Needless to say, we ended up having lots of protected vaginal sex but also unprotected oral sex (given and received). Very stupidly, we had one instance of unprotected vaginal sex that was very short (I was so simultaneously turned-on and anxious that I ejaculated within about 5-10 seconds of entry). I decided to do this because I know from my research that the vast majority of people already have HPV, and that the chances of transmission of herpes from one partner to another in any single sexual encounter is quite low. Still--really stupid of me.

Questions

1) I know this was a high-risk encounter, but what are the typical odds of transmission of HPV in any one sexual encounter? Herpes?

2) It's only been about 5 days, but I have yet to see any symptoms of herpes. Should I get a test or are they too unreliable?

3) If things don't work out with this woman, what should I tell future sex partners? Do I have a burden of disclosure?

Thanks!

1.  Personally I would not consider this a particularly high-risk encounter. Irrespective, as mentioned above, most single exposures do not result in transmission of infection. For HSV, in the absence of lesions, if your partner happened to be infected (unknown), estimates are that your risk for acquiring infection following a single vaginal encounter is less than 1% and perhaps lower than 0.1%.  Similar estimates of risk for transmission of HPV following a single encounter are not available however most experts agree that the risk of acquiring infection following a single exposure is relatively unlikely.  I would have a little concern about acquiring either infection from the exposures that you have described and see little value in testing.

2.  If you were going to develop symptomatic herpes, lesions would typically occur within 8 to 10 days following exposures. As I mentioned I suspect this is unlikely. There is virtually no value to blood testing at this time and, as you have mentioned, blood tests for HSV in asymptomatic persons are notoriously unreliable, both because they miss infections and they all too often give false positive results.Please do not pursue blood test for HSV.

3.  While we encourage disclosure of past partners and past STIs,  unless something unanticipated develops in the future, I see no reason to mention to possible future partners that your recent partner may have had cervical HPV or been exposed to a partner with herpes.

I hope this information and perspective is helpful to you. If anything is unclear or there is a need for clarification, please do not hesitate to use your up to two follow up questions for clarification. Take care. I would not worry about this exposure. EWH

When we were discussing the possibility of not using a condom (I had a vasectomy, so no real worries on the pregnancy front), I told my partner that I had been tested since the last time I had sex before her--because I thought I had. In fact, I forgot I hadn't been tested since one partner before her, an Iraqi woman in her 30s with whom I had unprotected oral sex (given and received) and protected vaginal sex. When I realized that I had been inaccurate in sharing my test results I felt terrible, but that had been a year and a half before and I haven't had symptoms of any kind in the intervening time. I didn't tell her (since I didn't want to scare her if there was no cause) but I made an appointment to get tested at Planned Parenthood just to make sure I didn't actually spread something to her. What STIs do you recommend I get tested for when I go in, or do you even think it's necessary?

Hope this helps. EWH