[Question #2000] Oral Risk

48 months ago
Hello,

I've read on the site that oral sex is generally considered safe sex. However, I still feel the need to ask my own question for some reassurance.

5 days ago, I made a stupid mistake and hooked up with a woman I met while I was out. We made out, sucked on her nipples and she gave me about 10 seconds deep oral, along with putting her mouth on the tip of my penis while I ejaculated.

I am fairly certain that I am not at risk for HIV. My concern is HSV-1. My parents and sister both get cold sores - I never have, but must have certainly been exposed to it at some point in my life. If I have been exposed, my understanding is that you cannot have HSV-1 both orally and genitally, is this correct? If I have not been exposed to it, what would my chances of receiving HSV-1 genitally be?

I have not and will not be in touch with person again. I do have a girlfriend,s o the anxiety and guilt are running deep. I'm hyper-focused on what I'm feeling in my groin area and it seems like there always something going on (feels sensitive, pressure, an occasional sting, etc). I'm assuming this is associated with the guilt and probably nothing. My girlfriend was already a little confused as to why I did not want to have sex weekend. In your opinion, was this exposure little risk enough to continue my normal sexual routine (unprotected with girlfriend)? It probably does not exist, but is there any data that shows the risk of receiving HSV-1 orally (1-100, 1-1000)?

Thanks for your help.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
It is correct that if you are infected orally, the risk of subsequently getting HSV 1 is extremely low. 
We don't have any statistics on the risk of transmission for HSV 1 with oral sex, so I can't give you a good scientific answer.  However, we know, for example, if a female infected with HSV 2 has sex 100 times in a year with a male who is not infected with HSV 2, there is only about a 4% chance that he will acquire HSV 2 in a long term relationship.  And we know that HSV 2 genitally is shed quite often - probably 15% of days sampled.  So you can see the risk is not as high as you might think.  So that's intercourse.  You only had a few seconds of receiving oral sex from someone who did not demonstrate a cold sore at the time (that would be higher risk than just receiving oral sex from someone who was infected with HSV 1 but didn't show a cold sore).  the average time from infection to symptoms is about 2-10 days, so you are about half way there through the waiting period. You are waiting for sores, not pressure or sensitivity).  I think your risk of contracting herpes in this situation is very low indeed, but if you were my patient, I would ask you to get a baseline HSV 1 test to see if you are already positive for HSV 1 so you wouldn't need to worry.  What do you think?

Terri
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48 months ago
Hey Terri,

Thanks for your response.

I can live with you saying that the risk is very low. So, you would suggest the baseline only for reassurance and not because you think I have been infected? I feel like it is rare based on the idea that X amount of people engage in oral with sex with people who are positive HSV-1 and infection is not something that's commonly heard about. 

Would kissing prior to oral make any difference? Would I first be infected in my mouth, so not in my penis (sounds like a stupid question even as I write it)?

Do I wait another 5 days before continuing sex with my girlfriend? We live together and have an active sex life. I've read that Dr. Handsfield would not worry in situations similar to mine, but my anxiety is basically going through the roof and I am trying to get back to some sort of normalcy. I am on medication for anxiety (4 years) and this has definitely been an event which has brought it all back.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
Yes, I suggest the baseline because if you see that you are already infected with HSV 1, you will be less worried that could have contracted this genitally.  It's possible that you could have been orally infected with kissing - another reason I would wait another 5 days before continuing sex with your regular partner.  Again, I think the chances of your being infected at this encounter are very low indeed but I'm cautious, I suppose, and would prefer to see you wait a little longer before resuming sex with your partner.  Your call of course.  Probably me just being overly conservative.

Terri
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48 months ago
Makes sense.

Final follow up - Am I overrating my risk here? The anxiety about this has been effecting sleep and work performance. I know that it is something that I should be concerned about, but is the risk so low that it doesn't need to be taking over my life? I know that something that isn't life threatening should not do this, but the guilt and anxiety really have me concerned about my health and relationship status. 

Thanks for all your help. I really appreciate it and hope that in another 5 days, I'll feel a bit better.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
Yes, the risk is very low and I believe you are overreacting a bit, please don't be offended by that.  This definitely should not take over your life!  My guess is that you won't have any symptoms within the next five days and that you will feel comfortable resuming sex with your regular partner.  Sorry this has been such a rough experience for you - I don't know about you, but I've always learned my most important lessons from mistakes I've made and times I've felt really distressed. 
Terri
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