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Oral Exposure with HSV2
I aquired hsv2 about 6 months ago which has been confirmed by a PCR test. My infection is mild with only 3 minor outbreaks since that disappear after 4-5 days. I also have Hep-B immunity from an old vaccination (blood test).
7 days ago I received unprotected oral sex from a south east asian escort in London. We used a condom for intercourse.
I woke up with a herpes blister the next day, I am unsure if the blister was already there or "growing" during the oral sex the night before, but I didn't notice anything. Considering that herpes in general and a possible blister during oral sex increase the chances of transmission for std's I would like to ask the following:
1) Is there any HIV risk in general and due to HSV?
2) Any other std's that I could have gotten?
3) Is there a need to test although today after 7 days I have no symptoms and the herpes blister has healed as usual after about 5 days?
4) how soon after exposure to ghonorrea, chlamydia and syphilis can it be tested for?
5) presuming that you say that there is no concern to be had after 7 days, would you also say that medically speaking there is no concern to have sex with somebody that has a clean bill of health? I don't want to put potential partners at risk.
Thank you.
7 days ago I received unprotected oral sex from a south east asian escort in London. We used a condom for intercourse.
I woke up with a herpes blister the next day, I am unsure if the blister was already there or "growing" during the oral sex the night before, but I didn't notice anything. Considering that herpes in general and a possible blister during oral sex increase the chances of transmission for std's I would like to ask the following:
1) Is there any HIV risk in general and due to HSV?
2) Any other std's that I could have gotten?
3) Is there a need to test although today after 7 days I have no symptoms and the herpes blister has healed as usual after about 5 days?
4) how soon after exposure to ghonorrea, chlamydia and syphilis can it be tested for?
5) presuming that you say that there is no concern to be had after 7 days, would you also say that medically speaking there is no concern to have sex with somebody that has a clean bill of health? I don't want to put potential partners at risk.
Thank you.
MEDICAL PROFESSIONAL
As generalizations, oral HSV-2 is uncommon and genital HSV-1 is uncommon in people with HSV-2. But the reasons are because of frequency of exposure, the likelihood of prior infection in people participating in particular risk activities, and so on. As for most generalizations, there are plenty of exceptions.
In this case, your escort partner had definite oral exposure at a time that your HSV-2 may have been highly infectious. She was definitely at risk and should be notified about it. And although the frequency of symptomatic outbreaks usually is low for HSV-2, it isn't zero and an unlucky few can have frequent outbreaks. (Some might argue that sex workers understand and tacitly accept a certain amount of STD risk. But in my view, that doesn't mean a client has the right to knowingly expose a sex worker and say nothing about it.)
However, the generalization about your risk of genital HSV-1 holds true. Your risk for that is very low, although not zero. But this is mostly because the risk is inherently low for any single oral sex exposide, not because of your prior HSV-2. That probably provides slight protection against HSV-1, but you definitely are not immune to it (unless you have had a blood test showing positive antibody to HSV-1 as well as HSV-2).
In this case, your escort partner had definite oral exposure at a time that your HSV-2 may have been highly infectious. She was definitely at risk and should be notified about it. And although the frequency of symptomatic outbreaks usually is low for HSV-2, it isn't zero and an unlucky few can have frequent outbreaks. (Some might argue that sex workers understand and tacitly accept a certain amount of STD risk. But in my view, that doesn't mean a client has the right to knowingly expose a sex worker and say nothing about it.)
However, the generalization about your risk of genital HSV-1 holds true. Your risk for that is very low, although not zero. But this is mostly because the risk is inherently low for any single oral sex exposide, not because of your prior HSV-2. That probably provides slight protection against HSV-1, but you definitely are not immune to it (unless you have had a blood test showing positive antibody to HSV-1 as well as HSV-2).
Thank you for your reply.
- I thought oral hsv2 basically never occurs? And if it does it never reoccurs? Is this true? It will be difficult to do what you are suggesting but I will see if I can get in touch with her.
- after some hsv and oral related searches I read a comment from
http://www.medhelp.org/personal_pages/user/1998092
that hsv1 does not occur genitally on top of hsv2 if you had it for a while based on some research by Anna Wald at the University of Washington. Is this true? Does that imply I am basically "immune" to any additional hsv infection, anywhere?
- I thought oral hsv2 basically never occurs? And if it does it never reoccurs? Is this true? It will be difficult to do what you are suggesting but I will see if I can get in touch with her.
- after some hsv and oral related searches I read a comment from
http://www.medhelp.org/personal_pages/user/1998092
that hsv1 does not occur genitally on top of hsv2 if you had it for a while based on some research by Anna Wald at the University of Washington. Is this true? Does that imply I am basically "immune" to any additional hsv infection, anywhere?
MEDICAL PROFESSIONAL
See above.
MEDICAL PROFESSIONAL
Welcome to the forum. Thanks for your question.
I'm glad to hear your relatively new genital HSV-2 infection is on the mild side. However, you probably were highly infectious at the time of the oral sex exposure; often viral shedding often is high just before a visible outbreak. Therefore, the main risk here is to the escort. You should tell her to be on the lookout for symptoms of oral and genital herpes. The genital risk was low because of the condom, but not zero; but her risk of oral may be quite high, especially if she hasn't previously had HSV-2.
To your questions:
1) Having HSV-2 roughly doubles your risk if exposed. But stress "if exposed". It is statistically unlikely your escort partner has HIV; and even if she does, oral sex is such low risk that HSV-2 makes no dfference. One estimate of oral to penile HIV transmission is once every 20,000 exposures, which is equivalent to receving BJs by infected partners once daily for 55 years before transmission might be expected. With a double risk on account of HSV-2, it's 1 in 10,000 (27 years) -- still nothing to be concerned about.
2,3) Oral sex is low risk for all STDs and zero risk for some. You are at slight risk of gonorrhea, a second herpes infection (HSV-1), syphilis, and NGU. But low enough that you can ignore it and do not need testing if you don't develop symptoms like new penile sores/blsiters, urethral discharge, or painful urination (all within 1-2 weeks).
4) Gonorrhea/chlamydia testing is valid now (any time more than 3-4 days after exposure). 6 weeks for syphilis.
5) It is impossible to guarantee you aren't infected. But if I were in your situation, at this time I would resume unprotected sex with my wife without fear of infecting her with any STD from this event.
6, below) Yes, just a coincidence; much too soon for this exposure. Neither herpes nor any other STD can start to cause symptoms sooner than 2-3 days after exposure.
I hope these comments have helped. But do contact the escort and tell her of her exposure. She will appreciate it (although might chastise you about not telling her of your GHSV-2 before the event).
Good luck-- HHH, MD
I'm glad to hear your relatively new genital HSV-2 infection is on the mild side. However, you probably were highly infectious at the time of the oral sex exposure; often viral shedding often is high just before a visible outbreak. Therefore, the main risk here is to the escort. You should tell her to be on the lookout for symptoms of oral and genital herpes. The genital risk was low because of the condom, but not zero; but her risk of oral may be quite high, especially if she hasn't previously had HSV-2.
To your questions:
1) Having HSV-2 roughly doubles your risk if exposed. But stress "if exposed". It is statistically unlikely your escort partner has HIV; and even if she does, oral sex is such low risk that HSV-2 makes no dfference. One estimate of oral to penile HIV transmission is once every 20,000 exposures, which is equivalent to receving BJs by infected partners once daily for 55 years before transmission might be expected. With a double risk on account of HSV-2, it's 1 in 10,000 (27 years) -- still nothing to be concerned about.
2,3) Oral sex is low risk for all STDs and zero risk for some. You are at slight risk of gonorrhea, a second herpes infection (HSV-1), syphilis, and NGU. But low enough that you can ignore it and do not need testing if you don't develop symptoms like new penile sores/blsiters, urethral discharge, or painful urination (all within 1-2 weeks).
4) Gonorrhea/chlamydia testing is valid now (any time more than 3-4 days after exposure). 6 weeks for syphilis.
5) It is impossible to guarantee you aren't infected. But if I were in your situation, at this time I would resume unprotected sex with my wife without fear of infecting her with any STD from this event.
6, below) Yes, just a coincidence; much too soon for this exposure. Neither herpes nor any other STD can start to cause symptoms sooner than 2-3 days after exposure.
I hope these comments have helped. But do contact the escort and tell her of her exposure. She will appreciate it (although might chastise you about not telling her of your GHSV-2 before the event).
Good luck-- HHH, MD
Lsatly
6) Is there any connection between the herpes blisters and the oral sex? I thought maybe the sex worker gave me hsv1 on top of hsv2? But wouldn't it be too soon to have anything visible a few hours later? Is it just coincidence?
6) Is there any connection between the herpes blisters and the oral sex? I thought maybe the sex worker gave me hsv1 on top of hsv2? But wouldn't it be too soon to have anything visible a few hours later? Is it just coincidence?
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
