If a female has a primary gHSV-1 OB INTERNALLY, what does the man have?

[BM14809]

I am a sexually active male in my late 20s. Last herpes testing was approx 1.5 yrs ago. Negative igg & igm for  both 1 & 2. I have not received updated testing results back since the below played out.

Recently, I had unprotected oral and coitus with a female, our first time together. A few days later she presented with a fair amount of deep internal vaginal pain, which, upon visual examination, was diagnosed by her OBGYN as a deep vaginal tear from sex. The doctor said it was significant (around 2 cm) and had to stitch it. I have a large penis, and the sex was relatively aggressive, but this has never happened with any females before, to my knowledge. Doc takes urine test for STDs, prescribes creams, etc. to speed healing.

Urine tests were all clear, but obviously that didn't include any herpes testing. Female returned to doctor approximately 1 week later (now 2 wks from sexual interaction) complaining of persistent and worsening pain. Doctor reviews and finds the stitch became unhinged, re-sutures. He also viral cultures the tissue around the tear (again, deep inside the vagina) for HSV.

One week later doctor informs female that the culture was HSV-1 positive. So, on to my questions:

1. If this was indeed a primary infection, and assuming it came from me, does the fact that the virus was isolated so deeply insider her definitively mean that I must have HSV-1 genitally? I can't find any data on shedding rates in local regions during primary OB (e.g. labia, vulva, perianal area, cervix). What we do know is that HSV-1 is rarely, if ever, transmitted genital-to-genital, which makes me think this infection was caused orally. The question then becomes, is it possible for a female to have a deep internal-only primary HSV-1 OB as a result of a new infection? The doctor did not swab other areas unfortunately.

2. What percentages of female primary HSV-1 or 2 breakouts happen internally? Do we have any data on that?

3. What are the chances that she could have been experiencing a recurrence that was simply exacerbated by the vigorous sex and resulting tear?

4. If my bloodwork comes back positive for HSV-1, I'll never know where it is. Do I honestly have to disclose in that case? Given the transmission statistics, if those with oral HSV-1 aren't spilling the beans, it seems like a silly double standard to ask those with genital HSV-1 to. This case specifically is obviously very circumstantial and ambiguous, because of this I struggle to reason through the ethical piece here. There are a ton of conflicting viewpoints from expert to expert.

[feelingundone]

That's correct, I believe she had the infection before.
There is no real data for what you're looking for. No money for research for what amounts to be a skin condition. That and hsv1 has grown as a genital infection. In fact half of all newly acquired genital infections are hsv1. Unfortunately research hasn't kept pace. If i were you I'd test now. If it's negative well then the odds are you didn't give it to her.

[feelingundone]

I would be more inclined to believe she had an outbreak due to the trauma. Most primarys with hsv1 will have flu like symptoms as well. It is also more rare to have lesions internally and not externally as well.
If you do test positive then i would inform future partners. Like you said, until an actual outbreak occurs it would be impossible to tell where the infection is located.

[BM14809]

Thanks for the feedback. To be clear, you'd be inclined to believe she had a preexisting HSV infection and the tear caused an OB?

[BM14809]

Also, can you comment on the internal OB to male gHSV-1 link, if any? I am curious to know more about this topic as I have pored over endless research but cannot find real data on this incidence.

Thanks again.