Aa
Another bad decision
A couple of months ago I visited a massage parlor and had the happy ending and nothing more. I am a physician and should have known better but we all screw up at some point. Like many posters I have lots of anxieties over this. I have had intermittent mild symptoms or urethritis since then ( no pain, discharge or dysuria). At about the two month mark I got an STD panel which was negative for everything except Igg for Hsv-1 at >5. I have had oral cold sores for years. I also got a urine culture this week which was negative. My internist gave me a dose of 1g azithromycin prior to the results.
Here are my OCD questions. From my reading of posts it would be very difficult to get an STD via hand to genital contact. Have you ever seen a case of genital herpes from herpetic whitlow transmission? I know whitlow is very rare.
I assume the oral HSV-1 infection protects me against genital herpes. Should my wife be tested for HSV-1?
Thanks!
Here are my OCD questions. From my reading of posts it would be very difficult to get an STD via hand to genital contact. Have you ever seen a case of genital herpes from herpetic whitlow transmission? I know whitlow is very rare.
I assume the oral HSV-1 infection protects me against genital herpes. Should my wife be tested for HSV-1?
Thanks!
MEDICAL PROFESSIONAL
I don't recall the exact data, but in the US 60-70% HSV-1 by age 50 is about right. Higher and lower in other countries; and in the US, substantial variation according to race, socioeconomic level, and in different parts of the country.
"Mild" depends on definition. Recurrence frequency generally is a lot lower for genital HSV-1 than HSV-2, but there is no difference between them in clinical manifestations of the initial infection or recurrent outbreaks. (As discussed, you don't have it and are not at risk. But I imagine you are thinking of consequences if your wife were to acquire genital HSV-1.)
Let's end this thread. All is well. Take care.
"Mild" depends on definition. Recurrence frequency generally is a lot lower for genital HSV-1 than HSV-2, but there is no difference between them in clinical manifestations of the initial infection or recurrent outbreaks. (As discussed, you don't have it and are not at risk. But I imagine you are thinking of consequences if your wife were to acquire genital HSV-1.)
Let's end this thread. All is well. Take care.
This site has lots of great I information. I learned that 70% will have antibodies to HSV-1 by age 50. Also it seems that genital HSV1 is a very mild infection compared to type 2.
Thanks
Thanks
MEDICAL PROFESSIONAL
As for HSV one can imagine a theoretical risk of HPV transmission by hand-genital contact, which has been invoked to explain occasional genital HPV infections in technical virgins. However, if it occurs, it is probably limited to mutual petting/masturbation, i.e. if genital secretions are used as lubricant. That seems unlikely in a massage scenario, where the risk probably is zero for all practical purposes. If HPV ever shows up in your marriage, e.g. if your wife has an abnormal pap smear, it will more likely be the result of distant past (premarital?) exposures.
Protection against type-specific HSV re-infection is independent of symptoms.
Your anxieties notwithstanding, you're not going to be able to talk me into seeing any significant risk for you. I truly believe you are home free. Try to let it go and move on.
Protection against type-specific HSV re-infection is independent of symptoms.
Your anxieties notwithstanding, you're not going to be able to talk me into seeing any significant risk for you. I truly believe you are home free. Try to let it go and move on.
Thanks for the answer. Is it also true that the risk of hpv transmission is very low from hand to genital contact?
If I never had a history of oral lesions, would there be concern for a possible genital infection with HSV-1? ...just curious.
Thanks for the quick reply.
If I never had a history of oral lesions, would there be concern for a possible genital infection with HSV-1? ...just curious.
Thanks for the quick reply.
MEDICAL PROFESSIONAL
Welcome to the forum. I'm happy to help. Bottom line: Very low if any risk for STD, and definitely no worries about herpes.
The best evidence -- which is primarily epidemiologic -- is that people are highly resistant, if not completely immune, to new infections with the same HSV type they already have, anywhere on the body. Since you undoubtedly have a chronic HSV-1 infection, and oral to genital HSV-2 transmission is very rare (and you remained seronegative to it), you can be certain you didn't catch herpes during your massage parlor adventure.
STDs are not transmitted by hand-genital contact. Although in theory one can imagine the rare exception for herpes, the above reasoning applies to the hand contact as well as oral -- even if she happened to have a whitlow at the time.
Prior HSV-1 is associated with less severe clinical manifestations of initial infection with later genital HSV-2 infection. There are conflicting data as to whether HSV-1 reduces the infection rate itself; probably it does, but only a little bit. But as noted above, you weren't at risk for HSV-2 from this event anyway.
Turning to other STDs, chlamydia rarely infects the oral cavity, so oral to genital transmission is rare. Gonorrhea can occur, as can nongonococcal urethritis -- the latter perhaps due to normal oral flora, rather than the usual STD pathogens. In any case, the azithromycin would have been effective prophylaxis against both gonorrhea and NGU, and also, for that matter, against syphilis.
Testing your wife for HSV-1 is an option, but certainly not required -- and certainly not because of your massage experience. Probably you already avoid kissing and cunnilingus when having an oral herpes outbreak, and you of course should continue to do so. But there could be risk of transmission to her from asymptomatic viral shedding. If your wife is already HSV-1 seropositive, it would reassure you that she is at little or no risk regardless of what precautions you take. If negative, perhaps it would reinforce your intent to be careful when having an outbreak. But it might just increase your worry about infecting her. So those are the pros and cons; the decision is yours (and hers).
I hope this helps. Take care-- HHH, MD
The best evidence -- which is primarily epidemiologic -- is that people are highly resistant, if not completely immune, to new infections with the same HSV type they already have, anywhere on the body. Since you undoubtedly have a chronic HSV-1 infection, and oral to genital HSV-2 transmission is very rare (and you remained seronegative to it), you can be certain you didn't catch herpes during your massage parlor adventure.
STDs are not transmitted by hand-genital contact. Although in theory one can imagine the rare exception for herpes, the above reasoning applies to the hand contact as well as oral -- even if she happened to have a whitlow at the time.
Prior HSV-1 is associated with less severe clinical manifestations of initial infection with later genital HSV-2 infection. There are conflicting data as to whether HSV-1 reduces the infection rate itself; probably it does, but only a little bit. But as noted above, you weren't at risk for HSV-2 from this event anyway.
Turning to other STDs, chlamydia rarely infects the oral cavity, so oral to genital transmission is rare. Gonorrhea can occur, as can nongonococcal urethritis -- the latter perhaps due to normal oral flora, rather than the usual STD pathogens. In any case, the azithromycin would have been effective prophylaxis against both gonorrhea and NGU, and also, for that matter, against syphilis.
Testing your wife for HSV-1 is an option, but certainly not required -- and certainly not because of your massage experience. Probably you already avoid kissing and cunnilingus when having an oral herpes outbreak, and you of course should continue to do so. But there could be risk of transmission to her from asymptomatic viral shedding. If your wife is already HSV-1 seropositive, it would reassure you that she is at little or no risk regardless of what precautions you take. If negative, perhaps it would reinforce your intent to be careful when having an outbreak. But it might just increase your worry about infecting her. So those are the pros and cons; the decision is yours (and hers).
I hope this helps. Take care-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
