[Question #1338] Herpes

49 months ago

I had unprotected sex 3 times with someone: once I noticed red marks next to her vagina; once there was blood from her vagina, all over me, even though it wasn’t her period; and the last time there was a crusty section near where the red marks had been. She said that sometimes she gets “pimples” down there.  (She also gave me oral sex a couple times, and I gave her oral sex at least once and used my fingers on her maybe 3-4 times. I also noticed small red dots uniformly blanketing her butt – but maybe that could have been just her skin getting flushed or something....)


1.  What are the chances she has herpes?  (From reading about it, it sounds to me like she does – but please tell me if there are other likely explanations and your estimate of the odds?)  

2.  If she does, what are the chances that I have it now, after the activities described above?  

3.  If she has it, can I get genital herpes from (a) kissing her; and/or (b) her giving me a blow job?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
49 months ago
Good morning,
The oral sex she gave you a is not a risk IF she has genital herpes, which you don't know.  Lots of both men and women get "pimples" on the buttocks, around the genital area and on the thighs.  Also, herpes on the buttocks looks like groups of water blisters.  Rarely have I seen herpes lesions scattered across the buttocks and certainly no "blanketing" the buttocks.  That sounds like something pretty different to me.  Also, I'm not sure what blood all over you from her vagina would be if not her period?  Pertaining to your question, herpes would not cause there to be blood all over you from her.

1.  Overall, about one in four women in the US between 14 and 49 have HSV 2 genitally - more have HSV 1 genitally as well. 
2.  If she has herpes, and you had unprotected sex with her three times, the risk is still quite low unless she had herpes lesions present at the time.  I can't give you an exact number but if I was forced to take a guess, with no lesions, it would be less than 1 in 100.  The circumstances for which we have statistical risks for HSV 2 transmission don't really fit your situation so very hard to guess
3.  If she has it, and only genitally, then kissing her is zero risk and her giving you oral sex is also zero risk.

So let me ask you - how long ago was this contact and have you ever had a herpes antibody test in the past?  Do you know if she's been tested?

Terri
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49 months ago
Thank you.  

Yes, I didn't think the light red dots uniformly dotting her buttocks would have been herpes - but I didn't know if they might be something else?  They might have just been her skin's being flushed.

She definitely was not on her period.  When I looked up the causes of vaginal bleeding after sex, STIs were listed as one possible cause.  For example, mayoclinic.org says, "Possible causes of vaginal bleeding after sex include:...  Genital sores that result from sexually transmitted infections, such as genital herpes or syphilis"?

I would have thought that what I described would have meant that lesions *were* present:  red marks near her vagina, vaginal bleeding all over me, then a crusty strip near where the red marks had been.  So I guess my question is (a) what is the chance that those are herpes lesions (or some other STI?)?; and (b), if they are, and I had unprotected sex with her three times, what are the chances that I now have it? 

This contact was on 10/1, 10/5, and 10/10.  The last herpes antibody test I have records for was 4/30/'12.

After these experiences, I asked her to get tested.  She eventually did but not until 10/27.  She said her doctor told her that the results would take two weeks since they required a pap smear.  I guess I am afraid that, if her doctor tested her for herpes at all, the doctor might not have done a blood test and, since whatever was there was already beginning to heal, she could get a false negative.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
49 months ago
The word lesion is probably different for different people - in my mind, red marks are not lesions, nor is bleeding all over you.  While we might see a little blood from an STD, I rarely see herpes lesions bleed, certainly not to the extent of "blood all over me" ever.  I'm not sure about the crusty strip - hard to imagine that from your description.  If you are saying they are scabbed areas, that could be herpes I suppose.  You certainly waited long enough from the contact to the antibody test - very good.  The test misses perhaps 5-7% of HSV 2 infections so that's pretty darn good for accuracy. 

If your partner is getting a herpes test from a pap, then it is not a blood antibody test, correct. 

I think you are in the clear.

Terri
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