. However, you really should be having no fears or concerns about hand-genital transmission to partners.
I hope this helps. Best wishes-- HHH, MD
I reviewed your previous threads on this and the HIV prevention forum. In the first of those, you expressed a great deal of responsibility in your concern about the potential for transmission of your genital herpes and how to prevent it, on which Dr. Hook congratulated you. I add my support for that attitude. However, the subsequent discussions and this one suggest you are more concerned than necessary about the potential for HSV-2 transmission.
HSV-2 is rarely if ever transmitted except by insertive genital intercourse. Nobody can say the risk is zero from hand-genital transmission, but in our 30+ year careers in the STD business, neither I nor Dr. Hook has ever seen a patient with new HSV-2 infection who had not had genital intercourse, usually unprotected. You have a misunderstanding about autoinoculation, which occurs almost exclusively during the course of initial HSV infection; it is rarely a problem more than 3 months after acquiring the virus. Its rare occurrence has few if any implications for hand-genital transmission to partners. Further, with your recent outbreak pretty much healed, it is unlikely you were continuing to shed virus.
Apparently you are not on suppressive antiherpetic therapy or you would have mentioned it. As you may know, avoidance of transmission by depending on symptomatic outbreaks -- i.e. avoiding sex until healed -- is a largely ineffective way to prevent transmission of HSV-2. Most transmission events occur during asymptomatic shedding of the virus. Given your concern about transmission, I strongly recommend you talk to your provider about starting suppressive therapy with valacyclovir or one of the other antiherpetic drugs. It will reduce both the frequency of your symptomatic outbreaks (although you don't say how common they are) and will markedly reduce asymptomatic viral shedding and, therefore, the potential for transmission to sex partner. In addition, discuss your HSV-2 with any and all current, future, or potential sex partners before having sex with them, and use condoms. However, you really should be having no fears or concerns about hand-genital transmission to partners.
I hope this helps. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
