[Question #7162] HSV-2 Transmission Methods

6 months ago
My girlfriend of two years is positive for HSV-2. She takes 500mg of Valacyclovir on a daily basis, and we don't engage in any sexual activity if she is having a breakout (she's had two in the two years that I've known her).  Since July 2019, we have not engaged in intercourse (vaginal or oral). I was tested for HSV (combined) in late August 2019 (7 weeks following protected intercourse at that time) and was negative (I had taken a test a year prior and was also negative). Since that time, we've engaged in mutual masturbation, always washing hands and never touching any other body apart after engaging in the act nor does she touch herself and subsequently touch me). In July 2020, I tested for HSV (combined test) and it came back positive with igm+ (1.7)/igg-.  My Dr. explained that this was due to a recent infection (within ~30 days), which was confusing given we were separated for 10 days prior to the test and did not have any sexual contact (other than kissing) for several weeks prior to that (she was having an outbreak).  I have never had a cold sore anywhere,  I have never seen any blisters on my fingers, and I've never seen (nor has she had) a cold sore  if she does have HSV-2 orally. 

1.  What are the risks associated with mutual masturbation?  I understand the risk to be low, and while we did not engage in any activity during the breakout, could I have become infected from mutual masturbation just prior to the breakout?
2. How long should I wait to be re-tested to confirm the igg to be positive?


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
6 months ago
1.  Mutual masturbation does not hold any risk, you were fine there.
2.  The CDC says NEVER to do an IgM test as they have many false positives.  It's so unfortunate that that testing was done, whether you ordered it yourself or it was ordered for you.  Given all the precautions you take, I think this is almost certainly a false positive IgM result. 
If you use a condom with intercourse and she takes daily valacyclovir, the risk of you getting HSV 2 is incredibly small!

Terri
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6 months ago
Thanks, Terri - appreciate your quick response.

As a follow-up to your response on question #1, would it then not be possible for the virus to infect the finger through a cut or abrasion on the finger?

To clarify #2, would you recommend a repeat of the igg test to confirm whether the igm was a false positive? If so, how long should I wait?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
6 months ago
If there is a break in the skin of a finger and that finger is used for masturbation of an infected partner, then yes, conceptually, that is possible
If the IgG is not positive within 12 weeks of  a sexual contact with an infected person, that's as good as it is going to get.

Terri
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6 months ago
Thanks, Terri.  Last question. 

One area I did not correctly explain - when I am referring to mutual masturbation, what I meant was more so reciprocal masturbation (i.e., we stimulate each other). It appears that based on your last response, it is very well possible my positive igm could have been in response to those sexual acts (i.e., abrasion on finger could transmit the virus), correct? If transmitted this way, do I avoid contact with my eyes/other body parts? When I retest should I only retest for igg and opt out of igm (my Dr. did order these)?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
6 months ago
I knew what you were talking about.  I think it is extremely unlikely that the IgM result reflects a new infection on your finger.  I think you may have misunderstood my response.  The risk would be to you if you had a break in your finger skin.   Not her finger.  If she has a break in the skin of her finger, that is no risk at all.  Herpes is not in the bloodstream.  And if you acquired HSV 2 on your finger, you would have symptoms of redness, blistering, and pain in the finger.  Is that the case with you?  If yes, you didn't mention that.  And if that is the case, then yes, you should avoid your eyes, of course.  But if you don't have these symptoms, you don't need to worry about your eyes.  The IgM should never have been done.  I hope that when you retest, you should do only IgG testing.

Terri
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