So sad, contracted herpes from oral sex, HIV?

[regretsthis1]

Dear doctor,

I know your FAQ says otherwise, but it seems as if I have contracted herpes from receiving oral sex.

10 days ago, I allowed a man to perform oral sex on me. He inserted a lubed finger in my anus and finished me off. I also licked his penis for about 10 seconds but he was not aroused and I doubt he had any precum on him.

Anyways, I have been very paranoid and was reading your forum which I believe i was under no risk at all. I have had HSV-1 since a child (cold sores on my lips).

Last Friday (1 week after the encounter), I saw several tiny red sores on my penis. I immediately went to the hospital, and my doctor asked me if I noticed any discharge (no), and looked at the sores and said "yeah, i'm sorry but that looks like herpes". She took a sample to get cultured and then I asked her the risk of contracting HIV and she said it was quite low but asked if I would feel better getting tested. I knew that results wouldn't really show up positive so soon but I took the test anyways.

On Saturday, before I started acyclovir, the sores had noticeably decreased in size, and by today they aren't very visible at all (looks like red tender skin where the sores were). I also feel a couple sores around my anus, but those seem to be smaller too.

My doctor informed me that I could still get infected with HSV-1 genitally, which sounded probable because it was from oral sex. The man I received the blowjob from could have had HSV2 on his mouth but chances of that were less likely. This is consistent with what I've read on herpes sites like yoshi2me.com and the SF STD clinic, but your FAQ says this is not possible...

Anyways, sorry for the long post but for the past couple days I was having diarrhea and I have been waking up kind of sweaty. These are possible symptoms of ARS so I am very worried. Maybe inserting the finger in my anus could have opened up a cut, and I didn't see any sores on this man but maybe he had some and transmitted HIV through that. He certainly transmitted something (most likely herpes), so HIV seems like a possibility.

I asked the man if he had any diseases before our random encounter and he said no. He said he had a test from a week prior showing that he was HIV negative, and asked if I wanted to see it (i didn't insist on seeing it, so I don't know if he was lying but I assume not). I asked about herpes and he said no as well, but it looks like I've been infected with something from him..

What are my chances of contracting HIV from him, knowing that I probably contracted herpes from him? I have only had 1 sex partner other than this man, and I know she does not have any diseases. I cheated on my gf of 4 years to have this one incident and she is not talking to me. We had sex a couple days after my incident with the man so she has been freaked out she got something from me, what are her chances of that happening?

Anyways, to sum up... what are my chances of HIV, what could I have, and what are the chances she has an STD?

[H. Hunter Handsfield, M.D.]

Some STD Forum regulars have already given you some useful advice (below).  If you indeed had cold sores since childhood, you could not have acquired HSV-1 in the sexual encounter you described.  But it's not possible for me to know the reliability of either your oral herpes or the doctor's belief that your penile lesions were due to herpes.

The odds of catching HIV were extremely low from the exposure you describe, even if your partner was infected.  And not very many peole lie about HIV if asked directly, so you probably can be very confident he wasn't infected.  As other forum users have pointed out, acute retroviral syndrom (syndrome) (ARS) almost always has fever, which you do not describe.  In any case, symptoms are a totally unreliable indicator of HIV, regardless of what you have read on the internet.  Having an HIV test is the only way to know.  But your odds of having HIV probably are in the same ballpark as your winning the jackpot in the next lottery.

And it follows that you almost certainly didn't acquire any STD that you could transmit to your girlfriend.

Best wishes--  HHH, MD

[Christie2004]

Dr. H doesn't usually say something is impossible (unless it is!).  He generally says "next to zero odds" or very low odds...not usually impossible.  There have been a couple of odd posts here and there about contracting STD's through clothes and far out things like that..and to those he has said is impossible.  

You need the herpeSelect test to be sure of what's going on.

[regretsthis1]

Thank you for your reply. If it were impossible to get HSV-1, what about HSV-2 from the actions I described? You stated on your FAQ that it is impossible to get HSV-2 from oral sex.

Also, I have heard that there is a test that can be taken within 10 days after infection to detect for HIV (I believe it is called PCR testing?) Do you recommend this?

And last, my lesions are pretty much all healed by now, and it was not a serious outbreak. Is this a sign that I probably do not have HIV? What other STD's could produce sores like I described?

I get my culture results back on Wednesday, and will probably post here to ask a couple more questions. Thanks in advance for your attention~

[regretsthis1]

I forgot to mention that he licked my anus as well before sticking a finger up it.

[veryconcerned123]

You stated that you have had HSV1 since childhood.  If that is the case then you can't possibly have contracted HSV1 on your genitals from the described encounter.

While some people may have HSV2 of the mouth it is not common. Even more uncommon is that if he had HSV2 on his mouth and with the absence of a cold sore that it would be transmitted to you during one episode of oral sex.

An ER doc saying something "LOOKS" like herpes and it being herpes are totally different things.  If you do have genital herpes you had it before this incident.

Don't spend so much time on the net. Yoshi is a herpes alarmist. She has herpes and for many months she would post on the dermatology forum more or less telling everyone that they had symptoms of herpes.

I am not trying to be too hard on her, but it kind of seemed like
it made her feel better to know others may have become infected.

Put HIV out of your mind.

Good luck my friend!

[regretsthis1]

I don't want to disagree but I truly have only had 1 sexual partner before this and she does not have anything, and we have been monogamous and I am sure of this. (which makes this event all the more devastating). She is getting tested soon as well so we will figure this out.

It also seems odd that I received my first ever outbreak at the exact time after receiving the blowjob (2-10 days after being infected, first outbreak occured). Also, my doctor said she "thought" it was herpes and obviously did not say 100% if it was, but she has seen it and you haven't so I would be more inclined to trust her. She also took a urine sample and blood test for syphillis, and results will be back on Wednesday (I hate waiting!)

The National Herpes Hotline and the San Francisco City STD clinic both state that it is possible to get HSV1 genitally even if you have it orally, just that it's not as likely. My doctor said so too.

Not to disagree with the prestigious Doctor on board here, but this is the only site I have read that it is not possible to get HSV1 genitally after having it orally.

I'm sorry if any of my words are offensive to you, veryconcerned123 (thank you for your response btw, i need people to talk to after this event) or the Doctor here. I am very emotional after this event, and am in the middle of other family problems right now, so I'm very stressed out.

[regretsthis1]

Herpes aside, I am still more worried that I got HIV. I seem to be coming down with a sore throat or something right now, so I pray that it is not.

[veryconcerned123]

I am not offended in the least. I realize that you are upset. The only thing that you can do at this point is take a Herpes Select test when enough time has passed and see what the results tell you.

If the Dr. did a swab and it comes back positive I guess that would also confirm the diagnosis.  

If you end up having HSV I on the genitals you will probably never get outbreaks. It would be a lot better than having type II.

Anyway right now you are stressed, and you don't know for sure that you have contracted anything. My advice (not that you are asking) would be for you to try to calm down and hope for the best.

You might not have anything. Two and a half years ago I had my own nightmare scare. I know how out of control this thing can become if you let it.

Try to calm down before you make yourself nuts. Worrying won't make things any better for you.

Remember we are all hoping that it all works out. Listen to Dr. Hansfield. He knows his stuff. He is the expert when it comes to STD's, and he will be straight with you.

Good luck my friend!

[H. Hunter Handsfield, M.D.]

I don't know whether or not herpes caused your penile skin lesions.  Herpes is the most common cause, and a doctor thought that was what you had, so it seems a good bet.  But that conflicts with your history of having oral herpes in the past, which would make it unlikely to acquire a new HSV-1 infection.  I have know way of knowing which was more accurate, the doctor's diagnosis your your past history.  (Many people don't know what cold sores are, and many who say they had them did not.  The most common mistake is to believe that canker sores--open sores inside the mouth--are cold sores.  They are not, and canker sores are not due to herpes.)

I don't know where you read that genital HSV-2 can be acquired by oral sex, but that is not true.  Recurrent oral herpes due to HSV-2 is vanishingly rare, and in 30 years in this business I have never seen a case of genital HSV-2 that could be attributed to oral exposure.  It it occurs, it is extremely rare.

The speed of healing says nothing about whether or not you caught HIV.  As I said above, getting HIV by oral sex is rare, if it happens at all.  The symptoms you described did not sound to me like ARS, regardless of what you read.  (ARS virtually always causes fever, for example, and diarrhea is not a common symptom.)  You probably do not have HIV.

I don't continue prolonged dialogs on the forum.  The provider doing your test is the one to address questions to, if you have further concerns after the results are availalble.

HHH, MD

[regretsthis1]

Well, I got my results back. Negative for everything (herpes culture, HIV, chlamydia, gonorrhea, and syphillis). I know it's too early to say for HIV, but I'm already feeling much better and much less anxiety *crosses fingers*.

I don't know what the sores were, and my doctor informed me that the culture test isn't a very reliable test for negative, but I will get a Herpes Select test this week and in 4 weeks to see what the results are. I have had cold sores/blisters on the exterior of my lips and nose, about every few years since I was small (indication of HSV-1). I certainly hope this is not herpes but all signs point to yes. Only the test results will tell me, though.

I will also get an HIV test in 4 weeks to double check. Before I was preparing myself for bad news regarding HIV but now I am trying to live my life and not put myself in that situation to worry again.

Thank you SO much for all your information you have provided on this board, Dr. Hansfield. You are doing a wonderful great service to people everywhere, educating us about the risks of STD transmission and I wish the best of luck to the CDC and your work to hopefully cure or control STD's and STD transmission~