[Question #6477] PTSD-Risk Assessment Kissing a CSW

16 months ago
Dear EWH,

I find your advice very promising. I would like to ask for your opinion.

This event happened less than 24 hours ago. I was in Budapest and engaged in a sexual encounter with a CSW. She wasnt a street prostitute but comes from nearby region every weekend. The acts performed were kissing and protected fellatio. She was  very keen on hygiene and well being and insist on baths , clean towels, soaps, mouth wash, etc.

I kissed her twice, each for about 30-40 seconds. During kissing, our tongue was involved  but for a brief period. So there was exchange of saliva. 
However, the kiss was not too deep or not for long duration. I didn't see any sore on her lips and seemed very clean ( may be because of her make up). She licked my nipples too, but thats not my concern.

Everything seemed fine. However, after our act some part of her lipstick came out ( obvious after the all the kissing) and I saw a small brown section of her lips. She is a smoker so may be her lips might be darker in shade or like most people, a dry section of the lip. But this makes me worried whether it was a Herpes sore HSV 1. I am getting very panic about the situation and there is a lot of anxiety and I am very scared.

I come from India and have been tested twice for hsv 1+2 igg couple of years ago ,and they were negative.Never has cold sore till date. So I would like to know :

1. Whether it would be a no risk event even if I assume she had oral herpes. Please consider that I dont have one.

2. If it is not a "No risk event" how small or big would the risk considering that we kissed twice.

3. Do you recommend testing? On the note, I trust your judgement more than my anxiety.

4. How many days after the event I can consider myself safe or out of the woods ?

Though I understand you reply will be based on medical background and professional. I would like to know your personal opinion too.

I look forward to your response. 

Thanks!
VD53


16 months ago
Also, I would like to add that after that act, I washed/rinsed my mouth with luke-warm water. 

Also during the kiss , the tongue reached till lips and not made through to the inside.
16 months ago
What adds more to my anxiety is what I have read in the questions on this platform. In some answers it written that Kissing can transmit hsv virus. I am not sure now what scenario does it relates to.

Sorry for repeated texts.
16 months ago
Dear Dr.,

I would request if you can provide your opinion. Though the topic might not seem too urgent, but it is giving serious anxiety.

I look forward to you response.

Thanks
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
16 months ago
Hi, this is Terri and I answer the herpes questions here.  Dr. Hood referred your question to me.  I am assuming that you've had no cold develop since this encounter.  Correct?  Oral herpes does not present as a brown spot, so that's very good news.  And the fellatio is not a risk at all since a condom was used - good job! 

1. Whether it would be a no risk event even if I assume she had oral herpes. Please consider that I dont have one.

I think this is an extremely low risk event.  Your kissing time was limited, brown spots are not how herpes presents itself and you've developed no symptoms, all excellent signs that you did not acquire oral herpes at this event

2. If it is not a "No risk event" how small or big would the risk considering that we kissed twice.

I would say very close to no risk - tiny risk!


3. Do you recommend testing? On the note, I trust your judgement more than my anxiety.

I do NOT recommend testing, no.  If you develop lip sores, I would suggest that you get them swab tested but if no sores, no swab testing and no blood testing is necessary

4. How many days after the event I can consider myself safe or out of the woods ?

If you do not develop sores in the 10 days from the encounter, I think you can stop worrying about this.

Terri Warren
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16 months ago
Dear Terri,

Thank you for responding. Your response gives me some relief. I also would apologise I had been impertinent. But, I hope you understand that it all stems from anxiety.

I did not experience any cold sore after the event. The encounter happened on Saturday mid-day, so it has been 2 days so far. However, I do experience some tingling outside the nostrils and inside throat. I believe this might be because of cold weather and food in Budapest.

What is more bothering me the fact that whether her makeup might have covered her cold sores which I wasn't able to recognize. Although, I carefully observed her face ( specially lips) before the act, but still "what if" bothers my mind. I had never experienced cold sores in my life and even thought of acquiring it frightens me.  So would that be possible that sores can be covered by makeup? And if so, my exposure was very limited?

Also, in many posts it is mentioned that kissing can result into cold sores. I believe that might be the case when a person is exposed on daily or regularly basis, or for long durations, am I right?  I also believe a single encounter, like mine, may not be sufficient to result into anything.

After the fellatio, the girl's saliva, in good quantity, was on my lower abdomen, which she cleaned with tissue, and later I cleaned thoroughly with water. This might be because of lubricant of the condom. I hope this present a no-risk too.

The girl kept good hygiene standards in the apartment she operates, clean rooms etc. She also urges people to have bath and cleaning of all sorts. The only thing is she had limited English skills, and I wasn't able to explain or ask whether she gets cold sores or not, and that what it all adds to panic!

Last, isn't there a vaccine for HSV 1?

Thanks
VD 53
16 months ago
Today, I see a cranker sore developing beneath the gums. Does that add to the risk?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
16 months ago
Have you had canker sores in the past?  If yes, then this is likely nothing different.  I personally don't think that make up is good at all in covering up cold sores.  If you looked at her lips and didn't see anything other than a brown spot, I don't think you should worry.  Kissing is more likely to be a source of transmission if the kissing is repeated more often with a person with cold sores, yes.  I'm not sure why it would freak you out so much to get a cold sore - about half the population is infected with HSV 1 - but clearly this is something that worries you.  The saliva on your abdomen is NOT a concern -the skin of the abdomen is too thick for virus to penetrate, if indeed there was virus present, which we don't know at all.  If you develop sores on your lips, get them evaluated.  But I suspect that you won't.

Terri
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