[Question #6101] Oral HSV1 Encounter - Risk of Transmission

18 months ago
Hello, I've never had HSV related symptoms in my life - and I have done 2 Igg tests in the past. One test a year ago, and one test 2 months ago. Both Igg tests were negative for HSV 1 & 2.  So for now, I'm assuming I don't have HSV.

Recently I started dating a girl, and we had protected sex twice - with unprotected oral sex and kissing. I just found out that she gets cold sores twice every year, and she has been having these yearly outbreaks ever since she was a kid. Now obviously, I feel a bit uneasy about this. She could have been shedding when we had our sexual encounters and I have clearly been at risk. 

I heard that there's a 25% chance of HSV1 transmission if they get recurrent cold sores every year. Does it mean there's a 25% chance I have HSV1 now?? That's a big number, so I'm pretty worried.  

1) Judging from your experience, what are the chances that these 2 sexual encounters I had would result in me getting either genital HSV1 or oral HSV1? The kissing and oral sex probably lasted for 5 minutes on each encounter.

2) Even if a person is currently shedding the virus, what are the chances that it would be transmitted to me? Is it 100% of the time? Do you have any numbers of the risk profile involved if they're currently shedding?

3) Hypothetically, if she hasn't had visible cold sores in years, would that be safer? What's the risk of HSV1 transmission if your partner rarely gets cold sores? Does it even matter?

4) In your experience, how many people who are positive for HSV1 actually have outbreaks and display symptoms? I heard that around 70% of HSV1 positive people don't display any symptoms or get cold sores. Is that true?

Thanks for all the help!
18 months ago
One more thing,

5) I think my foreskin was very dry and could've had some cracks/broken skin when we had sex. Would that highly increase the risk of transmission if she was shedding? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
18 months ago
I heard that there's a 25% chance of HSV1 transmission if they get recurrent cold sores every year. Does it mean there's a 25% chance I have HSV1 now?? That's a big number, so I'm pretty worried. 

That statistic is incorrect.  People who get several recurrences per year (I believe the study looked at people having 6 or more recurrences per year) shed virus on about 25% of days. 

1) Judging from your experience, what are the chances that these 2 sexual encounters I had would result in me getting either genital HSV1 or oral HSV1? The kissing and oral sex probably lasted for 5 minutes on each encounter.

First of all, know that the IgG test misses 30% of HSV 1 infections compared to the herpes western blot, the gold standard test.  HSV 1 is the cause of recurrent cold sores.  So it is possible that you are already infected and the test missed it.  Second, 2 encounters are very low risk especially if she had no symptoms at the time.

2) Even if a person is currently shedding the virus, what are the chances that it would be transmitted to me? Is it 100% of the time? Do you have any numbers of the risk profile involved if they're currently shedding?

It is not 100% of the time, not even close!  We do not have the statistics that you are seeking, however.

3) Hypothetically, if she hasn't had visible cold sores in years, would that be safer? What's the risk of HSV1 transmission if your partner rarely gets cold sores? Does it even matter?

People who get recurrent cold sores shed more often than people who are simply HSV 1 positive or have a distant history of symptomatic cold sores.  So yes, the fewer cold sores, the better in terms of transmission

4) In your experience, how many people who are positive for HSV1 actually have outbreaks and display symptoms? I heard that around 70% of HSV1 positive people don't display any symptoms or get cold sores. Is that true?

70% of those infected with HSV 1 do not report symptoms.  So your statistic is correct.

5) I think my foreskin was very dry and could've had some cracks/broken skin when we had sex. Would that highly increase the risk of transmission if she was shedding? 

Yes, breaks in the skin does facilitate transmission.

Terri


---