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HSV2 and risks
I am a single heterosexual male around 30. I have this interesting "lifestyle" where I randomly meet different woman for casual sex and probably have an average of 5-10 partners during the year.
I choose carefully and never had any STD, since I test regularly(every half a year).
I've been HSV1 positive for a number of years but never had an outbreak because of it. About a month ago I performed a rigorous cunnilingus on one of my partners and 4 days later got 3 blisters on the corner of my mouth that looked like herpes (I know what it looks like since my mother has frequent outbreaks).Nothing on my penis since it was a protected vaginal sex.
I freaked out and immediately took Valtrex and put abreva cream on. The blisters dried up in 3 days and that was it.
Now for the questions:
1. I am assuming that I got HSV2 from the oral and that is what caused my blisters since my HSV1 never resulted in an outbreak. Is that a correct assumption?
2. Do you think I should mention to my partners that I have HSV2 even though I didn't test for it since I still need to wait for another 2 month for a conclusive test?
3. Should I now stop giving cunnilingus since I am risking my partners health?
4. I have also read that I am in an increased risk for HIV because of this. Is that so even for oral HSV2? Is that only for cunnilingus or for vaginal sex too?
5. I am bit nervous to continue with my lifestyle, even though I ALWAYS protect myself. Am in an increased risk now to get other STDs even from protected vaginal sex because of this infection?
Thanks
I choose carefully and never had any STD, since I test regularly(every half a year).
I've been HSV1 positive for a number of years but never had an outbreak because of it. About a month ago I performed a rigorous cunnilingus on one of my partners and 4 days later got 3 blisters on the corner of my mouth that looked like herpes (I know what it looks like since my mother has frequent outbreaks).Nothing on my penis since it was a protected vaginal sex.
I freaked out and immediately took Valtrex and put abreva cream on. The blisters dried up in 3 days and that was it.
Now for the questions:
1. I am assuming that I got HSV2 from the oral and that is what caused my blisters since my HSV1 never resulted in an outbreak. Is that a correct assumption?
2. Do you think I should mention to my partners that I have HSV2 even though I didn't test for it since I still need to wait for another 2 month for a conclusive test?
3. Should I now stop giving cunnilingus since I am risking my partners health?
4. I have also read that I am in an increased risk for HIV because of this. Is that so even for oral HSV2? Is that only for cunnilingus or for vaginal sex too?
5. I am bit nervous to continue with my lifestyle, even though I ALWAYS protect myself. Am in an increased risk now to get other STDs even from protected vaginal sex because of this infection?
Thanks
MEDICAL PROFESSIONAL
As I said above, I'm not convinced your oral lesion was herpes, because of how quickly it resolved; most herpes outbreaks require 8-10 days to heal. And even if herpes, your question is unanswerable. It is not usually possible to discern triggers for oral herpes outbreaks, except for local trauma or sunburn. (Recurrent oral herpes is often triggered by facial surgery and outbreaks are common in skiers or sunbathers who don't use sunblock.) Nor is there usually any obvious reason why outbreaks start to appear in previously asymptomatic people.
You should inform partners of your HSV-1, which probably is oral regardless of whether the recent lesion was herpetic, and you should avoid exposing them by kissing or cunnilingus if you suspect you are having an outbreak. Otherwise, nothing need be said.
What i your friend's rationale for recommending valacyclovir before sex? If the idea is to protect partners from your HSV-1, a single dose 3 hours earlier probably would not be effective for that purpose. If it's to protect you from future HSV-2 infections, it might work, but we don't know; such use has never been studied. But the risk is so low for any particular exposure that it doesn't seem warranted.
If you remain anal about ruling out HSV-2, have another blood test at 3 months. But if it were me in the same situation, I wouldn't feel the need. If you want to return with a common to report such a test result, feel free. But I won't have any further comments or advice until then.
You should inform partners of your HSV-1, which probably is oral regardless of whether the recent lesion was herpetic, and you should avoid exposing them by kissing or cunnilingus if you suspect you are having an outbreak. Otherwise, nothing need be said.
What i your friend's rationale for recommending valacyclovir before sex? If the idea is to protect partners from your HSV-1, a single dose 3 hours earlier probably would not be effective for that purpose. If it's to protect you from future HSV-2 infections, it might work, but we don't know; such use has never been studied. But the risk is so low for any particular exposure that it doesn't seem warranted.
If you remain anal about ruling out HSV-2, have another blood test at 3 months. But if it were me in the same situation, I wouldn't feel the need. If you want to return with a common to report such a test result, feel free. But I won't have any further comments or advice until then.
I am just wondering what could have triggered an HSV1 outbreak if I have been infected long before but was always asymptomatic? does that mean that there is a potential problem with my immune system?
Hello Doc,
As you recommended I took the full STD test exactly 5 weeks since my last encounter. All the results are back and everything is negative with the exception of HSV1 (which I already knew). Also, no further cold sore breakouts since that first time.
What's next? Can I continue kissing and giving oral without mentioning anything or should I wait longer?
Someone also recommended that I take Valtrex 3 hours prior to sex. Do you agree?
THX!
As you recommended I took the full STD test exactly 5 weeks since my last encounter. All the results are back and everything is negative with the exception of HSV1 (which I already knew). Also, no further cold sore breakouts since that first time.
What's next? Can I continue kissing and giving oral without mentioning anything or should I wait longer?
Someone also recommended that I take Valtrex 3 hours prior to sex. Do you agree?
THX!
MEDICAL PROFESSIONAL
Welcome to the forum and thanks for your question. I'll try to help.
Congratulations on a safe approach to your chosen sexual lifestyle. While multiple partnerships obviously carries a certain amount of elevated STD risk, you are doing it in a responsible fashion.
Although it is possible you acquired oral HSV-2, I'm inclined to doubt it. Initial infections with a new HSV type usually are more severe than you describe, and would likely cause lesions primarily at the sites of maximum friction during the sexual exposure -- which probably was not the corner of your mouth. And initial infections usually cause more widespread lesions and sore throat. Further, even with the anti-HSV treatments you describe, 3 days is too quick for healing of an initial HSV infection. I'm more suspicious that you had an outbreak of oral herpes due to your chronic HSV-1 infection; or that it was something else entirely, not herpes at all. (Even recurrent herpes rarely heals as quickly as 3 days.) These aren't hard and fast rules, it it could be HSV-2 -- but I don't think so.
For those reasons, most of your questions are getting ahead of the game. Before you make any decisions about what to say to future sex partners, modified sex practices, HIV risk, etc, you need to determine whether you in fact caught HSV-2. You need an HSV blood test right away (for both HSV-1 and 2). If negative for HSV-2, have another test in a couple of months, i.e. around 3 months after the exposure and oral symptoms. If both results are negative for HSV-2, it will show you weren't infected. (If the initial result is negative, it will be pretty reassuring all by itself, but not definitive until 3 months.) In addition, if in the coming weeks you have another oral outbreak of any kind, see a doctor or clinic immediately (within 1-2 days) for direct testing for HSV. If that happens, my bet is on HSV-1.
As for HIV risk, it is technically true that having HSV-2 elevates the risk of HIV if exposed. It roughly doubles the risk. However, if your sexual practices and consistent condom use continue as they have, you will still be 100% protected against HIV. And a doubled risk really doesn't make much difference anyway. If your lifetime chance of HIV were, say, 1 in 10 million, it would rise to 1 chance in 5 million. No big deal, right?
So for now, stay mellow. Until you sort this out, I would suggest you not perform cunnilingus on your partners and ideally no kissing as well. Otherwise I see no need to change anything. Get tested as outlined and let me know the results, and you can then address what changes if any need to continue in the future.
I hope this helps. Best wishes-- HHH, MD
Congratulations on a safe approach to your chosen sexual lifestyle. While multiple partnerships obviously carries a certain amount of elevated STD risk, you are doing it in a responsible fashion.
Although it is possible you acquired oral HSV-2, I'm inclined to doubt it. Initial infections with a new HSV type usually are more severe than you describe, and would likely cause lesions primarily at the sites of maximum friction during the sexual exposure -- which probably was not the corner of your mouth. And initial infections usually cause more widespread lesions and sore throat. Further, even with the anti-HSV treatments you describe, 3 days is too quick for healing of an initial HSV infection. I'm more suspicious that you had an outbreak of oral herpes due to your chronic HSV-1 infection; or that it was something else entirely, not herpes at all. (Even recurrent herpes rarely heals as quickly as 3 days.) These aren't hard and fast rules, it it could be HSV-2 -- but I don't think so.
For those reasons, most of your questions are getting ahead of the game. Before you make any decisions about what to say to future sex partners, modified sex practices, HIV risk, etc, you need to determine whether you in fact caught HSV-2. You need an HSV blood test right away (for both HSV-1 and 2). If negative for HSV-2, have another test in a couple of months, i.e. around 3 months after the exposure and oral symptoms. If both results are negative for HSV-2, it will show you weren't infected. (If the initial result is negative, it will be pretty reassuring all by itself, but not definitive until 3 months.) In addition, if in the coming weeks you have another oral outbreak of any kind, see a doctor or clinic immediately (within 1-2 days) for direct testing for HSV. If that happens, my bet is on HSV-1.
As for HIV risk, it is technically true that having HSV-2 elevates the risk of HIV if exposed. It roughly doubles the risk. However, if your sexual practices and consistent condom use continue as they have, you will still be 100% protected against HIV. And a doubled risk really doesn't make much difference anyway. If your lifetime chance of HIV were, say, 1 in 10 million, it would rise to 1 chance in 5 million. No big deal, right?
So for now, stay mellow. Until you sort this out, I would suggest you not perform cunnilingus on your partners and ideally no kissing as well. Otherwise I see no need to change anything. Get tested as outlined and let me know the results, and you can then address what changes if any need to continue in the future.
I hope this helps. Best wishes-- HHH, MD
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.
