[Question #1848] Herpes risk from a lesbian threesome and disclosure duty to future partners

44 months ago

Hi Terri.  Recently I’ve had two threesome experiences that I enjoyed immensely, but they’ve left me with some mildly uneasy feelings.  One of my partners is positive for genital herpes; she manages it by taking daily antivirals to suppress outbreaks and asymptomatic shedding, and her wife of 3 years remains uninfected.  I made sure we were careful of cleaning toys between use and applying condoms, and making sure there was minimal/no genital-to-genital contact between me and the infected partner.  This second visit I did give her unprotected oral sex, and during both experiences there was undoubtedly transfer of fluids from fingers/mouths among all of us (still concerned about this, although I do understand that it is spread by skin-to-skin contact). 

At this point (3 weeks since first experience and 4 days since most recent experience), I have shown no physical symptoms, other than anxiety-induced overthinking of random itches.  I plan on visiting a clinic early next week to get a baseline IgG test.  This was my first (known) exposure to an STD and so I want to suss out what my risk of contracting the virus is from lesbian threesome activities, and what kind of disclosure of this potential risk I owe to future partners before kissing, oral sex, and genital/genital contact ensues.  Thanks for your help, Terri!   

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
Good morning,
I think you did all the right things during these sexual encounters.  Good job!
It sounds like the only mildly risky thing you did was to give the person with herpes oral sex.  HSV 2 doesn't like the mouth very much at all and infection there is unlikely though not impossible.  But the odds of getting herpes in this situation is low also because she is on daily antiviral therapy and also because it was a single incident, so statistically, transmission is unlikely - the more contact, the greater risk of transmission. 
At the moment aside from getting a baseline IgG test, the only thing to do is to observe carefully for any new sores in the oral area and if you develop any, have them swab tested right away, telling the clinician about your concerns.  I would be surprised if anything develops, honestly.  Herpes is not quite as easily transferred as one might think and my impression in this situation is that transmission is unlikely

Terri
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44 months ago
Hi Terri!! Thanks for your detailed response and efforts to ease my mind! Pardon my slow response, I wanted to wait and see how things went. It's reassuring that the most mildy risky activity was unprotected oral - 12 days since my most recent exposure no symptoms on my face are apparent. I went to a clinic and submitted blood sample for the IgG type specific, so I should know my baseline in a few days. 

In the meantime, I have developed redness on vulva/ inner lips, with some itching but mostly burning/irritation. Seems to extend in my vagina also. But No blisters or sores yet. I've never had a yeast infection, so I don't know what to expect and I've heard women often conflate early symptoms of that and genital herpes. I dont seem to have any of the other flu-like symptoms.

These symptoms follow on the heels of my latest period. It's been an unusual week and I'm hoping it's just a perfect storm of sitting in beer soaked pants for a few hours, eating a lot of carbs last weekend (I follow the low carb high fat diet pretty consistently), moist panties from being perpetually excited this week, and using a diva cup that I prahhhbably should have boiled first since it smelt kinda funky. 

What do I do moving forward and do you think I'm overreacting yet again? Treat for a year infection or just wait for blisters/sores. I thought I was good to go until this happened within the last two days, and I don't ever have these symptoms! Thanks for your help!! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
You could try an over the counter yeast medicine and see if it is helpful for you at all.  If you do notice any blisters or sore, please have them swab tested right away, preferrably using PCR, the most sensitive swab test we have right now.  I really doubt, given the experiences that you described, that you have herpes but best to keep an eye out.  And I doubt that new symptoms would appear 12 days after the exposure.  For now, just be mildly watchful and perhaps use the OTC yeast medication.  And try to not run around with beer soaked pants.

Terri
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43 months ago
Hi Terri!

Good news - my pants have remained beer-free and I have recovered from my bacterial infection.  My results from the type specific IgG came back, and I am testing negative for HSV Type 2 at this point, but will retest in several months just to be sure.  However, I was diagnosed as positive for Type 1.  Regardless of never having noticed anything resembling a cold sore, I'm not surprised given that 80% of people have it. 

During a pretty bad common cold/upper respiratory illness, my new lady has developed a cold sore on her upper lip.  I'm hoping I didn't infect her, but there's no way of knowing unless she gets the IgG test as well.  My last and final follow-up question is what are the chances of getting genital HSV Type 1 from oral sex with her symptomatic/asymptomatic?  I have read research that states both oral and genital infections of the HSV 1 are highly unlikely, and antibodies are antibodies regardless of exposure site.  Are my chances greater or less since I have never (to my knowledge) have any cold sores but am apparently infected with HSV Type 1?  Should I abstain from oral sex while her sore is healing, even if I have antibodies to the virus? 

Thanks for all your advice and anxiety-reducing input!

Beer Pants?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
Glad to hear about the dry pants!
So actually 56% of the US population between 14 and 49 have HSV 1 and 16% have HSV 2 infections.
Looking back over our conversation, you mention that this person has genital herpes, but do we know that it is HSV 2? 
I think it is really difficult to say how often people ACQUIRE HSV 1 at both locations at the same time - oral and genital - I don't think we really know that for sure.  What we do know is that it is highly unlikely that someone would have oral HSV 1 and subsequently acquire HSV 1 genital, or vice versa.  I think that's what you are asking above?  If you both have HSV 1 (the cold sore is almost certainly HSV 1) then either of you getting it in a new location is extremely unlikely.

You are most welcome.

Terri
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