[Question #8302] Confused re. G-HSV-1 transmission
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46 months ago
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On 5/13 I had unprotected sex with my then bf. He did not give me oral sex. I gave him oral sex. He took saliva from his mouth and moistened my vagina with that. Then we continued having sex until he ejeculated in me. I had completely shaved my vagina that morning. 4 days later I was itchy and had ulcers appear. I got STD tested 1week after our encounter and everything was negative. Went to my gyn and she swabbed the ulcers and that came back positive for HSV-1. Waited 4 months to get re IGg tested that came back 1.03.
I’m confused about how I got exposed to this virus. Seeing other ppl say hsv-1 is not genital to genital transmission. I thought it must have been shed frim his semen. He says he never had any symptoms ever. But his Dad had genital herpes and his past gf had mouth sores.
1. How did this virus get transmitted to me?
2. Moving forward what should I tell my current bf?
3. What is the risk of transmission to my bf genitally? What is the risk if my current bf gives me oral? Also, if he gives me oral then I then I kiss him? or we have sex then I give him oral right after penetrating me?
Just for the record I have been crying almost every day for 5 months. It’s hard enough being a 50 year old single mom and now this. I’m so angry and sad and devastated I sometimes don’t even know how to handle this. Thank you for listening and responding. I really appreciate it.
Btw. U suggested coming off valtrex to see how my body does , I did that 6 days ago. Feels a little weird down there but no ulcers that I can tell.
What is the benefit of my own body making antibodies vs. being on meds?
Thank you so much for all your help with all these questions. You ppl are saints.
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Terri Warren, RN, Nurse Practitioner
46 months ago
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If you waited four months to do an IgG and the index value was 1.03, that tells me that the IgG test for HSV 1, in you, and in others, isn't very good, is it? It misses infection in 30% of people with HSV 1 infection, as compared to the gold standard western blot. it also tells me that it is possible that you have had HSV 1 well before your first recognized ulcerations. I think it is highly unlikely that you acquired HSV 1 from him using saliva from his mouth to lubricate your vagina. And I also think it is unlikely that it came from his semen.
You should tell your boyfriend that you have the cold sore virus, genitally. We don't know what the actual risk is of transmitting to this boyfriend, but it is low. That is either through oral sex or intercourse.
There is not necessarily any benefit of letting your body take over vs. the medication, except that at some point, when you don't have a susceptible partner, you may wish to come off medicine.
I know this is a challenge for you, I totally get it, but remember this: about half the population has HSV 1 infection. Most is oral and oral infection is far more likely to be transmitted to a partner via oral sex than your infection. Don't let the stigma you read about guide you. Try to override the term "genital herpes" with common sense. You can do this!
Terri
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46 months ago
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Thank you for your response. My 1st outbreak was so bad genitally but my blood test was negative 4 days out. I went on Valtrex for a month then came off, 1 month later 1 ulcer formed on my labia so went back on valtrex for 2 months (then after being on valtrex for 2 months had a 2nd blood test done while on valtrex) that’s when it came back IGg 1.03. So I do believe this was the 1st time I was ever exposed to HSV1. I did not get any sores in my mouth, only genitally and severely. So it either had to be from his saliva or I was thinking genital to genital and the reason I mentioned I completely shaved was maybe there were little nicks/cuts on my vaginal skin that caused the virus to be shed and contracted more easily. What’s your opinion on this? Also, if I only had genital ulcers and nothing on my mouth is it safe to say I don’t have it orally and can give my bf oral sex safely? And should he wear condoms all the time to prevent transmission genital to genital from positive me to negative him? I appreciate your expertise on this matter.
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Terri Warren, RN, Nurse Practitioner
46 months ago
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Hmmm. I didn't know the part about it being so bad. That changes my opinion a bit. And I think we've talked before about this.
And the daily Valtrex could account for an equivocal HSV 1 antibody result 4 months out.
If this was indeed a brand new infection, which is now sounds like it was, it was either transmitted via intercourse or via saliva, both of which are really unlikely but not impossible.
When was the last time you received oral sex prior to the sores appearing?
And given all of this, is does sound likely that you only have this genitally. If that is true, yes, you can give someone oral sex without a risk.
Since your infection is probably new, at least 4 months old, it would probably be a good idea to have your newest partner use a condom with intercourse.
Terri
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46 months ago
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Yes it was a severe, at least 10 sores on and around labia, clitoris, one on groin, and internally. My gynecologist thought it was 1st exposure. We did discuss the effect of Valtrex and the low number. I understand that. Prior to encounter on May 13 (no oral sex, just saliva and intercourse) oral sex was given to me by a different bf March 18, so 2 months prior to my breakout, that bf said he’s never had any cold sores. My first sign was itch on May 17, I thought that was a yeast infection and took medicine for that, then ulcers appeared May 19, started Valtrex May 22. Still baffled I guess hard to tell if it was from saliva or sex, but the bf who I believe gave it to me just had an HSV1 test positive 52.3. So I think it was him, and it was 4 days after sex.
I’ve heard ppl with HSV are at a higher risk for aquiring HIV. Is that for both hsv 1 and 2? And why?
I am now almost 5 months out from 1st infection. What is the percentage at this point I will transmit this to my new bf? By having sex? And by him giving me oral? When will the risk of me transmitting it to him reduce? And if I take Valtrex what is the risk of transmission from me to him then?
Thank you very much for your help.
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Terri Warren, RN, Nurse Practitioner
46 months ago
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People who have HSV 2 are at higher risk of acquiring HIV IF they have unprotected intercourse with someone who is HIV positive. HSV 2 is not associate wtih a higher risk of acquiring HIV because HSV 1 recurs far less often, thus not presenting with as many breaks in the tissue that would allow HIV in, which is the issue with HSV 2. That, and the cells that come to defend against a herpes outbreak are the cells that HIV prefers to infect.
If you do not have an oral infection, only a genital one, you can give oral sex without any risk to a partner.
Valtrex will likely cut the risk of transmission to a partner by a significant amount, but we don't have a percentage. If we use HSV 2 as a model, that cuts transmission by about half. We als don't have transmission data to know how likely it is to infect him at all with HSV 1.
Terri
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