[Question #10376] Genital HSV-1
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23 months ago
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Hello. I was recently diagnosed with a yeast infection and genital hsv-1. I’ve only been with one partner who I know for sure has oral hsv-1, but I have not been with him for 2 years. Is it possible that I have had it for a long time without knowing and/or having an outbreak? Or are positive cultures only due to recent exposures?
Thank you in advance
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Terri Warren, RN, Nurse Practitioner
23 months ago
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So if I understand you correctly, you had a positive swab test for HSV 1? This could be a recent infection if you've received oral sex recently OR it could be a long standing infection and what you are experiencing is a recurrence of an old infection. Had you had an antibody test at the same time, it would have helped to sort that out for you.
Terri
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23 months ago
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Thank you Terri. Yes, an antibody test would've helped, should that have been done or just a swab test since there were sores? As for antibody tests, I think they can differentiate between HSV-1 and HSV-2, but can they tell you if it is oral or genital? (no symptoms present)
Lastly, I've been doing research, but am still a little confused about transmission possibilities (understanding that nothing is 100%). Can you confirm or better explain the transmission possibilities for a Genital HSV-1 positive female in a heterosexual relationship?
French kissing (with or without genital sores present): I've read that transmission this way is highly unlikely, is this correct? Is it possible? If so, how long should I wait after an outbreak?
Giving unprotected oral sex (with or without genital sores present): I've read that transmission this way is highly unlikely, is this correct? Is it possible? If so, how long should I wait after an outbreak?
Receiving unprotected oral sex (without genital sores present): I think transmission is possible due to shedding, but less likely without an active outbreak, is this correct? How long should I wait after an outbreak?
Unprotected vaginal sex (without genital sores): I think transmission is possible due to shedding, but more likely during an outbreak, with risks decreased with condom use, is this correct? How long should I wait after an outbreak?
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Terri Warren, RN, Nurse Practitioner
23 months ago
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The antibody test would only have told you if this is a new infection (no antibody present) or an established one (antibody already present) but you are correct that it would not have told you the location of the infection.
We have no data on transmission of HSV 1 through intercourse, but we know the risk is low. What we do have is shedding data. If you've been infected for two years or more, you shed on about 4 days out of the year. If the infection is new, you shed on about 13% of days. without an antibody test to help guide us, we cannot know how long you've been infected, and that would only be helpful if it was done when you were first diagnosed.
The risk is from the genital area - kissing is not a risk, nor is giving oral sex.
There is some small risk of receiving oral sex and it should be done when the skin has completely healed.
You are correct in your summary of having unprotected vaginal sex. Wait until the lesions have completely healed.
And if you are having sex with someone who already has HSV 1 anywhere in their body (like cold sores) the risk of transmission is incredibly low
Terri
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23 months ago
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Thank you Terri
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Terri Warren, RN, Nurse Practitioner
23 months ago
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You are most welcome
Terri
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