[Question #4710] HSV1 and Oral Sex

Avatar photo
80 months ago
I received oral sex from a female over the weekend who I know and is confirmed positive HSV1 and HSV2. While I know there are no risks from HSV2 I'm concerned about whether she could have transmitted HSV1 to my genitals. She had no signs of a cold sore and hasn't gotten one in two years. When they do appear, per her, they show up in her nose. She gave me oral sex probably 3 or 4 times, less than a minute each time. It's been 4 days and I haven't seen any symptoms. Was I at high risk here? If I don't see anything for a week would you recommend further HSV1 testing via IGG or should I simply assume I didn't get it? 
Avatar photo
Terri Warren, RN, Nurse Practitioner
80 months ago
You were not at high risk here, you were at minimal risk.  Have you had a negative IgG test in the past to know that you are not infected already with HSV 1?
If you don't have symptoms in 10 days, I think it is extremely unlikely that you became infected from this encounter, correct.

Terri
---
Avatar photo
80 months ago
Previously negative for HSV1 and HSV2.  Any reason to test without symptoms at 10 days?
Avatar photo
Terri Warren, RN, Nurse Practitioner
80 months ago
I don't believe with the encounter that you describe that it is necessary to test for HSV 1 if you have no symptoms at 10 days out, no. 

Terri
---
Avatar photo
80 months ago
It’s been a week and no sores have appeared. I assume if they were to they would be pretty noticeable? At this point would you say I most likely didn’t get infected? 
Avatar photo
Terri Warren, RN, Nurse Practitioner
80 months ago
I would say, yes, you most likely did NOT get infected.

Teri
---
Avatar photo
80 months ago
One last follow up here. I had asked a question in regard to this relationship and brief protected intercourse/further testing. I had unprotected sex with this person back in August. I tested negative for everything a few weeks ago. This was 4.5 weeks after the brief protected intercourse. It was recommended by you to be on the safe side to test again at 8 weeks which I plan on doing. I’ll plan on an igg for HSV1 and 2. This would be 8 weeks past protected vaginal intercourse and 3 weeks past unprotected oral. If I’m negative for both can I safely say I don’t have either strain? I am at 12 days past the oral sex and have seen no sores. I’m ready to put all this behind me. 
Avatar photo
79 months ago
One additional item here. I know you advocate against the use of the IGM test. However I had one performed. My logic was that I pretty much know I don’t have HSV2 at this point and I was negative HSV1 last time I tested. That was right before this oral exposure. I assumed going into it that a positive result only meant cross reaction with another virus (I’ve had shingles before and chicken pox) or at worst maybe I contracted HSV1. The test did come back negative. I understand that there was a large risk for false positive but given that absolutely no antibodies were detected can I safely say I didn’t get HSV1 from the encounter? Again no sores have developed. I still plan on testing finally for HSV1 & 2 via IGG after next week. I’ve decided for myself that any type of contact with this person isn’t worth it and I’d like to move on. If it were someone I wanted to pursue a serious relationship with I wouldn’t let herpes stop me, but as far as casual flings it’s not worth the worry after for me. 
Avatar photo
Terri Warren, RN, Nurse Practitioner
79 months ago
For the record, I didn't suggest that you test from this encounter.  Maybe we discussed testing from another encounter, the earlier ones? 
The thing is, the IgG test misses 30% of HSV 1 infections compared to the western blot.  In my mind, a negative IgG test for HSV 1 is helpful but certainly not definitive. 
And let me add that about 1/2 the population has HSV 1 so moving on from this person due solely to her HSV 1 doesn't make much sense.  If you have difficulty with her HSV 2 that's a different thing.  This is especially true since it does not appear that this is a long term serious relationship for you. 

Terri
---
Avatar photo
79 months ago
The HSV2 is the main concern. I understand the frequency of HSV1. However that was the only real risk from this encounter. If anything this whole experience has taught me I’m more comfortable with sex in a committed relationship. 
Avatar photo
Terri Warren, RN, Nurse Practitioner
79 months ago
The test is pretty darn good for HSV 2 - not perfect but pretty darn good.
I am also in agreement that sex in a committed relationship is way less complicated and much more fun ;-)

Terri
---