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Chances of Herpes After Protected Encounter + STD Questions

There is so much information on this site that puts me at ease that I can probably deduce any chance that I have herpes. But alas, I would like to throw out my situation for other opinions and suggestions for testing.  

I am a 32-year-old male and have no STDs. I am not experiencing any symptoms but I am at day 9 of a possible exposure (sex with female, protected with condom - shaft no covered as much but at least 85% covered from top, no kissing, missionary sex for about 4-5 minutes).  Our pelvic areas made some contact from general thrusting.  She did not appear to be shaved in the pubic area and there were no visible sores if there were any.  I do not know her sexual history but based off of other info I have received I know she has had at least 5 partners (male) in the past month or 2. Who knows how many more before that.

Herpes is my main concern based off of data and information online and even HPV.  Since it was a protected act, I have no major concerns for other STDs that condoms protect from.  I still tested for HIV at day 5 (possibly too early, but will probably retest) and gonorrhea and was told by Planned Parenthood if I don't hear from them at end of day Thursday, I am clear of those.  I have an appointment with my regular physician tomorrow just for a general look at my genitals and have already requested a full STD test screening (not sure what that testing covers, but I'll ask).  With all that in mind, some questions:

1) What is the likelihood of me contracting herpes after this encounter?

2) If I don't have symptoms, I know it doesn't necessarily mean I have contracted herpes.  But is there data showing rates of people being asymptomatic vs symptomatic?  It's frustrating to see that almost every article about herpes states "you can even have it without having symptoms" without elaborating.

3) What other STDs should I test for other than the ones I have tested for already?  

3) When should I do the full STD screening test?  I can do to any testing facility at any time to do it.

4.) I have had sex with 2 female partners before, 1 unprotected (11 years ago) and one protected (9 years ago).  All major STD tests came back negative for the screening I did after those encounters (both a month post-sex) but never tested for herpes.  Is it possible to have asymptomatic herpes after this length of time from these encounters if I never tested for it?  And could symptoms come up now at any time (unrelated to this most recent encounter)?

3a.) Which test should I do for herpes and when?

I would really like to know if I have anything ASAP (as we all do, I imagine).  I would be lying if I said I wasn't worried.  I have not engaged in any sexual act whatsoever since the occurrence.  I believe my mind is playing tricks on me thinking I have mild burning and discharge (hyper aware of my penis now, even tend to think I'm discharging when it is actually pee).  My appetite has dropped, my eye is twitching and things are getting serious with someone I have been with for a long time.  A positive word of encouragement would also be nice, if possible.
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You are way overthinking this. (I'm not sure how encouraging that is, but it's the truth.)

First, you used a condom, and even without full penis coverage, you are protected from HIV, gonorrhea, chlamydia, mycoplasma genitalium (MG or MGen), NGU, and trich. As long as the head of your penis is covered, you're protected from these.

You don't need to test for those.

Since you seem like anxiety is an issue, and you might test anyway, you can test for all but HIV at about 5 days. You can do a 4th generation DUO HIV test at 28 days and it will be accurate.

MG is a newer STD, and not all places will test for this. There is a new FDA test approved for it. You weren't at risk since you used a condom.

Using a condom reduces your risk for herpes, syphilis and HPV by about half.

It's estimated that 90% of us will get HPV at least once in our lifetimes. You can consider this an inevitability. You may not know you have it, since many strains do not give symptoms.

Syphilis is uncommon, but you can test for that at 6 weeks.

It is possible to have herpes without symptoms. We don't really know how many don't get symptoms. A study several years ago showed that 90% of those with hsv2 don't get symptoms, but we also now know that many with low positives on the IgG blood test may be false positives, so it's hard to say.

You're low risk with only 3 partners. You can do a type specific IgG blood test now, and if it's positive, it will indicate a pre-existing infection. It can take up to 4 months to show positive on a test, so if it's negative, you can test again at 4 months. Keep in mind that there are quite a few false positives for hsv2, so really consider if you want to take that chance being as low risk as you are.

The chances of you getting herpes from a one-time protected encounter are around 1 in 10,000.

Keep in mind that the number of partners doesn't always imply disease risk. Yes, it's true that the more partners one has, the higher the risk, generally speaking, but people who've had one partner can have an STD, and there are many sex workers who use protection regularly and haven't had one. My point is not to assume.

So too long, don't read? You're really at low risk here.



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15 Comments
Thank you so much for your answer and reassuring statistics.  I am at ease and will get tested some time next week for a full screening (15th, 16th or 17th day since exposure), including herpes.  The herpes test is an IgM test, which I have heard may cause more harm than good considering the chances of a false positive.  Although isn't it designed to detect antibodies early on? So it might be helpful? Should I not do this?

I didn't even bother to ask my doctor for a visual inspection of my genitals as I have no visible signs of worry.

One last question:

Considering my situation, is it possible to show symptoms of HSV-1 if no oral interaction happened?  In other words, if the other party has HSV-2 and/or HSV-1 and no oral or kissing occurred, can I contract HSV-1 with symptoms?  Of course, I have a small white pimple on my lip and reddish rash on my lower lip area which I am fairly certain is no cause for concern.
No, don't do an IgM test. It shouldn't be done on adults, and is terribly unreliable. It might give you a false negative, or a false positive. My own was negative when it should have been positive, and positive when it should have been negative.

The CDC and all herpes experts stress to not do the IgM for herpes. In theory, it looks for new infections, but it just doesn't work the way it's supposed to for herpes infections. It does for other things but not herpes.

If you have no herpes antibodies, either type 1 or 2, and get a brand new infection of either type, you are far more likely to have symptoms than if you had antibodies for either type already. Antibodies for type 1 can help keep new hsv2 infections mild. Not having either antibodies would mean that you have a primary infection, and a primary outbreak is usually - not always, but usually - pretty severe.

Get the IgG now if you must. I see no reason for you to test, but since you will, get the IgG. If it's negative now, and positive later, it's a new infection. If your result is below a 3.5, it could be a false positive. Ask for a HerpeSelect IgG test.

Oh sorry - ask for the HerpeSelect type specific IgG test.
Ok, I cancelled the IgM order.  I figured it was not a good one based off of everything I have read about it and you confirmed it.

I did call in to request an IgG test, but I failed to mention the specific type.  I will most likely be going to Quest for it, do they have the HerpeSelect type specific IgG test there?  It's hard to navigate on their site and difficult to decipher the test lingo online.

To your point regarding new infections, that is very helpful to know.  I have yet to have any symptoms.  The only thing at this point that I think is taking a slight toll on me is stress due to this situation along with anxiety and frequent urination, and I tend to have the sensation of urinating throughout the day for the past week.  I also seem to have droplets of urine that seems to leak after urinating.  Could this be caused my anxiety and stress?  Because I really do feel low and I know that I shouldn't be worried.  Easier said than done, I suppose.

I truly value and appreciate your information.

Are you getting this done through your doctor? Just ask them to change the order.

Quest does the type specific IgG - https://testdirectory.questdiagnostics.com/test/test-detail/6447/herpes-simplex-virus-1-and-2-igg-type-specific-antibodies?cc=MASTER

Your urinary symptoms strike me more as a UTI or prostate issue than an STD. If that doesn't stop in the next couple of days, see your doctor about it.

Also, talk to your doctor about your anxiety. Your reactions to this are not proportionate to the risk level.
Hi Auntiejessi,  

I thought I would provide some updates to my status (now 2 weeks since the encounter).  I am not experiencing any unusual symptoms and my urination issues have subsided.  I am seriously considering not taking the type specific IgG test now for the chance of a false positive and my low-risk considerations.  Considering the reliability of this test though, should I just do it anyways to verify that I do not have a past infection?  A false positive would also really make matters much worse for me as well...

Additionally, I wanted to let you know I totally freaked out this past Thursday because I noticed I had a tiny dot of a red scab on my scrotum (mid point in between the testis in the frontal area).  I immediately called a dermatologist, where I had 2 dermatologists look at it  (one being the main Dr) and he said it is angiokeratoma of fordyce (non-herpe lesion).  I was so relieved.  

My only question to that though is, if by the minimal chance it is herpes, what is the likelihood of being only one scab and if the scab-like clot heals over and goes away, should I be concerned?   Angiokertoma of fordyce does not seem to be something that scabs away and disappears.  Is it also true that herpes on the scrotum is less common due to the skin being a bit more tough down there (as opposed to the base of the penis and the penis shaft itself)?

I'm going back-and-forth with the idea of testing/not testing for other STDs as well.  But, if I do, if I tested this week (say, Weds) or next, how confident would you be in the negative results that I will most likely be receiving?  I am mildly concerned about possibly passing something to a partner soon during this possible "window period" of sorts.

I believe this will be my last post with questions, but I may follow up with test results for the benefit of everyone and those concerned following a similar situation.

Thank you so much.
I'm glad your symptoms have subsided.

I see no reason for you to test. If 2 derms looked at this spot, and decided it wasn't herpes, then it's not herpes. One small spot isn't likely to be herpes. I don't know anything about angiokeratoma, but did find this:

https://www.healthline.com/health/angiokeratoma#types

Angiokeratoma of Fordyce. These appear on the skin of the scrotum or vulva. They’re most commonly found on the scrotum in large clusters. This type can develop on the vulva of pregnant women. They’re not harmful, but are prone to bleed if they’re scratched.

They can bleed, so if it scabs, that's not unusual.

Yes, it is unlikely for herpes to appear on the scrotum.

Really, I wouldn't test if I were you. If you get a false positive, it will send you down an anxiety spiral that could take months to get out of. Your mental health is far more important, and your risk for herpes (and any other STD) is so, so low. To me, it doesn't seem worth it.
Dear auntiejessie,

I wanted to yet again provide you an update plus a few questions to tie up some loose ends for my peace of mind.

I tested at 6 weeks and 1 day post-encounter for a full STD panel, minus the HerpeSelect Type specific IgG test.  Everything came out negative!!  As syphilis was another concern lingering in the back of my mind, this was such a relief...to a certain extent.  

About 2 weeks ago , I felt a slight irritation/tingly sensation in my pubic area.  My logical mind contributed this to just pubic hairs against clothing and my recent hyper-awareness of the area.  I just wanted to be sure though so upon closer inspection I noticed this area had what appeared to be a small light reddish rash which was hard to see without some extra light. I went to the derma the next day and said it was most likely a skin irritation (I try to stay active; gym, running etc) and prescribed Domoboro's soak and hydrocartisone 2.5%.  I have yet to use the medication because I wanted to see if the irritation would go away.  It did, until yesterday.  The light reddish rash area is still there (it may have been in the course of these past 2 weeks) but the minor irritation is back..

I try to stay away from searching things online but upon rendering search result for what causes reddish areas in the pubic area, syphilis was highly ranked on a particular website.  At this point if I have had no symptoms of syphilis (8 weeks post-encounter) plus my 6 weeks negative, I should not be concerned, correct?  Also, I read an article where someone mentioned they once mistook a herpes lesion as a bug bite, which to also makes me concerned about this particular irritation as well.  Although, as far as I can tell, it isn't a raised area.

I am counting down the days until possibly taking a HerpeSelct Type Specific IgG test, which would be January (4 months).  Speaking of, December would be 3 months post-encounter, so how accurate would a 3 month HerpeSelect Type Specific IgG test be?  I am still on the fence about this test.  I know your answer already, but I really want to put all if this behind me once and for all.  Any assurance at any amount is greatly appreciated.
Things that cause genital rashes:

Irritation
Jock itch/ringworm
Yeast
Chafing
Shaving
Friction
Psoriasis
Eczema
Allergic reactions
Dermatitis
Lichen Planus
Folliculitis
Chemical irritants - soaps, detergents, etc.
Bug bites  

This isn't near a complete list, and I didn't even include STDs.

You tested negative for syphilis. It's not that. That causes a sore called a chancre.

I can't address the person who mistook a herpes lesion as a bug bite because I don't know that person, haven't read the article, didn't see a pic. Sure, I suppose that's possible. It doesn't mean it's happening to you.

The chances that you got herpes from this are 1 in 10,000. The chances that you'll be struck by lightning this year are 1 in 3,000. Do you fear lightning?

The chances that you got HIV are zero.

If you have a rash, let a doctor look at it NOW. If they think it might remotely be herpes (and don't be surprised if they look at it and say it's nothing), ask them to do a PCR swab on it. That's far more sensitive than a regular culture.

I wish you wouldn't do a herpes test. You don't need it, and the chances of false positives are good enough that it scares me for you. Most people (about 70%ish) will test positive by 6 weeks. You don't need to test.

Talk to your doctor about your anxiety. Your mental health is as important as your physical health, and right now, your mental health is in worse shape than your physical.
Auntiejessie,

I will definitely talk to my Dr about my anxiety.  I have an appointment with him next week for my annual physical. I am somehow managing to maintain a balance of staying calm on the outside and occasionally on the inside on an emotional level.   But, at times like today, I only worry and I am on the verge of tears.  I don't mean to sound overly dramatic, but this event really impacted me.  I really don't want to pass anything on to my partner.

I do have one final word of concern that I am hoping you can shine some light on.  It has now been 10 weeks since this encounter.  Since my last post here on the Nov 12th,  I did some maintenance below the belt in the form of trimming.  I trimmed so close to the skin that in about 4 days later I had a tingly sensation on those areas and the areas where two tiny light red spots appear and where I trimmed (both spots are about 3 inches apart, for all I know they have always been there).  I contributed the irritation to the hairs growing back since I have never trimmed that close before.   No big deal, until now.   A few days ago I started feeling a slight soreness on my tailbone region and still do.  On discussions here and elsewhere, HSV-2 concerned folks have described tingly sensations in the pubic area (like the possible irritation I have had) and tailbone pains as symptoms.  I never have had tailbone soreness like this.  This has me extremely concerned now (and I thought I was doing so well ...)

With your experience and expertise, can you give me any more info that will work in my favor that I do not have HSV that you haven't told me already?  Auntiejessie, I can't say this enough but I truly value the information you have given me.  I am going to mention this all to my doctor next week but any more final words and insight on my new concerns will really help the process of nearly putting these concerns behind me once and for all.

I am forever grateful.
So I was away last week for Thanksgiving. By now, if this was a herpes outbreak, you'd know. It wouldn't just be tingling. (By the way, I've never had tingling in my tailbone and I've had herpes for 15+ years. It can be a symptom, but it's not one of the more common ones.)

I really can't add anything that I haven't already.

Have you had your appt? What did your doctor say?
Hope you had a great Thanksgiving holiday!  Thanks for responding to my concerns yet again.

I didn't want to respond to you until I had my doc appointment but unfortunately I had to cancel it due to other matters.  However, I did want to provide a point of clarification in regards to my tailbone.  It was more of a dull pain than an actual tingly sensation.  Not sure if that matters, but I'm starting to believe it has something to do with a particular work out I did last Saturday (lunges and squats plus lots of sitting, the pain lasted  approx. 5 days and is practically gone).  Plus, the tingly sensation is now gone in the pubic area. These facts, paired with the information you just provided me, has finally put my mind at ease.

I have re-scheduled my regular physical appt for next month.  I don't see any need to be terribly concerned at this point any more.  I will do my best to heed your advice about not testing for HSV, considering I have had no symptoms and the light small marks on my groin area do not seem to be anything of concern.  I will be continuing physical relations with my partner with minimal concern.

Thanks again Auntiejessie.  I will try my best to enjoy the holidays and put this behind me 100%.  Happy Holidays!
"I don't see any need to be terribly concerned at this point any more." - I agree totally with this statement. I don't think you have any reason for concern at all. Just let it go now, and make sure to keep your next appt with your doctor, and talk to him about anxiety.

Enjoy your holidays!
Hi Auntiejessie,

Hope you had a great new year and holiday season. I had a really bad case of the flu for the first 3 weeks of the new year that set me back a bit.  

I just wanted to do a final (and yes, I really do mean FINAL) post/update here.  I am well over 4 months now since this encounter (4 months, 2 weeks to be exact).  Looking back at this whole experience, I really had no symptoms and my anxiety really did play the best of me.  With that in mind, I have one last question...

As you have stated here and other posts, you say that it could take up to 4 months for someone to develop antibodies for HSV if they have contracted it and testing via HerpSelect IgG would be rather accurate at this point.  I still do not plan on testing although I must ask - when one develops antibodies, is that nearly always associated with classic symptoms of HSV plus flu-like symptoms? How much more sure can I be that I do not have it considering I still have no symptoms at this point?  The whole idea of being aysmptomatic has really racked my brain but it is not nearly impacting me on a mental level as it did a few months ago.

I couldn't really find any clear answers for my questions so I thought I'd ask one final time here.

As always I give you my many, many thanks.
It's only associated with those symptoms if you are having a true primary outbreak, meaning no prior infection of hsv1 or hsv2. If you have hsv1 already, you won't have a primary outbreak, so it wouldn't be as bad, most likely. You might still have some of those symptoms, but you might not have all of them.

I wouldn't worry at ALL about herpes if you haven't developed symptoms. You used a condom, which offers significant protection against it, and you don't know that she has hsv2.

I would totally put it behind me and move on with no concerns whatsoever. :)

If I were you, I would also talk to someone about anxiety. You deserve to get some relief from that, or at least some good coping skills.

And you're welcome!
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