HSV-1 transmission rate - time proximity to first physical sign

[alf54]

Hello, anyone who can offer help,

Background:

Dating my partner for about 2 months. Bluntly, we are very worried right now. After consistent and prolonged sexual relations over the course of the weekend, the last of which occurred at about 3AM on Sunday morning, she woke up with first signs of a potential cold sore on her lip Sunday morning around 8-9AM. Having had a previous experience with a cold sore about 2+ years ago, she immediately used prescription cream obtained from her mother (who also gets the occasion cold sore). This seemingly accelerated the pace/progression of the sore.

I have never had a cold sore. I have been tested multiple times for both HSV-1 and HSV-2 - the last time being in late February of this year. I'll concede a longstanding phobia of sorts with STIs (the reason for the tests) and have tried to be very careful. Despite that, I've continued my relationship with this woman because I also concede the statistics regarding HSV-1 (~50% or so in the US). In other words, "unreasonable to avoid any potential woman who has HSV-1."

I also concede that, upon this experience and the research stemming from finding out of how soon after our sexual relations (including oral sex), I better understood that HSV-1 can actually be transmitted to places (like genitals) other than the traditional lips/mouth. That makes this far more worrisome than the "worst case scenario is I get the occasional cold sore on my lip."

My questions:

1. What kind of likelihood are we looking at for her passing me HSV-1 despite not seeing a physical sign during sexual contact + kissing? I've read all sorts of numbers in terms of how long before it actually is "contagious."
2. What kind of likelihood that it was passed to the genital area?
3. Is it a toss-up, of sorts, between whether I may have contracted it to my lips/mouth area or to genitals? I've read that, if I had already contracted HSV-1 (which I had not), it'd be more difficult for it to be passed to the genitals.
4. What should I look out for and in what time frame? I've read the signs commonly come out 3-6 days after possible exposure (if this pre-sign period was actually exposure). We're sitting at approximately 2 days and I only feel some minor cold symptoms - unsure if they're related.
5. What are the chances her prodromal stage actually began in the morning when she first saw a red mark, instead of "brewing" in the hours before (while we had sexual relations).

Any other advice or feedback is helpful, as this is a personally big concern (I know, that doesn't make us unique on an HSV board) and we're both quite worried for each other.

Thanks in advance.

[feelingundone]

Not at all. I am actually on vacation so I'm trying my best to answer questions. In this case yes the short answers are being done first as my time is limited.
On to your concerns.

Yes she was most likely contagious at the time of your exposures. The virus is at the surface before the actual signs of a cold sore become evident. That being said most exposures still won't lead to transmission. You could get a cold sore on your lip or genital hsv1 is possible as well. Unfortunately both at the same time is also possible although a long shot.
Most primary outbreaks happen 3-10 days after exposure. Most primary outbreaks of hsv1 when no other hsv is present in the body is very noticeable and can be severe.
Hsv1 on the genitals has much fewer outbreaks than hsv2 and sheds very little as well. Some folks never get another outbreak past the primary.
All you can do is wait and see unfortunately. After ten days you can feel confident you did not contract hsv.
Now for some better news. If you two are a committed couple then there is nothing to worry about as you can not ping pong the virus back and fourth. Meaning you won't give it back to her in an area she doesn't have it and vice versa. Also remember most adults have hsv1 so if in fact you did contract hsv1 then any future partners that have cold sores is immune from yours.
I know this is a difficult time but hsv1 is so common and it's really no big deal, although I know it feels that way right now.

[alf54]

Your answer is thoughtful, detailed and probably the most helpful response I've received - including probably 3-4 Doctor friends to whom I've reached out to for opinions. As I've conceded, this is a personal phobia. I've spent a good amount (potentially unnecessarily, it seems) of energy trying to avoid HSV-1 and the like. Yes, despite understanding 50-60% of women would likely have it.

Most definitely, on the genitals as I didn't even fully/previously understand HSV-1 could be passed there. I thought worst case would be I get it on my lips. You've said BOTH are possible (though longshot). Yikes!

*The ideal would be that I did not get it*, but it sounds like she was likely contagious during the encounter and, another variable, we had considerable contact (she gave oral for more than a brief time). I'm sorry for the length of this. It's a difficult time period for both of us, indeed. We've read that chances of transmission are in the 1 in thousands (1 in 10,000 i read) when there isn't a physical sign present. Does this basically change because her first sign was so close in time proximity?

Note: I did take a single Acyclovir pill on Sunday (day she found the visible sign and probably 12-18 hours after encounter). I realize this was a Hail Mary of sorts and unlikely to affect transmission.

[alf54]

Additional Note: Been taking L-Lysine daily since.

Finally, enjoy your vacation. Thank you for selflessly coming on here to help others. You're a godsend.

[alf54]

We've noticed that mostly questions with "positive" or good news/answers are commented on by helpful users. Is it the case? Are we not getting any help because this is likely bad news. Please help!