[Question #5173] HSV-2, Syphilis

25 months ago
A massage therapist put the tip of my penis in her mouth for a few seconds. I told her to stop. I did let her suck on my testicles for a few minutes. 
What are chances that I got HSV-2 from this encounter? What are the chances of Syphilis infection? And, should I assume I do not have HSV-2 if I see no symptoms (given that I have had an HSV-1 infection on penis)?
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
Welcome to our Forum. I'll be glad to comment.  Although there is a theoretical risk for infection through the brief contact you describe, the true risk of having acquired and STI, and syphilis of HSV-2 are very low.  Factors which all add up to very low risk include:

1. Syphilis is rare and oral syphilis is very, very rare.  When oral syphilis occurs it is more likely to occur among men who have other men as sex partners than in women. At present less than 20% of all syphilis occurs in women.
2.  Oral HSV-2 is very, very rare.  For reasons that are unclear, HSV-2 does not infect the mouth commonly even when exposed.  
3.  Most commercial sex workers such as your therapist do not have STIs.  Even if the therapist has either HSV-2 or syphilis, only a small proportion of direct exposures to infected partners (less than one-third of syphilis contacts, less than 1% of contacts to HSV-2) result in infection.
4.  You already have HSV-1.  Having HSV-1 reduces the risk for acquiring HSV-2 due to the immune response to the HSV-1 infection.
5.  Your encounter was brief.  The shorter the exposure the lower the risk

Bottom line, when you consider all of these factors, the exposure you describe was a close to no risk encounter of HSV-2 or syphilis.  Unless you develop sores or lesions at a site of contact, I see no need for testing. I hope this information is helpful.  EWH
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25 months ago
Thank you. I have had no symptoms. I received oral sex from my partner a few days ago. The partner has developed a cough. Could this be a symptom of HSV2?
Edward W. Hook M.D.
Edward W. Hook M.D.
25 months ago
No.  HSV-2 does not cause cough.  Further and even more importantly, HSV-2 is virtually never acquired from receipt of oral sex.  EWH---
24 months ago
Thanks. One last exchange! Can HSV2 cause a sore throat and fever if contracted orally? And can it be contracted orally through semen (I know contraction itself is rare)?
Edward W. Hook M.D.
Edward W. Hook M.D.
24 months ago
As I mentioned, HSV-2 is almost never acquired from oral contact. If it did and there were symptoms while sore throat and fever might be part of it, they  would be accompanied by oral lesions (ulcerations).

To my knowledge, HSV is not in semen but is acquired through direct oral contact.  

As you know, we provide up to three responses to each clients questions. This is my 3rd response.  Thus this thread will be closed shortly without further responses.  I hope my comments and assurances have been helpful. Take care. EWH
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