[Question #10662] HSV2 from Oral Sex

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21 months ago

I am a 33-year-old male and I'm having a very hard time right now, well the past few months in worry and wrapping my head around oral sex encounter I had with a girl was dating back in July. I had been seeing her for about a month before we were intimate 8/5 and haven’t been with her or anyone since. Protected intercourse, and unprotected oral sex for no more than a few mins. Week later while peeing I looked down and saw a small white painless patch flaky like dry skin (no pain, itching or anything wouldn’t have noticed it if I wasn’t trying to not miss the toilet bowl) lasted about 3 weeks didn't grow or change in appearance. I was anxious from that moment, jumped on google, and went down a rabbit hole. Landed on syphilis. Seen providers (5) and have got tested multiple times everything came back negative. Not sure how I landed on herpes but can’t shake it. I think because I couldn’t associate it to anything else I started questioning what could it be? I’ve already had HSV 1 for over 10 years or so. Patch started to go away after the NP at an urgent care gave me some anti-bacterial/biotic ointment. she kept asking about soaps and detergents I’m using.

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21 months ago

I really went down a path of then thinking I had eye herpes because of something I saw in the white part of eyes (got my eyes check and have perfect vision), also felt like I had burning/ warm sensations down there only when sitting (no outbreaks or anything). I ended up going to my doctor and getting another round of std testing and antibiotics (because he was thinking it could be prostate) and HSV IGG testing at 11 weeks and HSV 1 came back 40.00 and negative for HSV2. All other testing came back negative. My doctor keeps reassuring me it’s not HSV 2. 

What are your thoughts about this?

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Terri Warren, RN, Nurse Practitioner
21 months ago
HSV 2 is not transmitted via oral sex under any usual circumstances.  Condoms reduce transmission of HSV 2 from females to males by 65%.  Herpes definitely does not present as a white painless patch of flaky dry skin - just not at all.  I'm not sure why you think it's herpes but if you are basing it on that presentation, it isn't HSV.  I would believe the IgG test in this situation.  You are known positive for HSV 1 but negative for HSV 2.

Terri
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21 months ago
Hi Terri, 

Thank you for getting back to me and giving that insight. I honestly don’t know and it’s something I’ve been fighting with to understand how I landed there. Couple questions below for you:

1. Would you say that there was even a risk for it? I’m not clear as to how there wasn’t. 

2. Have you ever seen in your practice someone get HSV2 from oral sex? I’m sure you can understand why that’s a mind buster for many. 

3. Can you elaborate on the 65% condom transmission rate you quoted up there?

4. Maybe I have significant anxiety about this, but still have a sense of worry. Like I haven’t had sex since and will be seeing my girlfriend this week for the holiday. 
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Terri Warren, RN, Nurse Practitioner
21 months ago

1. Would you say that there was even a risk for it? I’m not clear as to how there wasn’t. 
The thing is that HSV 2 doesn't like the oral area at all and so rarely lives there.  I can't say there is 100% no risk but I've never seen anyone get HSV 2 from receiving oral sex and if I were in your situation, I wouldn't give this a moment's worry

2. Have you ever seen in your practice someone get HSV2 from oral sex? I’m sure you can understand why that’s a mind buster for many. 
Never

3. Can you elaborate on the 65% condom transmission rate you quoted up there?
Condoms reduce intercourse- related transmission of HSV 2 by 65%, from females to males.

4. Maybe I have significant anxiety about this, but still have a sense of worry. Like I haven’t had sex since and will be seeing my girlfriend this week for the holiday. 
OK?

Terri

 
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21 months ago
To #4 what I was trying to say is that I’m anxious of sleeping with my girlfriend because of this encounter and am worried of giving her something. You mentioned that you wouldn’t give this a moments of worry. Thats the worry … 

#5 do you think 11 weeks for igg test I had taken was enough time for accurate reading? 

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Terri Warren, RN, Nurse Practitioner
21 months ago
11 weeks is as good as the IgG test will get, so yes.  Waiting longer won't help the IgG test accuracy.
I understand that you have some anxiety about having sex with your regular partner but unless you chose to do the herpes western blot, you are going to be with the accuracy of the IgG test that tells you that you don't have HSV 2.  And I'm not a bit worried about you getting hSV 2 from oral sex so there you go.  I'm afraid I have not further tips to make this situation any clearer.

Terri

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