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What Are The Chances Of Genital Herpes Post Protected Intercourse?

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Posted on Tue, 16 Feb 2016
Question: Hi I recently had sexual intercourse vaginally with protection with someone who was asymptomatic who has HSV 1 & 2. I am wondering what the risks are of getting the infection from the intercourse one time. Can you get it from simple skin to skin contact or does there have to be a portal of entry like a lesion.
I was told by a Dr. on here that The chances of infection without an active lesion and just by skin to skin contact is very low. Since you used a protection it was a single time exposure the chances of actually getting an infection are less than 5%.
It is best to wait for 4 weeks and get a blood test done after that to completely rule out the chances of any infection.
But I wonder Would the chances be higher than 5% if the person was in viral shedding without open lesions present? Or would the chances still be low without any cuts on open sores on my body in that area, and no exposure due to protection. I am aware that not every person is aware when they are in shedding period although there are some mild symptoms.

Yes, thank you I was planning on getting the blood test as well. Do you think for both HSV 1 & 2 since the partner had both or just HSV 2?

Thanks,
XXXXXXX
doctor
Answered by Dr. Dr. Kakkar (27 minutes later)
Brief Answer:
The risk is low but I would suggest sceening for both Hsv types

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have noted down your concern.
Definitely, a condom protected sex is safer as compared to unprotected vaginal sex. Also, absence of clinical lesions confers less chances for transmission through sexual intercourse. However, even a condom protected sex during clinical asymptomatic phases is not 100% safe, as far as transmission of genital herpes is concerned. This is because a condom covers only a portion of shaft of penis and leaves a lot of genital skin exposed for skin-to-skin contact and rubbing/ friction e.g base of shaft of penis and adjacent pubic region. Its not just simple skin to skin contact but rather minute abrasions sustained during the act of sexual intercourse (and resulting epidermal compromise) that favors transmission by allowing the virus to pass through the damaged skin; intact skin is otherwise impermeable to herpes virus.
Viral shedding varies from time to time and it is more around about the time of a clinical episode (both before and after) though it is generally low in the intervening phases between clinical episodes.
I would suggest you to get screened for both Hsv 1 and Hsv 2; though traditionally Hsv type 2 causes genital herpes and Hsv type 1 causes oro-labial herpes but this distinction applied no more in present scenario and both types of Hsv can cause genital as well as oro-labial herpes.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (3 hours later)
Okay - So Dec. 17-31 I was tx c vanco for C. diff - but I feel like I've noticed since this partner I have noticed a small rash in the anal area where you would wipe and I probably wipe too hard (though anal sex did not occur) I do realize that parts can touch. I also had a small bowel series done the day prior. I believe if I am remembering correctly and I hope I'm wrong that a rash could be an early sign of infection. But I think that's correct, although I do realize it could be from this chronic diarrhea problem I've been having that we are trying to solve and also see if the vanco truly cleared the C. diff. Do you think I am much more likely to have the infection given that? Or that it's possible to just be from the diarrhea problem?

How far out should I be tested? 4 weeks? 6? I am an RN but remembering the little things from diseases I never treat being a PICC nurse sort leave you, I was trying to remember back to virology and I remember there had to be portal of entry. torn skin etc. I'm nervous now.
doctor
Answered by Dr. Dr. Kakkar (6 hours later)
Brief Answer:
I would recommend serial testing at 6 weeks and then at 12 weeks

Detailed Answer:
Hi.

Well, without having a look at, its hard to tell exactly whether the perianal rash/ skin condition is due to herpes Or due to an unrelated cause.
Herpes has a characteristic appearance that is easy to diagnose. It would present as multiple, discrete Or confluent, wet or crusted erosions, small in size and well defined. There would be associated symptoms like pain, burning sensation, tingling or itching.
I think you should get tested at 6 weeks, initially and then againt at 12 weeks.
However, I would like to reiterate that given the fact the your sexual partner did'nt had any active sores and also used a protection, it is more likely that you would have been spared from getting infected from Hsv.

Regards
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9610 Questions

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What Are The Chances Of Genital Herpes Post Protected Intercourse?

Brief Answer: The risk is low but I would suggest sceening for both Hsv types Detailed Answer: Hello. Thank you for writing to us I have gone through your query and I have noted down your concern. Definitely, a condom protected sex is safer as compared to unprotected vaginal sex. Also, absence of clinical lesions confers less chances for transmission through sexual intercourse. However, even a condom protected sex during clinical asymptomatic phases is not 100% safe, as far as transmission of genital herpes is concerned. This is because a condom covers only a portion of shaft of penis and leaves a lot of genital skin exposed for skin-to-skin contact and rubbing/ friction e.g base of shaft of penis and adjacent pubic region. Its not just simple skin to skin contact but rather minute abrasions sustained during the act of sexual intercourse (and resulting epidermal compromise) that favors transmission by allowing the virus to pass through the damaged skin; intact skin is otherwise impermeable to herpes virus. Viral shedding varies from time to time and it is more around about the time of a clinical episode (both before and after) though it is generally low in the intervening phases between clinical episodes. I would suggest you to get screened for both Hsv 1 and Hsv 2; though traditionally Hsv type 2 causes genital herpes and Hsv type 1 causes oro-labial herpes but this distinction applied no more in present scenario and both types of Hsv can cause genital as well as oro-labial herpes. Regards