[Question #144] Herpes and HPV concern

37 months ago
I was tested negative for all STI before this recent encounter. I am a 22yr old male and had sex with a 29yr old asian female, we had approximately 5 unprotected oral sex (me receiving the blowjob) and 10 protected vaginal intercourse within the span of 7 days. During vaginal intercourse, the condom occasionally stretched and slipped up but my penis head was definitely covered. She squirted multiple times during the encounter. I ended the affair and am worried that I might be infected with incurable HSV1/HSV2 and HPV during this encounter. It has been 3 days and I'm paying very close to my genitals due to anxiety. My genitals itch occasionally due to pubic trimming and there seems to be 1 red bump 5cm below my belly button which I suspect is due to the friction between my skin and trousers, no other symptoms. There are no visible outbreaks on the woman's lips and genitals during the whole time. I'm very paranoid and anxious atm and the GUM clinic in London only offers Herpes test if blisters are present. So,

1) We did make out a few times during sex, what are the chances that I'm infected with oral herpes HSV1?

2) What are the chances that I'm infected with HPV?

3) What are the chances that I'm infected with genital herpes HSV2?

3) Are the chances of me not being infected at all good enough so that I do not need to go get tested? 


37 months ago
I forgot to mention that when I made out with her, there was this metallic taste, wonder if it's HSV1. Thank you Doctor.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
37 months ago
Have you ever in your life had a cold sore on your lip?  If yes, then you already have an HSV 1 infection.  We don't actually have statistic about how likely it is to acquire HSV 1 with kissing or receiving oral sex. 
What has your sexual history been like before this?  It is felt that by the time a person has had five sexual partners, they have at least one type of HPV already.  Does this fit for you? There is not test for males for HPV currently.  The odds that you acquired HSV 2 in these encounters is fairly low given that you used a condom and had 10 episodes of intercourse but I cannot give you a specific risk assessment, given that we don't know your status re: HSV 2 before these encounters or hers. Have you ever been tested for HSV in your lifetime?

Terri
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37 months ago
I have already stated that I've tested negative for all STI before this encounter and am aware that there are no HPV test available for male. I only have had 3 partners before this. Dr Handsfield claimed that the odds of contracting HSV2 is 1/1000 of unprotected sex and condom would increase that odds by 10 folds, I am really looking for answers backed up by statistics like this.  Could you please refer me to Dr Handsfield because I've customised my question based on what I've learned from his replies. Thank you
37 months ago
Terri, I do not doubt your medical expertise. However, I'm disappointed because you have asked me questions such as 'Have you ever in your life had a cold sore on your lip' and 'Have you ever been tested for HSV in your lifetime?' when I've already mentioned in the beginning that 'I was tested negative for all STI before this recent encounter'. I'm currently very depressed over this incident and if possible, would like Dr Handsfield to answer the 4 questions I've posted. Thank you very much 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
37 months ago
The reason that I asked about herpes specifically is that many people believe that a full STD screen includes herpes testing when indeed. most often,  it does not.  I also asked about the cold sore because the HSV 1 screening test misses 27% of infection so sometimes it is more accurate to ask about symptoms in the patient's history than it is to rely on the test (if it is done) as in this case. My problem with looking at transmission rates with a specific number is that our transmission trials have always involved what we call survivors:  that is, the couples in these trials have already been together for quite some time when they enter a trial and have not transmitted HSV 2.  Most herpes transmissions happen within the first three months of a new relationship and these couples have already come well past that time without infecting the other.  Also, these couples KNOW that herpes is in the relationship and subtle precautions have been taken to avoid transmission.  In situations where someone does not know they are infected with herpes, transmission is more likely.  This is the work of Dr. Anna Wald.  I will be happy to refer your question to Dr. Handsfield, Greg.
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37 months ago
Thank you for the quick reply and clarification. Will be looking forward to Dr Handsfield's reply.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Greetings, Greg. I agree with everything Terri has said, including her caveats about calculations of per-exposure transmission risks. All statements about such risks should be viewed as very rough estimates that don't necessarily apply in all exposure scenarios. But I would also point out that it really shouldn't matter if the true risk for any specific exposure is one in a hundred, a thousand, or ten thousand. When a partner a) isn't necessarily known to be infected (with HSV, HPV, chlamydia, HIV, or any other STI), and b) has no obvious symptoms (e.g. herpes outbreak or warts), and when c) the exposures themselves are low risk, e.g. condom protected (mostly), and d) the exposed individual does not develop typical symptoms (emphasis on typical) within the usual incubation period, then the chance infection actually occured is always exceedingly low -- usually low enough that testing doesn't make much sense from a medical standpoint. It still may be warranted as a reassurance strategy:  anxious persons sometimes will be more reassured by negative testing than by odds calculations and the like.

If you would like any more information about your original questions, feel free to start a new thread. Choose the STI category and Dr. Hook or I will reply. (We do not distinguish between requests between the two of us -- whoever is up next will respond.) However, before you spend the money, I can assure you that the replies will not be materially different than what Terri and I have said here.

Best wishes--  HHH, MD


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