Aa
Moral Question about HSV-2
Hello Doctors.
I am a male who has ended a year long relationship with an HSV-2 genital female. We engaged in two isolated cases of condom protected sex, and one year worth of regular oral sex. I was blood tested multiple times a year after our last sexual encounter and was found to be HSV-1 (oral) positive and HSV-2 negative. I have inspected myself regularly for two years and anytime I've found anything suspicious I went to my GP and was reassured it was nothing everytime. General folliciticus or my anxiety. Either way, I have alot of confidence between never having blister like lesions and multiple blood tests that I am not infected. But I understand the test being only so sensitive, there still leaves SOME chance I may be assymptomatic and the test never caught my infection... So, my question is, knowing I was exposed to the virus (Likely being orally exposed) don't I have a moral obligation to tell partners (even before kissing) that I've had an exposure? Or is the compound lack of lesions, negative blood test, and unlikelyhood that I would transmit HSV-2 via french kissing or the like so small, that I should just move on? I know these are difficult questions, but the fear of kissing my children and particularly deep kissing my unbeknowst partners is difficult to move past. I appreciate your input. Again, I know the transmission rate for a one year relationship is about 4% for a man, using condoms decreases this. Also, since we primarily only had oral sex my chances are probably lower than 4% as well. But does an 80-90% accurrate blood test plus a less than 4% transmission rate equal dismissal of concern? I try to comfort myself by thinking if 1 in 5 adults have HSV-2, there must be a great deal of unknown oral exposure, and since people kiss everyday, HSV2 really doesn't spread so easily....?
I am a male who has ended a year long relationship with an HSV-2 genital female. We engaged in two isolated cases of condom protected sex, and one year worth of regular oral sex. I was blood tested multiple times a year after our last sexual encounter and was found to be HSV-1 (oral) positive and HSV-2 negative. I have inspected myself regularly for two years and anytime I've found anything suspicious I went to my GP and was reassured it was nothing everytime. General folliciticus or my anxiety. Either way, I have alot of confidence between never having blister like lesions and multiple blood tests that I am not infected. But I understand the test being only so sensitive, there still leaves SOME chance I may be assymptomatic and the test never caught my infection... So, my question is, knowing I was exposed to the virus (Likely being orally exposed) don't I have a moral obligation to tell partners (even before kissing) that I've had an exposure? Or is the compound lack of lesions, negative blood test, and unlikelyhood that I would transmit HSV-2 via french kissing or the like so small, that I should just move on? I know these are difficult questions, but the fear of kissing my children and particularly deep kissing my unbeknowst partners is difficult to move past. I appreciate your input. Again, I know the transmission rate for a one year relationship is about 4% for a man, using condoms decreases this. Also, since we primarily only had oral sex my chances are probably lower than 4% as well. But does an 80-90% accurrate blood test plus a less than 4% transmission rate equal dismissal of concern? I try to comfort myself by thinking if 1 in 5 adults have HSV-2, there must be a great deal of unknown oral exposure, and since people kiss everyday, HSV2 really doesn't spread so easily....?
Dr. HHH, I'm sure you shake your fist regularly at the computer at our excessive paranoia. =)
But hey... I would think it would be better to be overly concerned than carelessly infecting others.
@Shrimp: Dr. HHH has been big on exercising the tough love. But TRUST ME...(& I am the most paranoid person on this forum - or close to it,) your risk was virtually ZERO. You should harbor NO paranoia of oral exposures with a HSV II + person. I wish that would have been my risk (I had unprotected sex w/ an ex bf I didn't know was +). I experienced the worst stress of my entire life, to put it mildly.
It's time for you to move on & enjoy life! =D (I'm trying to follow my own darn advice!)
But hey... I would think it would be better to be overly concerned than carelessly infecting others.
@Shrimp: Dr. HHH has been big on exercising the tough love. But TRUST ME...(& I am the most paranoid person on this forum - or close to it,) your risk was virtually ZERO. You should harbor NO paranoia of oral exposures with a HSV II + person. I wish that would have been my risk (I had unprotected sex w/ an ex bf I didn't know was +). I experienced the worst stress of my entire life, to put it mildly.
It's time for you to move on & enjoy life! =D (I'm trying to follow my own darn advice!)
MEDICAL PROFESSIONAL
Your concerns are overblown. You don't have HSV-2, and if you did you would not infect your children unless you sexually abuse them. Beyond that I'm not going to speculate about outcomes that have less chance than your being hit by lightning. This thread is over.
Also, I hope I made it clear that the felatio and cunninglus was very regular, and happened many many days over the course of our year relationship... Sorry Dr. H, hope I'm not overdoing it...
I'm sorry Dr Handsfield, I had trouble with my email and had to create a new name... Anyway, many thanks for the responses. From a quantitative standpoint, when you say minuscule, I assume you mean likely less than 1%? I have read other posts where you have quantified risk percentage, and I'm not asking you to do that for me, but as a reader of the forum, this particular form of reassurance I feel is very effective.
Also, should I ever find myself in this situation again (hopefully not) Would you say that kissing your children on the head would be a lighting strike chance of passing hsv-2? I imagine that there are many, many individuals with oral HSV-2 that regularly care for and kiss their children, and see no trouble. This is my last post,
Also, should I ever find myself in this situation again (hopefully not) Would you say that kissing your children on the head would be a lighting strike chance of passing hsv-2? I imagine that there are many, many individuals with oral HSV-2 that regularly care for and kiss their children, and see no trouble. This is my last post,
MEDICAL PROFESSIONAL
As I said, the mouth is not highly susceptible to HSV-2; infection doesn't take well even if exposued. For the same reason, it is very unlikely your partner had oral HSV-2. On balance, I would judge the chance you caught either oral or genital infectionas about the same and miniscule in both cases. None of this changes my reply above.
The relationship is over and your fears did not come true: you didn't catch herpes. It's time to just put it behind you and move on with no concerns about it.
The relationship is over and your fears did not come true: you didn't catch herpes. It's time to just put it behind you and move on with no concerns about it.
Thank you Dr. But just to be clear, my ex and I both engaged in giving and receiving unprotected oral sex. So I suppose my risk for acquiring HSV 2 oral over the course of the year was actually greater than getting it genitally. Does this info change your opinion?
MEDICAL PROFESSIONAL
Welcome to the STD forum.
Your risk of having caught HSV-2 is even lower -- probably much lower -- than the estimates you give, for 2 main reasons. First, HSV-2 is transmitted dominantly by genital-genital sex. It is the rare person with HSV-2 who has an oral infection, and when oral HSV-2 is present, asymptomatic viral shedding and symptomatic outbreaks are uncommon. Therefore mouth to genital HSV-2 transmission is even rarer than genital to mouth.
Second, sometimes too much is made of the possibility of getting HSV-2 without symptoms. In fact, when couples are aware of HSV-2 in one partner and the uninfected person is on the lookout for symptoms, at least 60% are aware when they become infected. And in your case, I would guess that 60% is an underestimate. Most asymptomatic herpes isn't really asymptomatic, just unnoticed. Given your intensive (compulsive?) self examination and a few visits to health providers for things that worried you, it is unlikely you could have been infected without knowing it.
I'm not sure where you came up with only 80-90% accuracy for the HSV-2 blood test. A negative result 3+ months after the last exposure is closer to 95% reliable -- certainly no lower than 90%.
Considering these all these factors, I would put the chance you caught HSV-2, especially given the rather few unprotected sexual encounters, at very close to zero. You can go forward with 100% certainty you don't have HSV-2.
No person has an ethical obligation to inform future partners of past STD exposures, only documented infections. I don't know any herpes expert or bioethicist who would say you have an obligation to mention herpes to a future sex partner. Certainly I wouldn't do it if I were in your situation.
I hope this helps. Best wishes-- HHH, MD
Your risk of having caught HSV-2 is even lower -- probably much lower -- than the estimates you give, for 2 main reasons. First, HSV-2 is transmitted dominantly by genital-genital sex. It is the rare person with HSV-2 who has an oral infection, and when oral HSV-2 is present, asymptomatic viral shedding and symptomatic outbreaks are uncommon. Therefore mouth to genital HSV-2 transmission is even rarer than genital to mouth.
Second, sometimes too much is made of the possibility of getting HSV-2 without symptoms. In fact, when couples are aware of HSV-2 in one partner and the uninfected person is on the lookout for symptoms, at least 60% are aware when they become infected. And in your case, I would guess that 60% is an underestimate. Most asymptomatic herpes isn't really asymptomatic, just unnoticed. Given your intensive (compulsive?) self examination and a few visits to health providers for things that worried you, it is unlikely you could have been infected without knowing it.
I'm not sure where you came up with only 80-90% accuracy for the HSV-2 blood test. A negative result 3+ months after the last exposure is closer to 95% reliable -- certainly no lower than 90%.
Considering these all these factors, I would put the chance you caught HSV-2, especially given the rather few unprotected sexual encounters, at very close to zero. You can go forward with 100% certainty you don't have HSV-2.
No person has an ethical obligation to inform future partners of past STD exposures, only documented infections. I don't know any herpes expert or bioethicist who would say you have an obligation to mention herpes to a future sex partner. Certainly I wouldn't do it if I were in your situation.
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.
