[Question #1826] Herpes and HIV risk

43 months ago
Hi, I am 27 male living in Sydney
I had protected oral (women performed oral on me with condom on) and protected vaginal intercourse with casual sex worker for very short duration 2-3 minutes in May 2016. Condom did not break. This was first time I had sex and I regret it. I am circumsized. I had multiple HIV tests all came back negative. Latest test was at 8 months post exposure and it was negative. I had herpes igg test too at 8 month mark and it was negative for both hsv1 and hsv 2.  I had no lesions , sores or outbreak so far. Recently  week ago I went to chiropractor becuase of the lower and upper back pain. Chiropractor massaged by lower back and buttocks with hands and also apllied some kind of tiger balm. since then I have itchy buttocks, itchy rectum/Anus and mild pain in the anus.  She (chiro) had no sores or cuts in the hands. She (chiro) did not touch rectum/anus.

My questions are
Did I pick up herpes from this recent exposure assuming chiro has herpes? Can herpes be transmitted from hands?  Am I showing symptoms from first exposure now? How conclusive are HIV and Herpes Igg tests at 7-8 months post exposure?
I want to start new relationship Can I have sex without condom with my partner? I dont want to put my partner in any kind of risk and danger. Do I need to wait for 12 months test for conclusive results? Is it possible for body not to develop detectable HiV and herpes antibodies for 7-8 months post exposure?  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
I can say with a great deal of certainty that you DID NOT acquire herpes from this medical encounter.  You are not showing symptoms of herpes at all, but you may be reacting to some substance that she used for the massage itself.  The negative IgG test for Herpes at 8 months is very accurate indeed - compared to the gold standard western blot the IgG HSV 2 test picks up 95% of infections.  I congratulate you on using condoms for both intercourse and receiving oral sex - this offered you terrific protection against sexually transmitted infections.  You will not put your regular partner at risk of anything from this experience and you most certainly don't need to wait 12 months to test for anything - no testing at all is required in your situation.

Terri
---
43 months ago
Dear Terri

Thank you so much for your response. As I mentioned earlier I am more worried about chiropractor  session I had recently. Becuase since then I have developed itching around anus, buttocks, penis and groin area. Recently developed itching and tingling in and around lips and there are small pimples below the nose  at edge of the upper lip they appeared yesterday. Its been 11 days since chiro session. Becuase of theses symtopms I am very concerned, anxieted and always in fear. If it turns out to be herpes eventually It would be shame. not sure how can I handle.
My questions are

Is it possible that I am showing herpes sysmtoms after 8-9 months of possible exposure with casual sex worker given that my  2 IGG tests one at 5 months and one at 8 months were negative for both hsv 1 and hsv2?  I never had cold sores.

Can I rule out my first exposure if I am diagonised by herpes now?

I would like to have one more IGG test so after how many days do you recommend to take it after chiro session as the possible exposure?

I did ask chiro, she said she does not have herpes, she used hand sanitizer before starting session. She never touched my genitals. 
Her hands may have touched my face and lips during streching and other exercises.

How likely is to transmit herpes from  hands and fingers given no sores?

If those pimples turn out to be cold sores and lesions what swab testing do you recommend for accurate results? Viral culture or PCR?

A quick response is very much appreciated.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
Again, I don't feel that you sexual encounter with the sex worker put you at risk for herpes since you were so careful with condom use.  With 95% certainty, the test would have picked up this infection, if you had it.
I don't not understand the next question.
I'm not clear why you think the chiropractic visit was a potential risk for herpes?  If she used hand sanitizer before the visit, that is adequate to kill the herpes virus is she happened to have it on her hands which would be very unusual in itself. 
Herpes is not shed from fingers and hands like it is from the genital area as it is too thick for the virus to get out.  So it would take sores on the fingers or hands for virus to be present and given to someone else.
PCR is the most accurate test for swabbing lesions.

Terri
---