[Question #7321] HSV 1

4 months ago
I am a 50 year old male and am concerned about  contracting HSV1 from my girl friend.  A year ago we both sent in blood and urine samples to a lab.  My results came back STD free and her urine test indicated that she had genital HSV1.  She has never had  oral HSV1 but I have had cold sores and the Shingles a few times in my life. 
We have always used condoms for vaginal and 
anal sex but not while I receive oral sex.  I don’t perform oral on her.  We tested again a few months ago but this time we had the hsv1 and 2 blood test.  Her results confirmed that she has hsv1 but mine were negative for hsv1 (even though I have had cold sores).
Twelve days ago we had protected vaginal intercourse.  The condom never covers the whole shaft and her vagina secretions touch my unprotected penis base and testicles.  Afterwards, she was performing unprotected oral sex on me and scratched my shaft.  The scratch broke the skin but didn’t bleed much.  She had touched her vagina a few minutes before and was sucking my shaft and stroking it with her hands.  After 12 days I have no noticeable symptoms.  
How much risk do I have by having protected sex with an hsv1 positive partner.  And how likely is it that I could contract hsv1 on the scratch on my penis?  What is the probability that I transmit HSV1 by having unprotected sex on a female that is HSV free?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
4 months ago
No urine test or blood test could determine if an HSV 1 infection is oral or genital.  If she has had cold sores ever in her life then that is where her infection is and it is unlikely that she would also have it as a new infection somewhere else.  Shingles is a very rarely recurring condition so I don't think I understand why she would have recurring shingles.  The best test to know if she or you is infected with HSV 1 and/or HSV 2 is an IgG antibody test, and you've both had that test.  The problem is that that test misses 30% of HSV 1 infections, compared to the gold standard western blot.  That is a third of infections!  If you have had cold sores ever in the past, I would trust that history over the results of the IgG test for HSV 1.  If you also have HSV 1 and so does she, I wouldn't worry about contracting it genitally from her at all.  The scratch is zero concern.  Let me know what other thoughts you have about this. 

Terri
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4 months ago
Thank you, and I do have a follow up question. 
I think you misunderstood my statement regarding Shingles. I have had recurring shingles before and wanted to know if it effects my risk for acquiring genital HSV1. 

We were both tested twice for hsv1 using the IgG procedure.  If I have had cold sores but tested negative for hsv1 (once through blood and once through urine) and she has tested positive twice for hsv1 and had multiple genital hsv1 outbreaks, should we continue to use condoms for vaginal or anal intercourse?  I am concerned about the risk of me getting genital  hsv1 if maybe what I had on my mouth was actually something different than oral hsv1.  If that were the case should I be safe and wear a condom knowing that she definitely has genital hsv1 and I might not have ever had HSV?  Also, can you recommend a home testing HSV kit that use Western Blot?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
4 months ago
I didn't misunderstand.  Shingles only recurs once in 4% of people who have it once, much less more than once.  Where are your shingles recurrences?
The IgG test misses 30% of HSV 1 infections so your negative, in the face of cold sores, cannot be trusted.
There is no home test for western blot. 

Terri
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