STDs Expert Forum
Transmission Question
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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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Transmission Question

Dr.,

Thanks for all your advice and assistance with the Forum; you are providing a much needed service to us all.

My question is what is the transmission risk of acquiring HSV 1 or HSV 2 on the hand by performing hand-to-gential contact (stimulation)if there are no symptoms present (known symptoms)? Would surpressive therapy reduce any risk?

There has been discussions on the Forum concerning this topic detailing information on other STDs, such as HIV, but in searching the archives I could not find one that specifcally details HSV 1 or 2 transmission to fingers via hand-to-gential contact.

Just want to make sure I know the risks for future protection.

Many thanks and happy holidays.
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To my knowledge, transmission of HSV (of either type) by to the hands or fingers by genital contact has never been documented. Nobody can say it never happens or cannot happen, but undoubtedly it is extremely rare--even (in response to your follow-up clarification) without the infected person being on antiviral therapy.  That said, if someone performs a hand job one a partner with a symptomatic herpes outbreak, it would make sense to use barrier protection or at least wash hands afterward, just to be safest.

Good luck--  HHH, MD
8 Comments
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Avatar_n_tn
Sorry Doctor!   I forgot to say what is the risk of transmission if the person receiving stimulation (from fingers/hand)has HSV 1 or HSV 2, but does not have symptoms and the person is on antiviral therapy?
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Avatar_n_tn
I think you are at very little risk if at any. I "fingered" a girl and later found out that she had HSV-2, but had no symptoms. I did not contract it as results of a test 3 months later proved. But I think you would be at risk if she had an outbreak and you had a open wound on your hand. Other than that I think you have no real worries.
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Avatar_n_tn
Thanks Dr.,just to clarify:

1.  It is not impossible, but certainly rare for someone to transfer HSV-1 or HSV-1 from the genitals to the hand or fingers.

2. Given this, I would assume you would say this is a low risk act if the person who is infected and on the receiving end is symptom free.  What about asymptomatic shedding?  

3. If this is a low risk behavior is this because the skin on the hand/fingers is thicker and harder for the virus to pass through?

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239123_tn?1267651214
1) Correct.  2) Transmission risk is equally low from symptomatic and asymptomatic shedding.  3) That's a good bet, but I don't know whether the reasons are known for sure.  All I know is that I have never seen a case of genital-to-hand HSV transmission and it has never been reported in the medical literature, to my knowledge.  Given how much genital-hand contact goes on in the world, and the frequency of genital herpes, the risk of transmission has to be virtually zero.

HHH, MD
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University of Washington
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