Herpes from Oral Sex

[peewee999x]

Hi, I am a 20 year old student.  I am dating a girl who has hsv2.  We have never had vaginal sex, yet.  I have tested negative for herpes 1 and 2 and she tested positive by blood and culture in her vaginal area.

What are my risks of contracting hsv2 in the following scenarios:
1.  I allow her to perform unprotected oral sex on me.  Can I get hsv2 from this and if so, how likely?
2.  I use my finger to stimulate her vaginal area.  How likely am I to get hsv2 on my finger from this?

I noticed the last 2 times she performed oral sex on me I get red places just beneath the head of my penis - in the circumcised area.  It never blisters and ususally goes away in about 5 days or so.  It doesn't itch or anything else but when I peel the skin back and look at it, it frightens me.  It can be as much as a 1 inch long streak of red and all looks like it is under my skin and not on top of it.  What does this sound like and should I see a doctor for evaluation of this?

Should I be worried?  Should I insist she perform oral sex with a condom?  I am a math guy so precise answers are good for me.

Thanks.

[Edward W Hook, MD]

Persons with lesions are more likely to transmit their infections but they know they have lesions, therefore may abstain from sex.  On the other hand, infected people have small amounts of virus present at their sites of infection over 10% of the time but do not know when that time is and, often, do not even know they are infected.  Therefore because over 80% of persons with genital HSV do not know they are infected and are shedding over 10% of the time without lesions, most infections come from this source.  It's complex.

This will end this thread.  EWH

[peewee999x]

Doctor, thank you for your excellent advice.  I looked ath the ASHA site but still don't understand why most infections occur when there are no symptoms.  I also don't understand where the virus sets up.

For example, if a woman is having a labia outbreak is she also likely to be having the virus present, concurrently, inside of her vagina or is it generally localized to where the blister is displayed.  Secondly, is a woman having an outbreak 100 times more infectious than an asymptomatic woman or are there any stats on this?  If not, care to make an educated guess?

Thanks and this is my last question.

[Edward W Hook, MD]

Persons with active HSV recurrences and lesions are typically more ifnectious for partners than person who are asymptomatically shedding the virus.

No, the reason is is called asymptomatic is because there are no symptoms.  

For more infomration on HSV, I suggest you take a look at the excellent information available on the American Social Health Association website.  (Disclosure. Dr. Handsfield and I are both members of the American Social Health Association Board of Directors.)  EWH

[peewee999x]

Doctor, as far as future relationships - are women significantly more infectious/contagious when they are have outbreaks versus asymptomatic shedding?  Also, when a lady has a bump say on their labia are they also likely to be having bumps on their cervix, concurrently?

Is there any way to know if someone is asymptomatically shedding?

Thank you.  I am simply trying to educate myself for future relationships, etc so I can avoid potholes of the past.

[peewee999x]

Doctor, as far as future relationships - are women significantly more infectious/contagious when they are have outbreaks versus asymptomatic shedding?  Also, when a lady has a bump say on their labia are they also likely to be having bumps on their cervix, concurrently?

Is there any way to know if someone is asymptomatically shedding?

Thank you.  I am simply trying to educate myself for future relationships, etc.

[Edward W Hook, MD]

There is no need to inform future partners that you were exposed to a partner with herpes but did not get infected.

You do not need further antibody testing.  If you develop a lesion at a site of exposure, you should seek a herpes culture or PCR test.  EWH

[peewee999x]

Sorry for the repeat questions.

I have broke it off with this girl.  Ethically, I am ok to begin seeing someone else now with no mention of this?

Last, what you make you change your answer and say I need further testing?

[Edward W Hook, MD]

You are asking repetetive questions an asking for rprecise answers where they do not exist.

I, like your doctor, do not see a need for further IgG blood testing and NEVER recommend IgM testing.  EWH

[peewee999x]

Thanks.
To clairfy:
1.  Zero risk from her performing oral sex on me, correct?
2.  Am I likely to catch herpes from her by using my finger to stimulate her?
3.  Am I likely to catch herpes from her by using my tongue to stimulate her?

4. On a side note, we had vaginal penetration 3 months back.  I was drinking heavily and had just met her.  We had sex 9 times over the course of a week.  I used a latex rubber 6 of those 9 times.  She informed me afterwards that she was having a small outbreak on her labia.  I know I performed oral on here and everything.  I went to the STD clinic at 6 weeks and had a bump near my right scrotum cultured and it was negative.  There were 3 other red (under the skin bumps) the doctor dismissed.  The culture was neg and the IGG was neg.  He sent me to an STD for another test at 9 wks.  The IGM was 1.2, IGG 1 and 2 combo was 1.55 and the IGG was negative.  He said to stop testing.

Knowing all the above, do I need to have more bloodwork done or am I home free?  What percent chance do you think I have hsv2 since I have had no penile leisons, flu-like symtoms?

All advice welcome.

Thanks Dr. Hook

[Edward W Hook, MD]

Welcome to our Forum.  No math is needed here. If your partner has genital herpes, there is no risk of her transmitting that infection to you through oral sex.  Herpes is a locally transmitted infection which is transmitted through direct contact.  While there are other good reasons for encouraging condom use, here is no reason to use a condom to prevent genital herpes transmission in the situation you describe.  

As far as genital contact is concerned, you are ahead of the game. Studies show that partnerships in which the infected partner tells their partner of infection are statistically less likely to transmit infection than if they do not disclose. Risk can be further reduce through the use of condoms, avoiding sex when she is having an outbreak and, if she chooses, her taking suppressive antiviral therapy with medications such as acyclovir or valacyclovir.

I hope this comment is helpful. EWH