[Question #960] Need help please : No.2

50 months ago
Hi, I am 22years old female who is in a relationship with a 28years old male. I asked a similar question few days ago, and while Dr. Handsfield helped ease many of the concerns, but here are few quick questions

Two weeks ago, my partner had gone to a massage place and apparently had a hand job. The girl worker had spit on her hands twice and gave him a hand job for few minutes, right after apparently he has washed the area.  He has since experiencing a great deal of anxiety, he has a severe erectile dysfunction (where before we had sex minimum 3 times a week) and he is having all sort of weird pains in his sexual organs.

He has tested on day 9 for the hsv. His main scare is if he had contracted hsv 2 from the Saliva of the girl. he has already had cold sores from childhood

I have some questions:

1- His doctor has told him that oral hsv 2 is quite common, is that true ? if so how much of the time the oral hsv 2 is shedding ?
2- Has there been any record of the transmission of herpes (1 or 2 ) with saliva and hand job ?
3- Given that the results of the test will come in this coming week, is this result reliable ? (assuming this is his first exposure to hsv 2)  would a 4 weeks test be reliable then ?


Thanks a lot
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
Hi Ashley,
It is NOT true that HSV 2 is common - that is an error.  And when people do get it orally, they shed virus orally about 3-4 days out of the entire year.  Besides, it takes a rather large volume of virus to infect another person and you just aren't get to get that in the way this incident occurred.  I have never in my career of 33 years specializing in herpes, seen anyone get it from saliva and masturbation, though lots of people do worry about it.  I assume he has not had any symptoms of herpes, and I believe that he will not.  Good that he got a baseline test at 9 days but if he does test again, and I see no reason to do it again except to reassure him, he should wait until 12 weeks for greatest accuracy.  If he tests again at 6 weeks, that result has a 70% chance of holding at 12 weeks.  But honestly, this is NOT a risk - Dr. Handsfield and I agree.  Once he gets a final test, I believe his erectile dysfunction will go away.  It's amazing what our heads will do to our bodies, bless his heart.

Terri
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50 months ago
god bless you guys Terri, all of you, for helping us within these indeed the most difficult times of our lives.

He does not have any symptom,  neither blisters or sores and nor any fever or flu symptoms. He has just lost about 8 pounds in this two weeks out of anxiety and guilt.

Thanks again Terri,






Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
You are most welcome.

Terri
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49 months ago
Hi Terri,

about a week and a half has gone but we still do not have the hsv results. Is it common to take this long ?

He has lost about 10 pounds so far, It has been the worst part of our lives I guess, the only good thing is reading and rereading your comments. thanks again and again and I hope that as your experience suggest there be nothing to be worried of. 

I know that there was no risk for HIV and VDRL, but the results came back negative.  those results are not reliable at this time anyway (9th day after exposure), right ?

Lastly, about a year an half ago and before we start dating i insisted that we both get "full panel STD" testing. not knowing that Herpes is not part of it. My partner had a period of six months before in which he dated 2 women then. We kinda feel betrayed by the Doctor who not even mentioned HSV to us. Why is that the way it is ? this does not make sense, I know you guys are policy makers and I hope this comes as a testimony for a great deal of ignorance that exist regarding hsv, both in sex eds and testings.

Thanks a lot

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
49 months ago
I do believe that herpes antibody testing should be included in any STD screen, and if it isn't, patients should at least be aware that it isn't included so they could get it on their own.  The rate of false positives is low - about 5.5% - those are difficult but we know who has them (people in the low positive range of 1.1 to 3.5) and there are confirmatory tests available.  But to throw out the whole test because of these seems unacceptable to me.  Here is what the CDC says about herpes antibody testing:

"Type-specific HSV serologic assays might be useful in the following scenarios: 1) recurrent genital symptoms or atypical symptoms with negative HSV PCR or culture; 2) clinical diagnosis of genital herpes without laboratory confirmation; and 3) a patient whose partner has genital herpes. HSV serologic testing should be considered for persons presenting for an STD evaluation (especially for those persons with multiple sex partners), persons with HIV infection, and MSM at increased risk for HIV acquisition. Screening for HSV-1 and HSV-2 in the general population is not indicated."

I'm not sure why his testing is taking so long - normally it takes a much shorter time but I don't think the delay really means anything so hang in there.  I also don't believe that he needs further HIV and syphilis testing, no.  The situation simply doesn't warrant that.

Terri
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