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STDs  (Expert Forum)
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Anal Herpes with no genital anal sex
Answered by
Edward W Hook, MD - HIV Prevention, stds
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Anal Herpes with no genital anal sex

by BJL42, Jul 23, 2008 05:50AM
I was diagnosed with Anal Herpes Type 2. I wanted to know how I could have had this? I have had people perform oral sex on my anus in the past and I remember one person put a finger in me. None of these people which is probably a total of three throughout my sexlife ever had a cold sore present or anything on their finger. I also noticed small white bumps on the bottom of my scrotum. They are not itchy bumps and dont hurt at all. These same bumps have appeared on my thighs as well. Regarding the anal herpies, the layout of the infection is wide, about 2 inches in diameter around my anus. The rash did not itch, I felt severe rectal pain before seeing the rash and then the rash burned really bad when I walked. How did I get type 2 and not type 1. Again, I have never had a gential contact to my anus. These three people I have been with also performed oral sex on my penis and I have not had any blisters, sores, anything on my penis.

by Edward W Hook, MD, Jul 23, 2008 09:08AM
I do not have a good explanation for you.  You did not say so but I presume that the diagnosis was made by an anal herpes culture.  That being the case, I have several comments which MAY be helpful.  Whether or not any of them is relevant to your situation is difficult to say but may be helpful.

1.  Just because your partners did not have lesions does not mean that they cannot give you herpes.  In fact, most genital herpes is spread when the infected person does not have lesions yet has asymptomatic shedding of the virus from normal appearing skin.
2.  A small (very small) proportion of oral herpes infections are HSV-2.  We tend to minimize the frequency of this but it does rarely happen.
3.  For reasons that are unclear, when studies of HSV shedding have been done. There are always persons with genital herpes who also have rectal shedding of the virus.  How and why this happens has not been fully explained (at least to me) or proven.
4.  As to why one of your partners might have transmitted to your anus and not your genitals, again, this is a matter of chance and probability (remember, most exposures to herpes do not lead to transmission) and I have no other explanation.  Sorry

Whether any or all of these are operative is hard (perhaps impossible) to say.  No matter how or why, if this is truly rectal HSV and I have no reason not to think you're wrong if you say you do, I'm sorry to hear it.   Good luck.  EWH
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