Overly anxious or legitimately concerned?

[AnxiousFretter]

I'm a heterosexual male, dating for the first time in many years (was in long-term monogamous relationship prior).  I always wear a condom during intercourse, and have received oral sex without a condom several times.  I want to be safe, and I am not overly worried about most STDs since most are treatable and my chances of getting HIV are low since I always use protection.  

I am, however, incredibly worried about herpes.  Based on my readings, it seems like it is very easy to get and almost impossible to know if a partner is infected unless there are visible sores.  

After being with a couple of women, I was tested for all STDs after about 6 weeks.  Test results came back last week - all were negative, and the doctor told me I have never been in contact with either HSV1 or HSV2.  That was a huge relief, as I was so anxious about it I could barely sleep (I convinced myself I had herpes).

Last night I was with a new woman who is openly promiscuous.  She told me she always uses a condom, and had no STDs nor any reason to believe she had herpes.  She performed unprotected oral sex on me while I fingered her.  Then we had vaginal sex with a condom.  Now my anxiety about herpes has returned, and I'm probably going to be inspecting my penis every day for the next month.  If I understand correctly, sores would probably show up in the next 20 days?

Am I worrying too much?  Based on what I've read, this is pretty low-risk behaviour.  But after reading some threads, I'm convinced that herpes is highly contagious, incredibly common, and very easy to get (even with a condom).  Also, do I need to wait before being with another partner (because I don't want to spread anything if I've been infected).

I would appreciate a doctor's analysis of my situation.  I am considering abstaining from sex until I can work out my anxiety issues, but it's likely that I will get caught up in a moment at some point and repeat this whole process again.

Thank you very much for this site

[AnxiousFretter]

Thanks for the replies.

EWH, can you please elaborate on what you said:  "That is not to say that I applaud your practice of safe sex, nor your precautions."

Should I be concerned about the oral sex transmitting HSV to me?  Would you recommend that I get tested again (considering I was tested just last week)?

I have returned to my routine of close inpection of my genitals, and have noticed 2 small red spots on the underside of my shaft.  They aren't noticeable without close inspection, and I have no fever.  Is 36 hours too soon for symptoms to appear?  Also, how obvious are the sores?  Do they stand out with a casual inspection, or can they be subtle and easy to miss?  In other words, can you tell me what to watch for, and if/when I should go to the doctor?

Thanks again

[Edward W Hook, MD]

The answer is - overly anxious.   That is not to say that I applaud your practice of safe sex, nor your precautions.  At the same time, I think you are overly worried.  Let's review a few facts about herpes:

1.  Indeed it is common, about 20% of US adults have HSV-2, the virus that causes most genital herpes and 60% have HSV, the virus that causes both cold sores and some genital herpes.  Furthermore, about 80% of persons who have these infections are unaware that they have infection.  Of these, most are unaware not because they are asymptomatic but because they have attribute their herpes symptoms to something else.
2.  Another fact is that most exposures to partners with herpes do not lead to infection.
3.  Yet another fact is that condoms are good protection for prevention of herpes, reducing the risk of infection a great deal.  
4.  Finally, to be fully forthright it is also true that herpes can be spread by persons who do not have lesions present.  In fact that is when most herpes is spread. That's the reason that condoms are always a good idea.
5.  Lastly, should you get herpes (I hope you will not) it is not the end of the world.  The infection is manageable, should you get it.

Taken together, my advice is to practice safe sex as you are doing.  As your partners if they are infected but even if they are, be aware that safe sex will protect you.  finally and most importantly, do not let fear of herpes paralyze you - such fear is an overreaction.

I am sure your will have other questions. Rather than asking them here however, please seek advice through other sources.  Specifically, much information about herpes can be obtained by accessing excellent informational web sites such as the one run by the American Social Health Association (disclosure, Dr. Handsfield and I are both on the Board of Directors of ASHA).  Take a look.  Hope this helps. EWH

[Totaler]

Herpes is by far the scariest STD... No doubt. For me it is scarier than even HIV because I know my chances of getting HIV is very very low.

However, i am sure you will hear from the good doctors soon that one time condom protected sex is very low risk for herpes transmission. And that if you don't develope ovious sores in the next few weeks you are home free. By obvious i mean you probably don't have to check your penis obssessively everyday to know something is up. So lay off checking your penis everyday as you will convince yourself you have it. God knows I have been there before. Even a negative HSV2 blood test didn't calm me down...so don't go down my route.

Good Luck!