[Question #5309] Oral HSV1 Transmission

22 months ago
I have a quick follow-up on Question 5103 regarding transmission of oral HSV1. As I understand from the response,  it is very unlikely that a very quick kiss on the lips/cheek can transmit HSV1 (low chance) and oral HSV1 can also be transmitted by sharing utensils etc again with a low chance. However, as I understand since oral HSV1 is pretty common, one could get infected at some time. My questions then are:

(a) How exactly is Oral HSV1 transmitted -- Does it require extended contact with mucous membranes generally. For example, can someone with  oral HSV1 kiss their partner or should they avoid kissing? Is kissing  on cheeks and other body parts (not mucous membranes) safe?

(b) Assuming absolutely no symptoms, is it recommended to get tests for HSV-1 done on a regular basis (for eg yearly) since one can get oral HSV-1 from non-sexual contact as well? Also assume one is in a strictly monogamous relationship? In such cases (where both partners have no symptoms), is oral sex safe?

(c) If one has oral HSV-1 then how likely is it that they also get HSV1 on their genitals from oral sex? How likely is it to get oral HSV-1 on the genitals?

(d) My belief is that HSV-1 usually does not cause serious symptoms and frequent outbreaks (mostly a inconvenience). This is in contrast to HSV-2 where outbreaks occur far more frequently.  Is that correct? 

Generally, I ask these questions to be sure that I can perform oral sex with my wife  without further worries and stay safe. Thanks!
 
22 months ago
I would greatly appreciate if someone could please take a look at the questions I had. Thanks a ton, once again!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
(a) How exactly is Oral HSV1 transmitted -- Does it require extended contact with mucous membranes generally. For example, can someone with  oral HSV1 kiss their partner or should they avoid kissing? Is kissing  on cheeks and other body parts (not mucous membranes) safe?

If one person is infected and the other is not infected, passionate kissing can transmit the virus to the uninfected person.  Kissing on checks is fine and without concern.

(b) Assuming absolutely no symptoms, is it recommended to get tests for HSV-1 done on a regular basis (for eg yearly) since one can get oral HSV-1 from non-sexual contact as well? Also assume one is in a strictly monogamous relationship? In such cases (where both partners have no symptoms), is oral sex safe?

I'm not sure I understand your question.  If you are infected and your wife is not and you give her oral sex, you can infect her genitally, even without symptoms, correct, if your infection is oral

(c) If one has oral HSV-1 then how likely is it that they also get HSV1 on their genitals from oral sex? How likely is it to get oral HSV-1 on the genitals?

If the person has oral HSV 1, it is EXTREMELY unlikely they would get it in a new location.  We do not have transmission on data on someone with HSV 1 oral infection giving oral sex to someone who is truly negative.

(d) My belief is that HSV-1 usually does not cause serious symptoms and frequent outbreaks (mostly a inconvenience). This is in contrast to HSV-2 where outbreaks occur far more frequently.  Is that correct?

New HSV 1 infection can be just as dramatic and uncomfortable as HSV 2 but it does recur far less frequently in the genital area.  That is correct.

Terri
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21 months ago
Thanks for the clarification!
1) This is regarding question (b): I have no idea whether I have oral HSV-1 and same with my partner. We will be in a strictly monogamous relationship and have had no previous sexual partners. Since HSV-1 can be potentially accquired through non-sexual contact (via shared utensils) I am asking if medical practitioners recommend regular testing for HSV-1 on a yearly basis. I assume that unless there is high risk sexual behavior or one of the partners is known to have HSV-1 or shows symptoms, testing is not recommended, but please can you confirm. For the record, both of us have no symptoms of HSV-1 at all. I am sure I don't have HSV1/2 on the genitals. 

I just want to ensure that I understood Dr. Huntsfield's answer for question 5103 (where he recommends no testing for HSV-1(for eg. lap dance where one is fully clothed is a very low risk scenario -- I gather) unless it is high risk scenario or one of the partners shows symptoms of Herpes (HSV-1/2) and hence the above question.  Thanks a ton!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
1) This is regarding question (b): I have no idea whether I have oral HSV-1 and same with my partner. We will be in a strictly monogamous relationship and have had no previous sexual partners. Since HSV-1 can be potentially accquired through non-sexual contact (via shared utensils) I am asking if medical practitioners recommend regular testing for HSV-1 on a yearly basis. I assume that unless there is high risk sexual behavior or one of the partners is known to have HSV-1 or shows symptoms, testing is not recommended, but please can you confirm. For the record, both of us have no symptoms of HSV-1 at all. I am sure I don't have HSV1/2 on the genitals. 

Providers do not recommend testing on any regular basis and all of us would dispute getting herpes from shared utensils.

I just want to ensure that I understood Dr. Huntsfield's answer for question 5103 (where he recommends no testing for HSV-1(for eg. lap dance where one is fully clothed is a very low risk scenario -- I gather) unless it is high risk scenario or one of the partners shows symptoms of Herpes (HSV-1/2) and hence the above question.  Thanks a ton!

I would totally agree with Dr. Handsfield on this one

Terri
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21 months ago
Thanks a ton for the clarification! This information was super-useful! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
I'm glad

Terri
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