I would say that there is no way we can have an accurate number like that.  The risk is higher in a new relationship, lower in a long-term relationship, whether medication is taken and for how long, whether condoms are used, and for how long, so many factors!  However, as Dr. Handsfield pointed out, this number comes from a study where we looked at valacyclovir to reduce transmission of herpes in discordant couples - that is, one person had herpes and the other did not. One group had the infected person take valacyclovir daily and the other group infected person took a sugar pill. The reason I don't think we can extrapolate that completely to all couples is that these couples had already been having sex for a while prior to entering the study and we know that most transmission of herpes happens in the first three months of a relationship. There are reasons for that - new couples have sex more and the uninfected person has not been exposed to the virus before and has not mounted any sort of reaction that could be potentially protective.

If you gave someone oral sex, the risk would be low because you are correct, HSV 2 has a strong preference for living in the genital area.  So if you were the giver of oral sex to a female, as I think I am reading correctly, the risk if probably no different than a woman giving a male oral sex.  The difference in risk applies to intercourse where females are more vulnerable to herpes acquisition than males are. 

it is possible to have HSV 1 and 2 orally though that would be rare indeed.  In addition to HSV 2 not liking the oral area, the HSV 1 oral infection MAY provide some local immune response that reduces the risk.

Terri

The sperm isn't really the risk - the risk is the skin of the penis. 

So if I understand this correctly, you gave oral sex to someone back in May and are wondering if this presents enough of a risk to get an antibody test.  I personally don't think so.  Have you ever had a herpes antibody test in the past?

Terri

To follow-up what would you think is a conservative risk assessment is if one person has genital  herpes and receives oral from someone that does not. No condom or meds. 

Secondly, in most cases when would you usually see symptoms? I have read 3-20 days with most cases being 10 days if you are to have symptoms?

HSV 2 really doesn't like the oral area and so I think the risk here is quite low.  It isn't zero, but it is low.  If someone were to acquire HSV 2 by giving oral sex to someone who has HSV 2, the symptoms would be oral, not genital.  Does that make sense?  And the timing would usually be 2-10 days.  Perhaps a little longer in some cases, and it would look just like a cold sore.

Terri