STDs Expert Forum
What are the odds that I have Herpes?
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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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What are the odds that I have Herpes?

Three days ago I visited a legal brothel in Nevada and had oral and vaginal sex with a prostitute. It lasted about 5-10 minutes. I wore a condom, but there may have been some skin to skin contact at the base of my penis. Afterward I immediately cleaned this area with a disinfectant (used to clean the shower) and washed the area in the shower. The next day I saw a doctor and got a prescription for Valtrex. I took 1000mg about every 4 hours for 24 hours hoping it might work like a morning after pill. I have now cut back to 1000mg every 12 hours. She said that she was clean and that she has to be tested every 30 days to work there, but that is no guarantee. I am really worried about the possibility of contracting herpes and I know I should get tested, but will the Valtrex affect the results? I really don't want to tell my wife about the incident if I don't have HSV. Will the Valtrex reduce the possibility of transmitting it to her while I await the test results? I'm feeling tingling near the base of my penis, on my balls, and near my anus. Could that be the prodrome? I really need your help. Thank you.
239123_tn?1267651214
Welcome to the forum.

You have seriously overreacted to a minimal risk situation.  Your actions, especially in your inappropriate treatment with valacyclovir -- which did absolutely nothing to prevent herpes but, as you suggest, could interfere with finding out whether you were infected.

I would estimate the chance you caught herpes form the exposure described as well under 1 chance in 1,000, maybe as low as 1 in 100,000.  It was wrong of your doctor to agree to your reqeust for valacyclovir treatment.  Research in animal models shows that an anti-HSV drug given before exposure prevents infection.  But if treatment of the exposed animal is delayed until only an hour after exposure, it has no effect in preventing infection.  Taking valacyclovir the next day therefore did nothing to reduce the chance you were infected.  And it could indeed result in delayed positive test results in the event you actually caught HSV.

Your symptoms are not remotely suggestive of herpes.  They are typical, however, for genitally focused anxiety increasing your awareness of trivial symptoms or of normal body sensations.  In addition, there is no such thing as prodrome in an initial HSV infection; it's only an issue for recurrent herpes outbreaks.

My strong advice is that you stop valacyclovir; and if you don't develop typical symptoms of herpes, you don't even need testing.  I also recommend you continue unprotected sex with your regular partner.  That's what I would do in your situation.

Regards--  HHH, MD
3 Comments
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Thank you for your advice. I'm still feeling very guilty, but a lot less worried about Herpes. I have stopped taking the Valcyclovir.

I read in another post that washing the area with alchohol or a disinfectant might actually increase the risk of transmission. Do you agree with that?

Thanks again for your very helpful advice.
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239123_tn?1267651214
Thanks for the thanks.  I'm glad to have helped.

The business about cleaning, alcohol, etc increasing risk is speculative, i.e. no data exist.  A single research report suggested a higher rate of HIV in men if they washed with soap and water after unprotected exposure to infected sex workers.  But it was a small, weakly designed study and to my knowledge it was never confirmed.  The risk of herpes or any other STD has never been studied.  On the other hand, in distant past decades, it was widely believed that washing after sex helped prevent syphilis.

My take on it is that there is probably neither much help nor harm from washing with soap and water after sex, i.e. no change in risk of HIV or other STDs.  If there is any effect either way, I'm confident it's small.  From a simple hygiene standpoint, some people like showering or bathing after sex, and I would not discourage it.  However, I would avoid vigorous scrubbing, and would also avoid alcohol in the genital area -- too irritating, especially on moist tissues (under the foreskin, female labia, etc).
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