[Question #6621] Genital herpes type 1

12 months ago
Hello,
Brief history: The past 3 months I have been exclusively dating a new guy, now my boyfriend (no condoms). About 6 months ago I had a few sexual encounters (oral/genital sex) with another partner (used condoms). Then about a year before that I got out of a year long relationship. So two weeks ago I noticed a semi painful bump on my vagina, and I went to my doctor the next day and had culture taken as well as my blood drawn. I discussed the std possibility with my boyfriend whom has never had symptoms of herpes, and we talked about how to prevent transmission to him. The culture came back positive for HSV1, and my blood tests came back negative for both. After doing a little research (and hoping it could have been a false positive) I came to the conclusion it was most likely a new infection, therefore from my current partner. My doctor messaged me and gave me the same conclusion. I’ve talked to my boyfriend about this and I know he has not been with anyone since we have been dating. My heavy spotting from my new IUD has made it where my boyfriend has only performed oral sex on me twice, the last time at least 1.5 months ago. Therefore I don’t believe he has oral hsv. I read it’s harder to transfer hsv1 genital to genital? Maybe it doesn’t matter where has it or how I caught it. At this time, my main concern is somehow catching oral hsv1 now, and that is my partners concern. If we both have genital HSV1 how likely is it that we acquire oral as well through oral sex? Also, especially if you agree I most likely acquired this from him, there really would be no point of suppressive therapy? 
Side note- I’m shocked that my HSV1 blood test was negative at all as my dad and sister have oral and I was never cautious with sharing things with them.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
Let's step back for a moment.  I think you should trust the positive swab test from the lesion.  However, the IgG test (and I'm hoping that was the test that was done - not IgM) misses 30% of HSV 1 infections.  It could also be negative because you have new infection, as you suspected.  But you are correct that HSV 1 is rarely transmitted via intercourse (not impossible but very unlikely).  And if the last time you received oral sex was 1.5 months ago and you had a single bump, I suspect that this infection may not be new.  We know it isn't brand new as the time from infection to presentation of symptoms with a new infection is 2-10 days.  So it could still have come from your current partner but without him doing an IgG test, knowing that is misses 30% of HSV 1 infections, we can't know much.  I would suggest that he do that test, to try to find out of he has HSV 1.  If you both have HSV 1 infection, it is extremely unlikely that either of you will get an outbreak in a new location on your body - you orally and him, who knows where for sure, but likely orally.  The best antibody test for HSV is the herpes western blot which is available only from the University of Washington, if you wanted to pursue that.  Please let me know what other questions you may have.

Terri
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