[Question #953] Risk from recent potential exposure/unprotected encounter

50 months ago
First of all, thank you all for the valuable & much needed service that you provide. 

I had an unprotected encounter with a close friend 5 days ago.  Slow/gentle penetration occurred for 1-2 minutes at the most. He was on the receiving end of oral sex & there was mutual touching.  I'm concerned about the penetration, despite it being brief.  Here's the main reason why....

My friend is in the process of ending a 8+ year marriage.  I previously worked for the provider from whom his (ex) wife received care & I know that she received treatment for genital herpes.  I can say with near certainty that she was infected prior to their relationship.  For obvious reasons, I never shared that information with him, (assuming he didn't know). Regardless of my knowledge, the encounter between us occurred.  I had no STI's prior to this encounter & have tested negative for HSV 1 & 2, HIV, etc. in the past, (HSV testing was done with the IgG).

Let's play devil's advocate & assume he IS infected & isn't on any suppressive therapy. Roughly, what was/is my risk, (for HSV or other STI's), from those 1-2 minutes of gentle, unprotected penetration? It's possible we could have a relationship after his divorce, however I would be concerned about putting myself further at risk.  Even though I no longer work for his wife's provider, I still feel it would be inappropriate to divulge information about her & suggest that he get tested now as a result.  Thank you in advance for any information/advice.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
I would say that the risk of you acquiring HSV  from him, assuming it is HSV 2, at this encounter, would be extremely low.  If a man who has herpes has sex with an uninfected woman 104 times per year without a condom, about 10 will become infected.  And I think we can assume that most sex lasts for more than 1-2 minutes.  So you can see that your odds at a single encounter are very low.  No, we can't say zero, but very low - you can do the numbers if you are a math person.  It's very good that you never disclose that you know about his ex wife's herpes status - that could be real trouble for you, great judgment there but then you already know that - just reinforcing your decision!  I also think the risk of any other STI is very low as well.  Do you know why they are getting divorced?  Does he report her having other partners as the reason? 

Terri
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50 months ago
Thank you so much Terri. I appreciate your reassurance.

First of all, I don't believe the divorce is due to infidelity. It's more a matter of incompatibility. 

1. What sx should I be on the lookout for in the unlikely event I was infected?  I've read everything from red bumps to blisters & also fever, body aches, tingling, etc. I have a bout of diarrhea & upper abdominal pain at the moment, but no fever, chills, etc. that I can tell. If those symptoms are accurate, do they typically occur prior to or during the outbreak? I admittedly have done a few "self inspections" & don't see anything resembling bumps or blisters yet, approx. 1 week after that short episode of intercourse. 

2. If my friend & I were to pursue a relationship at some point, what kinds of physical contact are generally considered low/no risk?  I've read that oral sex is considered relatively low risk for HSV 2. Is that correct?  I know that any future intercourse should include a condom. If a relationship occurs at some point I'd feel comfortable asking him just to get tested without making any mention of his wife's status. 

3. With the stats you mention, would it be accurate to say that with couples in whom 1 partner is infected, with 2x/week sex, the uninfected partner only has a 10% chance of contracting it each year??  Those odds are surprising to me, as we often hear about how 20-25% of the population is infected with HSV 2???

Again, thank you so much for your help! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
Diarrhea and upper abdominal pain are NOT symptoms of herpes.  You should be looking for sores in the genital area.  The rest of things like fever and body aches can happen with herpes but are far more commonly associated with sores than not sores.  If you've gone a week with no sores, then I think that's a good sign.  The average time from infection to sores is 5.5 days. 
The first thing to do if you want to pursue more of a relationship would be to get him tested, correct, and you want IgG testing, never IgM.  He may well not have HSV 2.  And do you know if the wife has HSV 1 or HSV 2 genitally? Both can occur.  When the MALE is infected, the rate you describe is correct - if  the female is infected, it is about 4%.  In the US about 16% of people between 14 and 49 are infected with HSV 2.

Terri
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50 months ago
Thank you Terri.  Your expertise is greatly appreciated. 

First of all, I can't be certain which type of HSV his ex-wife has, but let's assume it's HSV-2, as that is more common genitally, right? 

It has now been ~2 weeks since potential exposure.  I have inspected myself as well as one can 1-2x a day since then & see nothing resembling open sores, blisters, red bumps, etc. & have not experienced any burning with urination.  With an initial outbreak would the sores typically be easily visible, or would you expect lesions to occur only up in the vaginal canal where they could only be seen upon examination by a provider?  I am currently on my period & have had some minor vaginal irritation for the last 4-5 days, but that has happened before, so I'm not overly concerned unless you think that's something to consider???

Given the absence of symptoms, (at least any obvious ones), & that it's been 2 weeks since intercourse, do you feel I'm pretty much in the clear at this point, or should I continue to do the self inspections for another week or 2? If I do that & still don't develop symptoms by that time, do you feel a blood test in another couple months would be worth it, or just let it go at that point?  Thank you!

Side note - is there a way to have my username changed? I didn't realize the name I registered with would be used. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
Yes, HSV 2 is more common genitally.  And yes, I think it is very likely that you would recognize symptoms, given how carefully you are observing for anything abnormal.  I would say you are very likely in the clear. Your risk was low to start with.  If you can let it go that's fine, if you can't then you can do another antibody test at 12 weeks. 
I can't change your user name, sorry about that, but there are lots of Jacquelines around, I would not worry about this issue.  If you want to contact the website manager directly, perhaps they can help with this?

Terri
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