[Question #9561] Oral herpes and Unprotected Oral Sex/Saliva

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31 months ago
Im a male that has been casually dating this woman for a couple months now. Kissed/made out for a while etc. recently, we had sex.
She informed me she gets oral cold sores a few times a year - last one was “a few months ago” and she mentioned she takes anti viral/viral suppressant meds daily. 

 She licked her hand to use her saliva as a lubricant to get me erect. 

Question- what is the general likelihood of Contracting herpes genitally from someone that has oral herpes (no present symptoms , antiviral, and hasn’t had a cold sore in a few months) when they use their saliva as a lube?
- also what’s the general likelihood of contracting herpes genitally via unprotected oral sex (with this same parameters- daily antivirals, no present symptoms, last outbreak was a few months ago)?

Thanks for the help
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Terri Warren, RN, Nurse Practitioner
31 months ago
I think the risk of you getting HSV 1 from her using saliva as a lubricant is extremely low.  The risk of receiving oral sex from her is a different thing altogether.  That risk is higher, BUT since she is on daily antiviral medicine, that's a goodo thing.  But are you saying that she is on suppressive therapy and breaking through that a few times a year?  That's not great.  I would inquire about the dose and medicine that she is taking to be certain it is an optimal dose.    Have you actually been tested to know if you might be infected?  About half the population is infected with HSV 1 but 70% don't know it.

Terri
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31 months ago
Yes, she has told me she takes daily medicine to keep her cold sores at bay- assuming it is the common cold sore antiviral. I didn’t want to pry into her exact med name and dosage as that may be an overreach by me at this stage in our relationship?
And yes she gets a cold sore infrequently maybe a few times a year. 
We have never engaged in unprotected oral sex (her performing on me). Just saliva lubrication. 

I have never had a cold sore for as long as I can ever remember. So since I’m be never had a symptom, doctors have always told me it’s not advised to do a blood test as they’re inaccurate, lead to emotional trauma/stress with data/next steps that can’t really be identified of real virality, and if I’ve been exposed like many people but have never shown a symptom (like 50% of the population) it creates worry that may be unnecessary since I can’t understand if I would actually be viral to other people yet there would be no data that would allow me to know that and action on it. 
I’m mostly worried about genital herpes potential from dating someone with oral herpes but have never ever shown any sore/symptom, etc. 
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Terri Warren, RN, Nurse Practitioner
31 months ago
well, I'm not sure how to advise you on the testing issue then, but if you never receive unprotected oral sex, then I don't see an issue here at all.

Terri
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31 months ago
Thanks Terri. 
What’s your stance/advisement on testing for someone that has never shown a symptom or have had a known high risk experience (having sex with someone with a sore present, etc)? 
I know the CDC’s stance is to not test or routine test unless someone has experience an active and confirmed system?  Herpes testing guidance is all very confusing on how to best be an active advocate of one’s routine/safe sexual health. 
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Terri Warren, RN, Nurse Practitioner
31 months ago
The CDC advice is also my advice due to the high rate of false positives on the IgG test UNLESS you choose to do the gold standard herpes western blot that does not ever give false positive results.  That is more expensive but far more reliable

Terri
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