I've read that you said most people have acquired oral herpes around 60% I know a lot of exposure comes from being a child but I have read that risk of getting it from receiving uncovered oral sex is around 1 in a 1000 but if so many people have it how is it that rare to get, even if you took out half the people assumed they got it as kids that's still a very large chunk of people who casually get it.

Condoms are pretty praised from you guys and in almost your years treating people just how common is it for people to get some form of sti while wearing one, if you split this up from single encounters to people who have sex with different people regularly. If you wear a condom and receive oral if lips for a brief period touch a part of the shaft that is uncovered can you assume at that point you no longer had protected sex and the same with vaginal for risks of skin to skin contact sti like syphilis and herpes

How often do people lie to you or you suspect? For example maybe someone says they were more careful then they were and things don't add up?

What qualifies as easily transmissible? Does easily mean almost a certainty if precautions aren't taken or does it mean it's still low risk but now low enough to dismiss it. 

Regarding herpes.  You are correct that by adulthood somewhere around 60% of persons have acquired HSV-1.  Most of those infections are oral.  For transmission to occur several things need to happen.  I'll provide a partial answer- if you have additional questions about HSV, they should go to Terri who answers our HSV questions. These include:

A.  The person who is exposed has to be susceptible- you cannot get HSV-1 (or -2) twice.  Thus 60% of people are not susceptible (most people with HSV-1 do not even know that they have it)

B.  The person performing oral sex must have HSV-1 AND be shedding the virus, either asymptomatically or from a cold sore.  People with HSV-1 do not shed the virus most of the time.

C.  Even when a susceptible person is exposed to an infected partner shedding the virus, most exposures do not lead to infection.  The precise infection rate is less than 1% and probably substantially less

D.  Factors such as the friction accompanying exposure, duration of exposure, etc. also can change the risk for transmission/acquistion

Condoms.  Condoms, when worn throughout an encounter with an infected person prevent nearly all infections due to HIV, gonorrhea, chlamydia and trich.  Because infectious lesions may not be entirely covered by condoms, they are somewhat less protective in preventing diseases which infect skin (as opposed to mucous membranes) such as herpes, syphilis and HPV.  For thee infections they are estimated to reduce infections by about 60%.  As a generalization, condoms are highly protective against STIs.

Most people appear to tell the truth when asked about their infection or vaccination (for HPV) status.  Most STIs are transmitted by persons who do not know they are infected.

Easily transmissible.  STIs are not as common or as easily acquired as most people seem to think.  For most STIs precise transmission rates are unknown.  For a few (HIV, gonorrhea, chlamydia, perhaps syphilis) transmission rates have been estimated.  It is safe to say that for most STIs, most exposures to infected untreated partners do not lead to transmission of infection.  When this fact is combined with the fact that most people do not have STIs (HPV and perhaps HSV-1 are the exceptions), transmission is relatively uncommon.  STIs are relatively common because lots of people have lots of sex.  

I hope this helps.  Any further questions will receive brief responses.  EWH

So.. if 60% of people have it, but most exposure when you're a susceptible person doesn't lead to exposure I guess I'm curious how more than half the population has it. 

I think I understand what you said in that let's say you acquired oral herpes like 15 years ago and didn't even know then someone giving you oral sex and if THEY have oral herpes then they can't pass it to you because you can't get it twice even in a different area at least that's what I think you said.

So then is a male receiving oral sex with a condom considered the lowest risk sexual activity if it's already unlikely to be infected with anything? Is the danger higher if you're performing it on someone else then?

Are the majority STDs transmitted purely through vaginal sex then, in all your years in this profession how often has someone come in and had a sti they acquired either knowingly or unknowingly from oral sex with a condom and only that?

Those are the last of my questions thank you for your time and happy holidays 

So.. if 60% of people have it, but most exposure when you're a susceptible person doesn't lead to exposure I guess I'm curious how more than half the population has it. 

Its a numbers thing.  Most people with HSV (1 or 2) do not know they have it, transmission can occur from asymptomatic and/or unrecognized infections, and there's lots of kissing and sex

EWH