[Question #1523] Questions about risk of contracting Herpes

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96 months ago

I’m a mid 40s male who is fit and has no known issues. A relationship that has been developing with I women I’ve known for a few months turned sexual recently. We had protected sex twice and oral sex a couple of times before I found out that she has herpes. She apparently contracted it from her ex husband long ago and found out when she was about to have surgery for early detected cervical cancer. She didn’t tell me because she was told by her OBGYN that she could only affect someone if she had sores. She hasn’t had sex with anyone in 9 yrs and had only had an outbreak once or twice many years ago. She was taking medication for several years but stopped since she didn’t have reoccurring symptoms. I’m really affectionate person that likes kissing and wants an intimate relationship but am really concerned now. I’ve read all of the information on several different sites including the CDC and ASHA, as well as watch all of Dr Handsfield’s videos but I still have questions. Since this is a very new relationship I don’t know the long term potential but am now reluctant to continue because I’m afraid of contracting if I haven’t already.

How high is the risk that I now have contracted Herpes through the sexual contact we’ve had?

Am I at risk of contracting from her from kissing, bare skin contact, or hand contact?

Am I at risk of contracting from her performing oral sex on me?

Does testing determine the existence of herpes as well as type ( oral, genital HSV-1 or 2)?

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Terri Warren, RN, Nurse Practitioner
96 months ago
Good morning.  First, I am very curious about how she was diagnosed with herpes.  You mention it was in conjunction with a diagnosis of early cervical cancer - you are sure she doesn't have HPV rather than HSV?  Second, if she does actually have herpes, I am wondering if she has HSV 1 or HSV 2?  One or two outbreaks in nine years sounds way more like HSV 1, the common cold sore virus.  If she was my patient, I would very likely recommend more testing unless her diagnosis was made from a swab test of a lesion and was typed as well. 

Assuming for a moment that she has HSV 2 genital herpes, I'll answer your questions now.

I think your risk is very low from two protected intercourse contacts.  Especially with no outbreaks present.
You are not at risk of contracting it from her through kissing, bare skin contact or hand contact.  I'm not sure I know what you mean by bare skin contact but I'm assuming you aren't talking about sexual contact.

If she only has genital herpes, you will not get it through her giving you oral sex.

Yes, testing can determine type but not location, although at least 95% of HSV 2 is considered to be genital.

Terri
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96 months ago
Thank you for the quick response. I should clarify that what i meant by bare skin and hand contact. I mean sexual contact (foreplay) outside of protected sex. This may be a stupid question but I'm assuming that I can contract from her if i give her oral sex. I'm really confused about the HSV1 and 2. I thought that there's a HSV1 and 2 oral herpes and genital herpes with HSV2 being more severe and frequent outbreaks. Considering 50% of people have oral herpes, if someone is tested positive for HSV1 with no symptoms, how do you know if it is oral or genital and whether that should be disclosed to sexual partners? Can you clarify “shedding”? Apparently this is when the virus may be on the surface of the skin, but there are no symptoms and Herpes can be passed through contact during this time. Skin being genital area only? Is this the only time that someone with no symptoms or outbreaks can transmit Herpes? This is a very overwhelming situation. I want to get tested but it sounds like the test wouldn’t be conclusive for several months
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Terri Warren, RN, Nurse Practitioner
96 months ago
You didn't answer any of my questions about your par503-295-6480tner's situation and diagnosis so I'll just answer your questions as though she really does have HSV 2, which I don't know now.
If you give her oral sex and she has HSV 2 genitally, there is a very small risk you could acquire this orally - very small.  It would look like a cold sore.  HSV 1 can be oral or genital - HSV 2 95% of the time is at least genital.  If someone tests positive for HSV 1, with no history of cold sores, and they have received oral sex in their lifetime, the HSV 1 infection could be oral or genital - no way to know unless a lesion appears that can be swab tested.  Shedding is the giving off of virus from the skin - that can happen with or without lesions.  Yes, shedding happens genitally or anally - not from normal skin like belly, thighs, buttocks. 

It wouldn't hurt to get tested now to determine your baseline situation.  If you are infected and don't know it, then it may still well show up on the antibody test.  But without knowing her type or how she was diagnosed, this might not be of much help to you in terms of whether it is risky for her to have sex with you or vice versa. 

I would put forth here that you need more information to know how to proceed here - about both of your true HSV status

Terri
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96 months ago
She doesn't know which HSV she has. Seems like she said that blood tests didn't show it though. I'm not 100% clear on how she was diagnosed so I'll have to ask more questions. Sounds like we should both go have a test done especially since it was over 10 years ago for her. I'll plan to get tested and ask her to as well.  You answered my questions assuming that she has HSV2 but that seems to imply that HSV1 has less risk of transmitting. I'll take the same precaution either way, but my last question is:
Is there less risk of transmitting HSV1 to me if that's what she has or does that only describe the severity? Thanks for you help.
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Terri Warren, RN, Nurse Practitioner
96 months ago
Yes, there is less risk of transmitting HSV 1.  It shed quite a bit less often from the genital tract than HSV 2. 
Good that you will be both tested.  You will only want IgG test - absolutely No IgM testing!  The other thing is that the HSV 1 IgG test misses about 30% of infections, so just keep that in mind when you get the results.  If you need to check back with me here to help understand results, I will be happy to help you both

Terri
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