What is the risk of HSV, HIV in unprotected sex?
Patient: Hello doctor. About 2-3 weeks ago I made a terrible mistake. I went to a strip club with my friends and got really drunk and high for the first time and I wound up getting a blowjob from a dancer and having sex (with a condom but it broke). I have seen many doctors AND an infectious disease doctor. All of them said my risk of HSV from a oral sex encounter is extremely low. Theoretically possible but very very minimal. Hsv 1 does not like the genital area because it resides in another set of nerves. As for the intercourse doctors told me risks for hsv2 is still very very slim.
For males it takes multiple exposures since they don’t have any mucous membranes down there, and the dancer more than likely didn’t have an outbreak as an outbreak would be VERY painful since it lives in the nerves and she wouldn’t be able to dance or have sex. Doctors told me not to worry about asymptomatic shedding as that’s not common and HIV risk is very low, because it is blood borne not really sexual fluids.
They told me she had more of a chance to catch something from me than I had from catching anything from her.It’s been about 2-3 weeks and I have no symptoms. All doctors told me that if I had been infected with hsv I would have had an outbreak by now. First outbreak is almost always in the first few days to first week. I was told if I haven’t had an out break by now, not to worry. Should I listen o my doctors? (Dermatologist, multiple general physicians, and infectious disease doctor)
Doctor: you have been given a mix of correct and incorrect information. Herpes opportunity has lots of good information. 50% of all new genital herpes cases is from HSV1.
your risks for contracting herpes in your penis area from one episode of oral sex is about 4% she has herpes. just because you don’t have an outbreak doesn’t mean you don’t have herpes. herpes can be dormant for years and years without manifesting. you need blood testing to check for antibodies to herpes virus to know if you have herpes in your system.
HIV has about 0.5 in 10,000 of you contracting HIV if she had HIV. super super small odds. Check CDC article.
Patient: A blood test would be accurate at this point for HSV?
Doctor: Blood test to look for antibodies to herpes type 1 and 2 virus is the best way to know if you have herpes. Many patients have cold sores and already have the type 1 herpes virus in their body and antibodies to the herpes virus as well. these antibodies can help protect you against herpes type 1 virus in your genital area.
Patient: Would the blood test be accurate at this point in time? Are my doctors correct about the asymptomatic shedding? Are they right that if the dancer had an outbreak she most likely wouldn’t be able to dance or have sex since she’d be in pain?
Doctor: you should read this about shedding, Check the Herpes opportunity I sent you earlier.
WHAT IS VIRAL SHEDDING?
Herpes can be transmitted with no visible symptoms. Here are the percentages of the time herpes silently sheds the virus based on the HSV type and location (not to be confused with transmission rates).
- HSV-2 genital 15-30%
- HSV-1 genital 3-5%
- HSV-1 oral 9-18%
- HSV-2 oral 1%
Shedding occurs more frequently during the first 6-12 months of having herpes than it does subsequently due to building up antibodies. Asymptomatic genital HSV-2 infections shed virus about 1/2 as frequently as symptomatic infections. If she had a cold sore in her mouth, it would be painful for her.have you had a cold sore or fever blister in your mouth before? that is most likely caused by herpes virus.
Patient: No I have not. Would the test be accurate? Were my doctors right that she would be in too much pain to dance or have sex? Are they right that my risk is low since I have no mucous membranes down there? Numerous doctors told me it would take multiple exposures.
Doctor: she would be too much in pain to dance or have sex if she had a case of active genital herpes active. If she had oral herpes virus, you have a 4% chance of contracting herpes per year of exposure. so if you had oral sex from her for a year, you would have a 4% risk of contracting genital herpes.
Patient: the singular risk would be minimal? Also is my hsv2 risk low like all the doctors say?
Doctor: yes, a single oral sex exposure risk would be super super super super small. and your HSV2 risk is super super small. Shedding from HSV2 oral is only 1% shedding rate. you don’t have to worry.
Patient: Just to be clear my hsv 2 exposure via the sex since the condom broke is still low?
Doctor: It is extremely extremely low risk.
Patient: The vaginal intercourse is low risk? Just want to be clear that the vaginal intercourse incident is extremely low risk
Doctor: the risks of spread of herpes to you genitally is 4% risk per year of having sex.
Patient: Hsv2 genital to genital that is?
Doctor: Yes, it is 4% risk of transmission per year of having sex if she has genital herpes in her body
Patient: Ahhh ok so super low risk, especially without active leasions
Doctor: yes, super low risks. look over that herpes opportunities handout. it has good information.
Patient: Thank you doctor so you believe I shouldn’t worry about HIV or HSV from this?
Doctor: No, you should not worry about HIV or HSV from this.