Possible exposure?

[erhesfer]

I am a f prev HSV1/2 neg. On the 5th I went home with a m who is HSV2+. My undies stayed on, but slept a few hrs with his naked penis against my thigh. I am worried that it may have also rested against the razorburn next to my underwear line, but i don’t know that it did.  He also put his fingers inside of me briefly. On the 19th my undies stayed on, but he did brush nakedly past the razorburn on my underwear line once or twice, and also poked his penis against my vagina once or twice through my underwear. 4 days later I got bad chills, aches, etc, but also a stuffy nose and cough.  Flu was going around. On the 25th Thurs pm I noticed two small red bumps on my vulvar lips, one eraser sized one tiny.  Fri I couldn't get to a doc, but the larger one seemed to have a yellowish scab or ulcer in the center. it didn't hurt much.  I tried to see a doc, but on sat am the bumps/redness were gone, leaving a tiny red scab a yellowish scab that were completely dry and painless.  Sun the yellow scab was gone.

1. What are my risks?  
a. Fingers – only if he touched himself first and was having an ob?
b. Can you be infected through momentary contact with razorburned skin? Or through underwear?
c. Or longer contact with more intact thigh skin?  What if his penis moved over to my razorburn while we slept?
2.  Does the primary herpes outbreak usually show up in the location of infection?  ie if i had been infected a month ago by sleeping with his penis against my thigh,  the primary outbreak would have LIKELY shown up there, right? Not on the vulvar lips. And would three weeks would be a long time to be latent?
4. Is it true that IF YOU DO get a primary with blistering and ulcers, they stay open and raw for at least a week?  20 days is quite different from my few days. But I clearly had some kind of sore and yellow scab. Can I take time to healing and painlessness as a pretty clear indication that this wasn't a primary herpes ulcer? Do I need to get tested in 3 months? Am I safe?

[Terri Warren, RN, Adult Nurse Practitioner]

Looking at 300 women with symptoms of first episode infection represents 300 women who have symptoms when they get herpes.  But that says nothing about the other people who get herpes who have minimal symptoms or no symptoms.  Do you see what I mean here?  That's like looking at the characteristics of people who get picked up for drunk driving and deciding that that represents drunk drivers.  However, there are many drunk drivers who never come to the attention of law enforcement.  Does that analogy make any sense?  

Still, I think your risk of acquisition, given your circumstances, is very low.

Terri

[erhesfer]

to clarify - i didn't have a fever, but i did have aches and malaise.  and by "some" exposure, i just mean the penis touching against my underwear between my legs before i could move away.  i really thought i was being safe!!

also, im sorry for the silly questions... hsv has been an unhealthy focus of mine for a few years. i will be away from my significant other/support system for a few days, so if possible can you wait a few days to reply if it is bad news?  

thank you. i'm so sorry.

[erhesfer]

Hi Terri
My HSV1 and 2 IgG tests were negative previous to exposure to this partner.

I am somewhat confused - i found a paper (albeit from 1987) that described primary outbreaks from ~300 patients, where 99% of women described them as acutely painful, mean number of lesions was 8 and the median time to re-epetheliazation was 19.8 days. This description (and the fact that it was pretty consistent across all 300 patients) sounds nothing like my symptoms, and it makes me feel like there is NO way my 2 or 3 day bump with a yellow scab (and that's assuming i didn't notice it right away, i only saw it for 1-2 days) was a primary herpes outbreak.  

But then i read on casual websites all kinds of scary descriptions - symptoms can be virtually anything, any red bump or ulceration is possibly herpes, and anything irritated like a bug bite, rash, ingrown hair etc, can also be herpes.  I did have SOME exposure, and i did have a fever, and then a mysteriously herpes-like bump, and then some funny nerve-y aches and pains in the days that followed. It would be so unfair, given that the most contact i had was his penis involuntarily touching my underwear (or possibly some skin nearby? how can i be sure?). I honestly wouldn't mind getting herpes from the right partner, but not this guy.

Can I reassure myself with the fact that (in your experience) a primary outbreak is kind of all-or-nothing, in the sense that IF you have an outbreak it is the true primary outbreak: 8-10 days of actual symptoms and follows the traditional time to healing?  Yes, i could still be asymptomatic and infected, but i would feel much better if i was confident that these bumps/scab were unlikely to be any usual primary outbreak.

Also how unlikely is the risk being "very low indeed?" I am unfortunately aware that even my full-butt underwear in that area doesn't cover all skin... but i am confident that it covered the labia in the location where the bump showed up.  Can i feel sure that my risk alone is so low that i really, really couldn't have caught anything and I don't need to test in 3 months? (even though i probably will, for sanity's sake).

Thanks so much for this.  

[Terri Warren, RN, Adult Nurse Practitioner]

The risks from this contact are very low indeed, either through the sexual activities in which you engaged or finers.  I'm not worried about the thigh contact.  A primary outbreak in your situation would probably show up first on the genital area, though that isnt' for certain.  I would say that your few days of symptoms are certainly not typical of any first infection I knwo about.  

Was your HSV 1 and HSV 2 test negative?  And you are absolutely certain you were tested for herpes?
I don't feel that you need to retest, no.

Terri