[Question #6514] HIV - Herpes Situation

16 months ago
Hello Doctor,

Before I got married to my wife in 2008 I went to a massage parlor where the woman licked my rectal area and masturbated my penis with her hand.  2 weeks later I had my first Herpes outbreak in the rectal area.  I have been only with my wife sexually since this unfortunate event, I also do not do any drugs whatsoever. I experience outbreaks quite often (several times a year).  At the time of my first Herpes outbreak I had gotten a swab of the rectal region from my dermatologist which came back with HSV-1.  I have also gotten a blood test std panel which came back for hsv-1, but not for hsv-2.  I have gotten tested for hiv numerous times, all being negative.  I’ve also gotten std panels which revealed all negative except for hsv-1.  From my understanding it seems unlikely that my rectal Herpes is due to hsv-1, due to the frequency of the outbreaks and the the licking of the anal region by the massage woman.  This really concerns me as I know that rectal Herpes really increases your risk of getting HIV.  If my rectal Herpes is from hsv-2, how do I prevent getting Hiv?  I am extremely worried about sitting down, wiping the rectal area, and fear getting hiv as a result of my frequent rectal Herpes outbreaks.  If my rectal Herpes is due to hsv-2 how do I prevent/avoid getting hiv?  How is hiv transmitted?  Is hiv transmitted the same way whether or not you have rectal herpes?  I want to avoid hiv despite having rectal Herpes, what can I do to assure I never get HIV?  Is the precautions needed to be taken different if you have rectal hsv-1 or if you have hsv-2 in order to avoid HIV?  My rectal Herpes must be due to hsv-2, what are the prevention measures I need to take in order to not get hiv?  Should I worry about sitting in the same car seat, chair, toilet seat, wiping with toilet paper, going in a pool, as a way to get HIV due to my rectal Herpes?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
16 months ago
I think that all of this fits VERY well with HSV 1 genital (rectal) infection, except the frequent recurrences.  The licking of the rectum suggests that the person doing the licking had HSV 1 oral infection and passed it to your rectum.  Your swab test was positive for HSV 1 as well, which fits perfectly with how it came to be there.  I would strongly disagree that your rectal herpes is HSV 2, given the positive swab test for HSV 1 and your negative IgG for HSV 2.  When you say that you have frequent recurrences, have you had those swab tested to confirm that they actually are outbreaks?  Sometimes people get mixed up about what are outbreaks and what are symptoms due to other causes, especially in the rectal area.
HIV is a sexually transmitted infection.  If you are only having sex currently with your wife and she is HIV negative, then HIV is not a worry for you.  You should definitely NOT worry about the non-sexual events that you list to get HIV. I hope this is reassuring to you.

Terri
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