Likelihood of HSV2 transmission female to male?

[concernedman]

Hello Dr. Warren,

Two days ago (11/5), I (male) had protected sex twice and oral sex once with a new female partner. The first time we had protected sex, I had on boxer briefs as a barrier. The partner later disclosed that they are HSV2 positive and have been so since 2008. She had no visible lesions or symptoms. She does not take Valtrax daily because it triggers outbreaks for her and instead relies on L-Lysine and monitors her diet carefully. Prior to me, she has had at least 5 partners over the last few years where condoms were not always used. None of her other partners to her knowledge (Including long-term partners) have contracted HSV2 from her and she says since we used condoms on top of that, she is very confident that I am OK. I have not been blood tested for herpes (and have never had a cold sore either).

I have read your handbook and looked up other studies online that say annual transmission rates from female to male when no outbreaks are present is 4%. Condoms can further reduce that number.
While I am not currently experiencing any lesions, there seemed to be a slight burning sensation in my urethra after masterbating. I am very scared/anxious that I have contracted genital herpes despite the odds being more on my side. My questions are:

1) How likely (high, low, percentages) is it that I will develop genital herpes?

2) If I don’t have any lesions form in after 10 days, will that mean that I’m OK?

3) Is two weeks too early for me to take a blood test?

4) Is there anything I can do now, or do I just have to wait until I have symptoms?

Thank you very much.

[concernedman]

Hello Dr. Warren,

To give you an update on the situation, I have been constantly checking myself for symptoms since my post last week. I went to an urgent care clinic on Saturday 11/11 and had a virtual visit later that same evening after I had noticed some red patches on the head of my penis. Only one of them had slight itchiness. Upon inspection and hearing about my lack of any other symptoms (swollen lymph nodes, flu symptoms, no bumps/lesions on shaft of penis), the nurse said it didn’t look like herpes but still prescribed me Valtrex and did a swab, urine and blood test, which I should receive the results for soon. During the virtual visit, the doctor noticed I had a lesion on the underside of the head of my penis that was consistent with a genital wart for HPV and said the other redness on my shaft was from penile eczema. I was prescribed a cream and ointment for both issues which I’ve started (only the eczema, because there was a hold up getting the other prescription).

The HPV diagnosis was a shock/surprise and I let my partner know. The doctor’s reasoning was that my stress levels over the last week (barely eating and sleeping) exacerbated the HPV to make the wart itchy. So far, it’s been 8 days since my exposure and I still haven’t had any HSV symptoms but am still very anxious and scared that it will change. I just want to follow up with you with my earlier questions.

1) How likely (high, low, percentages) is it that I will develop genital herpes from those two encounters?

2) If I don’t have any lesions form in after 10 days (I’m on day 8), will that mean that I’m OK?

3) Is two weeks too early for me to take a blood test?

4) Is there anything I can do now, or do I just have to wait until I have symptoms?

Thank you

[Terri Warren]

1) How likely (high, low, percentages) is it that I will develop genital herpes from those two encounters?
Extremely unlikely! The condom goes a long ways toward protecting yhou.

2) If I don’t have any lesions form in after 10 days (I’m on day 8), will that mean that I’m OK?
Not everyone who gets herpes gets lesions with a new infection, but so far, so good, if no lesions.

3) Is two weeks too early for me to take a blood test?
That would only give you a baseline result – you would need at least 8 weeks from the encounter to get any kind of reliable result and there are false positives on the IgG tests as well

4) Is there anything I can do now, or do I just have to wait until I have symptoms?
Correct, nothing to do now.

Terri

[Author]

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