STDs Expert Forum
Herpes Transmission and Saliva
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Herpes Transmission and Saliva

Since childhood, I have had Type I recurrent oral herpes (approximately 4 outbreaks a year on the mouth or lower cheek region until college; now I have only about 1 outbreak a year).  I take Valtrex when I feel an outbreak coming on, which works very well.

When in the shower, I often spit on my penis for lubrication before masturbating.  Most of the time, some of the saliva goes into the urethra, which is always partially open when I have an erection.  I may have spit on my penis and masturbated while I had a cold sore, but honestly I cannot remember.

I am worried that I may have spread my Type I oral herpes to the genital area.  Recently, I have had hard red bumps on my penis shaft (where hair is present) and yellow pustules near where my underwear rubs (which have itched).  I had these conditions examined by my family doctor and two dermatologists.  All three doctors concurred on a diagnosis of folliculitis after viewing the bumps.  After prescribing an antibacterial pill, the symptoms went away and did not return.

My concern is that Herpes takes many forms, and while a visual examination is good evidence, it is never conclusive.  Also, from researching the issue, I understand that the Oral Herpes Type I virus IS often present in saliva.

I read the Frequently Asked Question No. 13, (Oral Herpes Transmission to Other Body Parts).  However, as a wrestler, I have seen several individuals with extremely bad cases of herpes gladitorium after already having a previous oral herpes infection.  It was not pretty!  

I hope to eventually have unprotected sex with my future wife, but I would never want to unknowingly put her at risk of genital herpes.

I am a virgin, both in terms of vaginal, anal, and oral sex.

1) Is it possible to spread oral herpes to the genital area via saliva alone (given the way I masturbate)?  

2)      Can genital herpes exist in a male's urethra without him ever knowing it?
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The medical term for self-infection from one part of the body to another is "auto-inoculation".  Auto-inoculation is often described as a problem with herpes, the most dangerous form being transmission of HSV from an oral or genital lesion to the eyes; herpes in the eye risks serious damange and even blindness.  Occasionally auto-inoculation occurs to other sites, such as the fingers (called herpetic whitlow).

However, you have no worries:  Auto-inoculation with HSV is only a problem during the initial infection.  People with chronic infection and recurrent outbreaks are immune to infecting another part of the body.  You cannot infect your genitals with your own HSV-1 strain, and you also are immune from catching genital HSV-1 from a partner who performs oral sex on you.  By the same token, any risk of transmitting HSV-1 to your future wife or other sex partners is going come from kissing and oral sex (if they are susceptible), not from genital intercourse.

As to question 2:  Asymptomatic genital herpes due to HSV-2 is common.  But asymptomatic or recurrent genital HSV-1 infection is rare.

Good luck--  HHH, MD
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H. Hunter Handsfield, M.D.Blank
University of Washington
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