Odds of Contracting HSV 1 Through Oral Sex

[Curiousss101]

Dear Dr,

About a week ago, I received oral sex from my boyfriend who had a cold sore. I have heard that when the cold sore is scabbed or no longer oozing, then the cold sore is no longer contagious. From what I know, I have no history of having cold sores in the past. I am a 20 year old female. What are the odds of me contracting HSV 1 genitally when my boyfriend's cold sore was in healing process? (Also, I kissed him many times while he had his cold sore and I did not contract one on my lips.) Thank you.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

There are no data whatsoever on the risk of transmission of HSV-1 by oral sex.  It is true that the risk of transmission is much lower when oral HSV-1 lesion is healing than if the lesion is new, e.g. 1-2 days old.  Of course, there is a 50:50 chance you also are infected with HSV-1, which is present in up to half of all adults in the US (higher proportions in some countries).  If you are among those with prior infection, you are immune to a new one, anywhere on your body.  That you haven't caught your boyfriend's oral herpes despite kissing him when he had cold sores suggests you might in fact have been infected in childhood.

At this point, all you can do is wait and be on the lookout for genital sores suggetive of herpes, and see a health care provider if something shows up in the next couple of weeks.  Most likely nothing will.  You also could have a blood test to see if you already have had HSV-1 and therefore immune to a new infection.

I hope this information helps.  Best wishes--  HHH, MD

[Curiousss101]

Thank you so much Doctor. Just a few more things for some reassurance:

1.  Since I kissed my boyfriend while he had a cold sore and I didn't get one, that means that I may already have the virus? I asked my mother if I had cold sores as a child and she said that she doesn't recall. If I have never been exposed to the virus, would have I developed a cold sore on my lip?

2.  How long should I wait until I can no longer be worried?

3.  If something doesn't show up "down there" during a specific time period, do you suggest that I see a physician and get a blood test?

[Curiousss101]

4.  In November 2008 (8 months ago), a health care provider did a swab test for a yeast infection.  Since I was worried that I had contracted a STD at the time, she said that she will also get the swab test checked for herpes. The test was positive for a yeast infection and negative for herpes. The only thing I'm worried about is which type of HSV came out negative because I wasn't told. Could they have looked for both types of HSV or do you think they looked for just HSV-2, since that strain is one that causes genital herpes?

I'm a little worried now that my test in November came out negative for herpes, cause I may not have immunity to HSV-1.

[H. Hunter Handsfield, M.D.]

1) As I said, half of all adults have HSV-1, shown by positive blood test.  Most such infections occur in childhood and most people have no recollection and no family history of oral herpes, cold sores, etc.  So the answer is yes:  it definitely is possible you already have HSV-1 and therefore are immune to a new infection.

2) Most new HSV infections cause symptoms within 3-5 days, sometimes up to 10 days, rarely as long as 3 weeks.

3) You could have a blood test if you like.  In view of the next question, it's a good idea.

4) Herpes and yeast can cause similar symptoms, but since the yeast test was positive, you can be pretty sure it wasn't herpes.  But maybe it was.  If your blood test is positive for HSV-1, it won't tell when you caught it -- either in childnood or 8 months ago -- but it still will mean you are highly resistant to catching HSV-1 again.  If a blood test is positive for HSV-2, it probably would mean that was the cause of the problem in November.

[Curiousss101]

Thank you so much for your reassurance Doctor. I'm feeling more relieved. Few more things:

1.  Since it's been a week since I have received oral, and 2 weeks since I kissed my boyfriend when he had the cold sore and I have not developed any sores on my genitals or mouth, am I in the clear?

2.  Is it possible that I may have contracted the virus as a child, but did not show any symptoms?  Therefore, making my mother and myself believe that I have not been in contact with the virus?

[H. Hunter Handsfield, M.D.]

1) I already told you when to expect herpes symptoms.  You are more and more in the clear as more time passes.  With no symptoms at 1-2 weeks, probably you were not infected.

2) This also is a question I already answered.  Read my reply above.

[Curiousss101]

Phew, what a relief.  Thank you so much for your help Dr. Handsfield.  Looks like I managed to dodge the bullet in this situation.  I have definitely learned my lesson and will now look at this as a learning experience.  Thanks again!  (I have no furthur questions at the moment, but if I do, I will most likely ask you again).

[Curiousss101]

Dear Doctor(s),

I am now worried that I may have contracted HSV 2 genitally. Here comes the story. So I have been seeing this guy for a month now and when we first started having sex, it was unprotected. We started having sex almost exactly a month ago (July 15th was our first sexual encounter with each other). After the first time we had unprotected sex, I showed no signs or symptoms of any STDs. However, from July 26 - Aug 3, my guy went on a trip to Vegas. When he got back on Aug 3, we had unprotected sex again. About 4 days later, I started to notice something different "down there." It was itchy, burning and I noticed "paper-cut" like cuts at the bottom of the opening of the vagina. We were on our way to a 3 day music festival which took 8 hours to get to. Near the end of the drive, I finally had the guts to ask him his sexual history and told him about my cuts. Then, he told me that he had unproteced sex with a girl in Vegas. I immediately freaked out. Since we were 8 hours away from home and no where near a clinic or hospital, I had to wait 3 long days to get this checked out,

When we got home, I noticed that the sores had gotten worse. The cuts were more red and noticable and I noticed 2 new sores. One of my left inner lip and one on my right outter lip. They were tender when touched and the cuts on the inside of my vagina would sting SO MUCH when urine would touch it. So here's what I did:

- On the day after we got home, I got checked at a local walk in clinic. I told the doctor about my "cuts". She said that herpes is a possibly, but it also could be a yeast infection and is not 100% sure if it is herpes. She swabbed for herpes and other STDs. She also prescribed me Valtrex to get over the pain, even though I wasn't properly diagnosed with herpes.

- I started to get more and more paranoid, so I continued to see different doctors at different clinics. Two doctors were usless. They just took one glance at it and said it was herpes. They gave me no prescription, took no swabs, nothing. I found those doctors to be quite unprofessional and unhelpful.

- Yesterday (Aug 13) I went to my family doctor. She didn't say anything when she saw the sores. She's probably the sweetest lady I have ever met. All she said was, "Oh, I see that you have some sores. We'll just do some cultures for them and your results should come in between 3-5 days." She also told me that the first herpes outbreak is extremely painful and my genitals would be covered in sores, which it is not. She also gave me info on genital herpes.

- Today, I went back to the walk in clinic to see if my results were in. I told the doctor that I came in to see if my results came back. He said "Negative for yeast, negative for chlamydia, negative for gonorrhea, you're in the clear." I told him that the main reason why I was there for testing the other day was to be tested for herpes. He said, "Oh yeah, it says here that Dr. Cormack prescribed you Valtrex and says that you have herpes." I was so confused.

Q1: How come the doctor told me that it MIGHT be herpes and that she wasn't 100% sure, when she wrote down in my file that I have it?
Q2: If the Valtrex is working for my cuts/sores does that mean I have herpes?
Q3: Could the two doctors who just glanced at my vagina be mistaken? How come they didn't do swabs or prescribed me anything and just jumped to conclusions?

- Since I was confused with what was going on, the doctor then told me that I can get a blood test done to be 100% sure if I have HSV 2 or not. Since I live in British Columbia, I cannot get the special type testing and I have to pay $170 to get this test done. I will be getting the test done tomorrow and my results should be in 2 days after according to the doctor I recently saw. I am also waiting on the swab results from both my family doctor and the walk in clinic.

Doctors, I am so confused. Am I being to paranoid? Could those 2 doctors that said right away it was was herpes be mistaken? Do you suggest that I pay for the blood test or just wait for my swab tests to come back? I'm going crazy and I need your help!

[H. Hunter Handsfield, M.D.]

This is really a new set of questions and should be in a new thread, not a continuation of this one.  Also, your question is far too long.  When you start a new thread, please keep to the limit on number of characters.  Your question will have to be cut to about half the present length in order to be answered.  (Don't be tempted to let your question spill over into a comment; it all has to fit in the original window.)

[Curiousss101]

Also, my partner has not noticed any sores. Should he be tested and how? It has been over 2 weeks since his sexual encounter in Vegas. Also, I have noticed a bump under my skin on the left side of my pubic bone. Could this be a swollen lymphnode/sign of herpes? HELP ME DOCTORS!