Unhealthy Kiss?

[TampaBayKiss]

Doctor(s):

I am a gay male, who until a recent breakup was in the same relationship most of my adult life. While at a straight bar with friends and a woman started talking with me. As the night progressed, she began hugging me, holding my hand, touching my face, and kissing me on he cheeks. I didn’t really think much of it and just brushed it off. As, I was getting ready to leave with my friends; she unexpectedly gave me two big kisses right on my lips. Obviously, it was not an open mouth kiss, but the type where the mouth remains closed and the lips are in contact for about a second or so. This really freaked me out, as I am not used to such forwardness.

What makes me nervous is my hand she was holding was really dry and had a small cut on it from the dry skin. It wasn’t actively bleeding, but you could see red inside the “opening” where it was exposing the insides some. Also, my lips were very chapped. They were so chapped, in fact that they were cracked and flaking. There was no active bleeding, but they do have the small tears that make it look like it is. To add to all this, I have a canker sore in my mouth, toward the back, directly below my last tooth, on the gum-line, adjacent the inside of my cheek.

1.Given that the kiss was closed mouth, but lasted a second and I had the cracked/flaking chapped lips with inside canker sore; Am I at risk for any oral std’s like Herpes 1 or 2, HIV, Syphilis, Chlamydia, Gonorrhea, or even HPV? Could something pass through the possible open wound in my lips due to the cracking?

2. I have acne on my face. Could one of the above STD’s be transmitted from her kissing or touching an acne sore, active zit, or scar?  

3. Does the dry skin causing open cut on my hand pose a risk for any diseases since she was holding my hand?

4. I know I have no STD’s, not even Herpes 1, due to recent blood tests. Do I need to test for anything (including Herpes 1 and 2) due to this incident?

Thanks

[Edward W Hook, MD]

To answer your last question first, since we would recommend testing to start with, I would not recommend re-testing either.  Further, there is no information you have provided that suggests that such testing is warranted.

As for your results, they appear to indicate that you do not have antibodies to herpes viruses, thus there is no evidence of infection.

This will need to complete this thread. EWH

[TampaBayKiss]

Dr. Hook:

The "Negative 1.0" is not accurate. The result, however, is <0.9

[TampaBayKiss]

Dr. Hook:

May I please get your opinion one last time. I've read through where non-specific tests are not a good idea for Herpes. My lastest test was as follows:

HSV I/II IgG Rflx I-II Type Sp
HSV I/II IgG  <0.9 (Result) N (Flags) Index (Units) 0.0-0.08 (Ref interval)

Negative 1.0

Note: Negative indicates no antibodies detected to either HSV-1 and/or HSV-2. Equivocal may suggest early infection. If clinically appropriate, retest at a later date. Positive indicates antibodies detected to HSV-1 and/or HSV-2.

Please Note:
The date and time of collection was not indicated on the requisition as required by state and federal law. The date of receipt of the specimen was  used as the collection date if not supplied.

Do I need to retest being that the type specific was never ran or can I be confident I am Herpes free?

[Edward W Hook, MD]

thank you.  EWH

[TampaBayKiss]

Thank-you so much for answering my questions with thoughtfulness and patience. Your reputation certainly matches your beside manner. I only wish my own primary care physician was willing to entertain my questions in the professional manner in which you have. Regards.

[Edward W Hook, MD]

No, no risk, irrespective of any dental or gum disease that she and/or you might have.  EWH

[TampaBayKiss]

Thank-you for the reply. I just have an additional follow up. If she did have poor-oral hygiene, whether gingivitis, bleeding gums, etc...would there be any enhanced risk due to the fissures in my lips due to the chapping? My lips weren't actively bleeding, but there was a deep red (like blood) inside the cracks in my lips (from the chapped lips). I am thinking if her saliva or blood from bad gums entered these cracks. I also tend to have bleeding gums, myself. Is kissing really, no matter what spin is put on it, never a risk for HIV or other STD's?

[Edward W Hook, MD]

Welcome to the Forum.  I'll be happy to address your questions.  Before we get to specifics however, let me remind you that she is unlikely to have an STD- most people (even the forward ones) do not and secondly, there are no STDs which are transmitted by kissing - unless I suppose, you count cold sores (HSV-1) which ai guess could technically be considered an STD.  Unless she had an active cold sore on her lips however, once again you do not know if she has HSV-1 and even if she did, the risk of your becoming infected form a kiss would be estimated to be less than 1 in 10,000 - not something to worry about.

1.Given that the kiss was closed mouth, but lasted a second and I had the cracked/flaking chapped lips with inside canker sore; Am I at risk for any oral std’s like Herpes 1 or 2, HIV, Syphilis, Chlamydia, Gonorrhea, or even HPV? Could something pass through the possible open wound in my lips due to the cracking?
Please see above- even with your chapped, cracked lips I would not be worried.

2. I have acne on my face. Could one of the above STD’s be transmitted from her kissing or touching an acne sore, active zit, or scar?  
No, this too is not a concern.

3. Does the dry skin causing open cut on my hand pose a risk for any diseases since she was holding my hand?
Breaks in the skin, whether on your lips, hands or elsewhere are sites where you are somewhat more vulnerable to skin infections from the bacteria already on your own skin but are not meaningful risk factors for acquisition of infection from others.

4. I know I have no STD’s, not even Herpes 1, due to recent blood tests. Do I need to test for anything (including Herpes 1 and 2) due to this incident?
No, there is no reason for concern.

I hope my comments are helpful.  EWH