Risk of Infection

[sam_d36]

Docs,
I had protected oral with woman of unknown status (likely had many previous partners from what I know) - condom was on the entire time. We kissed for a couple minutes and she performed oral with condom on for about 10min - she did not lick my balls as far as I can remember but maybe saliva dripped there.  This was 4 days ago.  Dont have any issues right now but feel slight discomfort when urinating in genitals but this may be due to anxiety.  She did not have any obvious cold sores that I could see.  My question is whether I am at risk for anything - at this point the only thing I think potentially is herpes.  I am negative on all counts for any STD last time I checked.  Any thoughts appreciated.
Sam

[H. Hunter Handsfield, M.D.]

This doesn't sound at all like herpes.  My guess you are examining yourself too closely and your anxieties are affecting your perceptions.  But get professionally examined if you are convinced the "small bumps" are new or abnormal.

[sam_d36]

Dr Handsfield,

last night I noticed some red areas around the tip of my penis with what i would call small bumps.  they werent entirely obvious nor did they hurt.  this morning it looks slightly better but can still make it out.  naturally i started to panic somewhat.  I am currently 13 days from exposure so I thought I was generally past the time that anything would show up, if at all. would you advise any testing based on this?
Thank you.

[sam_d36]

Thanks so much for your quick and clear response Dr Handsfield!

[H. Hunter Handsfield, M.D.]

There are two questions here.  The first is easy:  HSV-1 is tropic (medically predisposed) for oral tissues.  If someone both kisses and receives oral sex from a partner with oral HSV-1, s/he is more likely to acquire oral than genital herpes.

The second seems to reflects a misunderstanding.  Half or maybe even more of NEW genital herpes is caused by HSV-1.  However, genital HSV-1 causes recurrent outbreaks a lot less often than HSV-2 does.  Therefore, among people with repeated genital outbreaks, HSV-2 is by far the most common cause.

[sam_d36]

One follow up question which I forgot to include in my original submission - with this type of exposure (oral) is it easier to catch hsv1 on the lips or on the genitals.  The only reason I ask is that I hear HSV1 is almost almost caught orally but now there is more occurenes of HSV1 occuring in the genital area.
Thanks again for you time,

[sam_d36]

Thanks Dr Handsfield for your response, that is reassuruing to know.

[H. Hunter Handsfield, M.D.]

I'm sure this is obvious, but I meant to add that with a condom, oral sex is truly zero risk for any and all STDs.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

Even with no condom, oral sex is entirely risk free for some STDs and low risk for all; not completely risk free, but with a much lower chance of any STD than unprotected vaginal or anal sex.  For more details, see the threads linked below.

http://www.medhelp.org/posts/show/1922236
http://www.medhelp.org/posts/show/1700243

So my advice is to not worry.  You don't need STD or HIV testing of any kind on account of these particular events and if you have a regular partner, you can safely continue unprotected sex without worry of transmitting any STD.

I hope this has helped.  Best wishes--  HHH, MD