[Question #7741] HSV Question

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53 months ago
My girlfriend and I have unprotected sex.  I recently noticed a red splotch mark above her left buttock (about 4-6inches wide and irregularly shaped).  I asked her what it was and she confessed its herpes but, she said, its the "oral" kind not the genital kind.  She told me she's had it since she was a baby (that she got it from her mother?) and that she takes Valtrex when it flares up - whenever she gets stressed out.  She says I have nothing to worry about but, of course, I'm concerned.  My question is:  Is this possibly true?  I can't make her take a HSV test to determine whether it's type 1 or type 2 but is it much more likely to be type 2 (and she's not being honest with me out of guilt) or could she be telling me the truth?  I'm going to get a test to be sure but if I'm positive, this doesnt prove that I got it from her I would assume.
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Terri Warren, RN, Nurse Practitioner
53 months ago
Hmmmm.  She could mean that she has HSV 1 genitally, but I don't know for sure and I'm not sure how she knows for sure.  Has she refused to get a herpes antibody test to determine the type or do you think she's had one before, a swab test from the lesion?  HSV 1 rarely recurs genitally so if this is recurring very often, I would question that.
All you can really do here is to get your own test and see what if anything you have. 
She could consider taking a daily dose of antiviral medication to help reduce the risk of infecting you, particularly since you don't know what type she has.  And condoms certainly reduce transmission as well.
And yes, if you are positive, it doesn't mean she gave this to you.
Have you ever had a cold sore on your lip or in your nose?  If yes, then you already have HSV 1 infection.
How do you feel about all of this?

Terri
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53 months ago
Thanks Terri.  It's been a difficult time as I now don't really trust her, quite frankly.  I think she may have HSV2.  I believe that she believes (or has convinced herself) that she has HSV1 genitally because HSV1 has less stigma than HSV2 (even though, hers is on her buttocks, not like a cold sore or something).  She says she had a test (years ago) and isn't interested in having another one.   I'm going to get tested later this week.  The fact that she didnt disclose this to me at the start of our relationship is obviously a huge issue.  I may press her to get "another" test, however, before I do that, can you help me based on the facts of our situation?  How likely is it that her version of the story is correct?  She has recurring outbreaks - every 3-6 months (once a year, perhaps) and takes valtrex to reduce the severity of the outbreak (but certainly not every day).  How likely is it that this is gential HSV1?  I have never had herpes symptoms and have never had a test for it.  I've had canker sores in my mouth over the years - never even had a real cold sore to my recollection.
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Terri Warren, RN, Nurse Practitioner
53 months ago
That's the problem with not disclosing herpes to a sex partner - trust becomes the bigger issue than the risk of transmission. 
HSV 1 genitally rarely recurs and it sounds to me like this is recurring far more often than the usual HSV 1 genital infection.  And I also don't understand what she means when she says she got genital herpes from her mother.  Buttocks herpes IS genital herpes. 
I don't see any reason to believe that in this case she has HSV 1 but I obviously can't say that for sure.  The average number of outbreaks per year, after the first year of infection, for genital HSV 1 is once every other year, approximately.  She has way more than that.
You can get your own test, but if you were infected recently, you may not get an accurate result at this time.
If she won't get an antibody test, you'll not know what the real situation is and will have to rely on your own testing, perhaps now and repeat in 10-12 weeks.

Terri
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