[Question #1919] still concerned

47 months ago
I asked Dr Hunter earlier that I got diagnosed with genital herpes 2 on the base of the penis where my lesions healed after the primary infection and it is in the place where condoms do not cover the area.. he told me that the chances of getting HIV if I get exposed to HIV in the future even if I used condoms consistently and correctly would be "Rare".. he said there is no need for an active outbreak for making it easier for hiv to enter ur body and that even healed lesions makes it twice likely for hiv to infect a person with a previous history of genital herpes and the same thing was stated in a research conducted by the CDC .. my primary concern is that since the area which is not covered by condoms gets exposed to vaginal fluids I may end up getting HIV even if I used condoms correctly and consistently without even braking it.. he said condoms are good way to protect you but it's not 100 percent .. but Dr Robert francisco had said that hiv cannot penetrate intact condom no way no how .. the only reason docs say it's not 100 percent is because people use it improperly or it breaks .. so my question is if I have sex with someone whose HIV status I don't know but I do use condoms correctly ensuring it doesn't break then should I worry .. ? has there been any documented case where a person got hiv even after using condoms correctly since the infected area isn't covered with condoms and the hiv infected vaginal fluids came into contact with the area ? should I get potential partners tested always before having sex ? what if the person is in the window period? how can u be 100 percent sure ? lastly I'm sexually active so is it a good idea to take hpv vaccine to ascertain that I don't get genital warts on my penis in the future ? im terrified at the idea of having sex since I got diagnosed .. I don't want to end up getting HIV just because my infected area is in the place where condoms do not reach.. I just wanna be happy like other people and feel safe everytime I use 
47 months ago
everytime I use condoms .. i know that during outbreaks u shouldn't have sex and the sores bleed easily making it easier for hiv to get in but do I worry even if the lesions have healed and I use condoms always ? and when can we expect a vaccine for herpes ? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
47 months ago
Welcome back. Bur frankly, most of your current questions were answered, directly or indirectly, in our previous discussion a few days ago. But I'll do my best to help again.

As for condoms not covering the area of your herpes:  If you're not having an active outbreak in that location, it doesn't matter if infected vaginal fluids come in contact with that area. As I said last time, the elevated risk from HSV2 is not because of having outbreaks. But I also said that the elevated risk isn't very high. 

It is true that HIV cannot penetrate intact latex. If you use condoms, you will be well protected against HIV, regardless of your herpes. 

Probably you will never have 100% certainty that a potential partner doesn't have HIV or other STDs. But I do not recommend that you ask partners to be tested before having sex. But if you choose your partners sensibly (e.g. no low cost, street walker sex workers and others at obviously highest risk) and use condoms consistently, you will be well protected and probably will never catch HIV. Your herpes really doesn't make much difference in this. But if you want 100% assurance of no exposure to HIV or other STDs, you're going to have to stop having sex unless and until you are in a committed, mutually monogamous partnership.

In our previous discusison, I gave you the reasons your herpes does not seriously increase your risk of getting HIV. Please re-read that discussion. Then let me know if anything still isn't clear.

HHH, MD
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47 months ago
thank u for easing off my mind .. what about hpv can I get vaccinated for hpv by gardasil so that I don't get genital warts on my penis.. and if genital herpes is so common why is everyone so concerned about it ? when can we expect a cure for herpes ? if I avoid sex when I'm experiencing prodormal symptoms can I avoid transmission ? and what about hpv how do I protect myself from hpv?? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
HPV:  If you are under age 26, you meet standard criteria for HPV immunization. After age 26, new infections are less common and vaccination isn't recommended. If vaccinated, it would protect you against 9 of the most common HPV types, including the 2 types that cause most genital warts and 7 others that cause 90% of HPV related cancers.

Herpes:  The reasons for herpes stigma and fears are complicated. But the single most common reason for concern is the need of infected persons to inform all partners before they have sex, which you also need to always do. Avoiding sex during prodrome or outbreaks prevents some transmission but not all. It is often transmitted without symptoms, which is why you need to inform partners. And also use condoms.

Apart from vaccination, there's not much you can do to avoid HPV. Condoms aren't very effective, because of skin contact above the condom. However, most HPV infections never cause symptoms and are harmless, so generally should not be a serious worry.

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46 months ago
the CDC research which I read said there needs to be no active sores for hiv to enter your body if you have successfully treated ur genital herpes so that is the reason I was concerned about the infected fluids coming in contact with the area which isn't covered by the condoms.. has there been a documented case like this where a person got hiv inspite of using condoms just becuase his infected area which is healed came in contact with the vaginal fluid which was infected by hiv .. next time if I have sex with someone with condoms I just want my piece of mind that the condom would protect me .. the elevated risk from genital herpes makes me worried and I get concerned as to what if the base of my penis where I get sores comes in contact with the vagina and I may get infected with hiv inspite of using condoms 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
As I said above, it does not matter if vaginal secretions contact the area where you had your herpes outbreak. The mechanism of infection in people with HSV2 is not contact with an area of former sores. Probably it is because people with HSV2 often have invisible (microscopic) breaks in the skin or mucous membranes in the genital area, but not necessarily in the same spot of the initial outbreak. (Recurrrent herpes, and asymptomatic viral shedding with microscopic outbreaks, can occur anywhere in the "boxer shorts" area -- buttocks, lower abdomen, upper thighs, etc.) But no matter where it might happen, I already explained why your chance of catching HIV is only slightly higher because of your HSV2. Please carefully re-read my replies in your first thread. If you choose your partner's wisely and consistently use condoms, you will remain at nearly zero risk for HIV.

That concludes the two follow-ups included with each thread and so ends this discussion. Please note that the forum does not permit repeated questions on the same topic or exposure, especially when the questions are driven by anxiety or when there is apparently difficulty in believing or accepting advice already given. This will have to be your last one; future questions on this topic will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce the temptation to keep paying for questions with obvious answers; because experience shows that continued answers tend to prolong users’ anxieties, when professional counseling often would be a better approach; and because repeat or anxiety driven questions have little educational value for other users, one of the forum’s main purposes. Thank you for your understanding.

Best wishes and stay safe. And do your best not to worry so much about herpes. The main effect on your life is NOT elevated risk for HIV. It is your ethical obligation to tell each and every partner about your herpes, even if you intend to consistently use condoms. If you have questions about that, and not about herpes and HIV risk, you would be welcome to ask another forum question, which would be answered by Terri Warren, our herpes expert.

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