Hi Doctors, 

I need your help after receiving unprotected oral sex from someone with genital HSV (unknown type). Her primary infection was last October and her secondary outbreak was in February. I tested negative for HSV and other STDs in December and have no partners in between. 

Brief timeline:

- Day 0: Exposure

- Days 1-7: Normal

- Days 7-12: Minor irritation, no visible symptoms

- Day 19: Red meatus; doctors attributed it to irritation. (ER doctor saw it)

-Day 20: Urologist gave me antibiotics for UTI and said only irritation Meatus.

-Day 21: Dermatologits Online said Balanitis

- Days 22 onward: Improved with treatment.

- Tested negative for HIV, gonorrhea, chlamydia, and syphilis at 5 weeks; herpes (both)at 6 weeks.

-Day 40 Showed pictures of how it started to the online dermatologist and mentioned no stds, only balanitis.

My questions:

1. If I test negative at 8 weeks, does that mean I didn't catch herpes?

2. Would a true negative have shown stronger symptoms?

3. Is the risk higher for HSV-2 or was HSV-1 a concern since she had no visible mouth sores?

4. What's your overall opinion on the risk from this one exposure?

5. Should I retest for STDs since I was at week 5, not 6?

I appreciate your help and input.

1. I would not suggest you be tested for HSV at all. If you do it at 8 weeks, it will make it very unlikely your minor symptoms were due to herpes. But the HSV blood tests are not conclusive until 3 months after exposure. Even then, one third or people with HSV1 never test positive. These are among the reasons testing doesn't make much sense for you.

2. Not necessarily. Most likely prominent symptoms would be more likely to be associated with earlier positive test results, but events isn't always true; and the trivial symptoms you describe almost certainly make no difference.

3. Answered by Terri. HSV2 is virtually never transmitted oral to genital, both because oral HSV2 is rare and when present usually is not easily transmitted.

4. Near zero for HSV and all STIs.

5. Except for HSV, all your tests at 5 weeks were conclusive. There is no benefit in additional testing.

I hope these comments are useful. I hope they help convince you that the sexual contact described should viewed as a non-event that should be having no effect on your life. Let me know if anything isn't clear.

HHH, MD