However I don't understand why there is no consensus among experts on some topics.

1. I went to infectious diseases doctor to speak about vaccinations and other things. He told me I can get types of genital HPV on my hands (6 and 11 I think) and transmit it later. You and a virologist I saw years ago said it is impossible. Should I wash my hands with soap before I wash my genitals?

2. Herpes transmission from a saliva droplet in the eye while speaking from somebody who gets outbreaks frequently. The doctor said it is possible and Dr. Hook said no. How can I prevent herpes if we stay together, eat together and do hand jobs?

3. Should I use gloves for hand jobs?

5 Also, on one medical site they told me that it is important to discuss CMV and EBV with partners, use condoms and control and treat these infections. Not sure if it was a credible source though. But what about The Body? They put CMV in one line with syphilis.) Also Jennelle Marie Pierce who is an expert in the field allegedly. I am not a medical expert so I wonder what is the reason for the absense of consensus among experts? What a patient is supposed to do when even experts disagree with each other?

 I would be very grateful for a clarification.

Thank you for your efforts.

I disagree there is "no consensus" on these issues. Consensus means the perspectives and advice of the majority, not 100% agreement. And obviously there are differences in expertise among various ID specialists; not all have accurate understandings of STI transmission risks. In addition, some providers naturally have very cautious advice, preferring to emphasize any risk at all without consideration of the magnitude of the risk. There is very strong consensus and agreement on these issues among genuine STI experts; we advise nothing on this forum that is inconsistent with strong majority and consensus views among STI experts.

4. We discussed dislocuire in your previous threads. I have not changed my mind that there is no need and I have no further advice on this.

5. One of my comments in your last thread was "EBV and CMV can be sexually transmitted, they are not generally considered STIs so this is somewhat off topic for our forum." Most STD experts don't generally deal with EBV or CMV as sexually transmitted risks. The chance isn't zero, but the limited data available suggest there is little risk and I do not advise disclosure.

Anxious persons need to very cautious in online searching. Anybody can write whatever they want. You'll take a lot less risk of misinformation or discordant views if you stay with professionally run sites (like academic and public health agencies) or at least professionally moderated, like this one.

HHH, MD

thank you very much.

1. I would like to clarify what measures should I take to prevent herpes from this guy (number 2 in my previous posting).

2. If I understood you correctly it us not necessary to take preventative measures regarding CMV neither sexually (condoms) nor in other interactions like sharing food. Am I right?

3. The info from this one site regarding using condoms and controlling and treating CMV and EBV is also wrong? It was a medical site but a very strange one to be honest. 

4. You are right about using professional sites. The problem is that even there you see conflicting information. 

6. Regarding herpes risks, can it be type 2 on his face as well as type 1 since he engages in all sorts of sex including oral with thousands of people? Can he spread type 2 to me as well by touching and daily interactions?

2. Yes, correct. I see no need for me to repeat the reasons.

3. I don't know what other "site" this refers to, but we have never recommended routine use of condoms for the purpose of preventing either CMV or EBV.

4. It is very difficult for anyone to comment on risks in ways that meet all potentially interested persons' needs and expectations. The issues are too complex and one size rarely fits all. I suggest you just stop web searching at all on these issue. Anxious persons generally are misled more than helped. (A few years ago the much cited online statistician Nate Silver wrote a book on statistics called The Signal and the Noise. In it he says (approximate quote) "Give an anxious person a computer with an internet connection in a dark room, and soon he will believe his common cold is the bubonic plague." Sound familiar?) Keep looking and you'll always come across information that raises rather than reduces your fears. It isn't worth it.

5. CMV is entirely harmless 99% of the time. It's not an infection anyone should take steps to avoid. And probably most case in adults are not sexually acquired anyway.

6. HSV2 infections of non-genital areas is very rare. That includes rare acquisition of infection in people who have frequently given oral sex to partners with genital HSV2.

1. The site I referred to is a site of HIV center where you can ask questions. I asked what should I do regarding CMV and EBV and contact with an HIV+ man and general precautions with others . On a similar site earlier  they told me not to bother and that almost everyone has it and no need to discuss it. On this one however they said the following:

" It is important to openly discuss your infections with the man. Even if he is on therapy the reactivation of EBV and CMV can cause complications. It will help him to take a decision about interactions.

 A. Kisses have only a small risk of CMV. EBV can be also be transmitted,  but it usually happens in childhood.

B. Every sex carries a risk of CMV and other infections. Condom use reduces this risk but doesn't eliminate it. Avoid contact with blood, semen, vaginal secretions.

C. Consult a doctor.

Control your CMV and EBV and get treated if necessary in order to minimize the risk of transmission and complications. Discuss it with partners and take decisions about safe interaction."

What is your opinion on this? I also don't get what my infection has to do with his reactivation.

2. Concept of informed consent. What they said is actually what I came across on other sources like Reddit where people say you have to disclose if you have smth transmittable, so the other has all the info to take a decision. Also here a week ago or so was a question about oral HSV1 (I think it was called HSV1 and daily interactions) where Terri Warren told to disclose it at least before oral sex as she saw a lot of despair and even legal consequences. Why is HSV1 different? It is also prevalent. If I understood you correctly, this concept of informed consent applies to some infections but not to others?

4. If I was your patient and came to you with this special case described in 1. (HIV+ partner on therapy), would your advice on CMV and EBV be different?

Thank you very much 

2. Informing partners of past or current STIs is not a black and white or always/never issue. Pros and cons exist and the nature of a relationship (casual one-off, committed and monogamous, etc) have their influences. I don't see oral herpes (HSV1) as any different than other sexually transmissible infections in terms of disclosure to partners:  sometimes yes, sometimes no.

3. Anyone can write whatever they want on the web. Sure "horror stories" about CMV exist, but that doesn't mean it's a frequent problem. 

4. No, my advice would not be different in event of an HIV infected partner on effective antiretroviral therapy.

That concludes this thread. It is your third on not only the same general topics, but with many of the same questions each time. Please note the forum does not permit repeated questions on the same topic or exposure, so this will have to be your last; such repeated questions receive no reply and the posting fee is not refunded. This policy is based on compassion, not criticism, and to reduce temptations to keep paying for questions with obvious answers. Experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have limited educational value for other users, one of the forum's main purposes. Thank you for your understanding. I do hope the discussions have been helpful. Best wishes and stay safe.