Welcome back to our Forum. May of the concerns your express are not too different from those you discussed with Dr. Handsfield about a year ago and much of what was said is relevant to the questions/concerns you express. The exposure you describe was very low for acquisition or transmission of any STI and at this point, what is going to happen has- further worry about it is not a productive effort. If your wart is under treatment it should reduce your already low risk of HPV transmission and the statistical risk of you getting HSV from her is low- you do not know if she even has HSV and if she did, the mathematical risk for you acquiring HSV is less than 1 in 10,000.
As for your specific questions:
1) What is my risk of contracting genital HSV2 from this frottage exposure??? (I already have oral HSV1).
See above- very, very low. While there is a theoretical chance that you might have acquired HSV, the risk is extraordinarily low.
2) I have HPV with a small genital wart that I am treating with Imiquimod cream but has not yet gone away (the wart is on the other side of my penis, not the part of the penis that rubbed against her as I laid on my back, so I am sure the wart did not touch her) What is her risk of contracting genital warts from me???
HPV infections are transmitted through direct contact of an infected site and the friction associated with sexual activity. If your wart did not contact her, there is certainly no meaningful risk for you to transmit infection to her. Even if there was contact, the risk for transmission is quite low.
3) I would like to continue applying the Imiquimod cream, but I also want to monitor my penis over the next 14 days for any signs of herpes. Is it possible that application of Imiquimod cream could delay/alter the appearance of HSV2 lesions, so that I would not know if I have acquired HSV2??? I know the blood test for herpes would not be affected by Imiquimod, but I'm wondering about the appearance of herpes lesions. Can I continue applying the Imiquimod??
See above- the risk of having acquired infection from the encounter you describe is quite low. There are no data on the use of imiqimod for prevention of HSV or that it would change the manifestations of infection if you were infected. I see no reason for you not to continue to use your imiqimod.
My sense is that, over all, you are worry entirely too much about this encounter. I urge you to put these concerns behind you and move forward. EWH
Thank you very much for your quick reply. I understand the risk of HSV is very low. I was wondering if I could ask one more question. Have you ever seen someone acquire genital HSV2 from frottage?? I take it you don't think I need to get an HSV blood test from this encounter? Thanks so much.
No, I've never seen anyone get HSV from frottage- not ever.
Further, I should tell you that we recommend strongly against using the blood test for HSV diagnosis. Particularly for you since you already have HSV-1, your risk of have a falsely positive blood test result is rather high. EWH