Herpes Simplex Virus (HSV) transmission survey
"HSV 1 Genital After HSV 1 Oral"
by H. Hunter Handsfield, M.D.
Mar 26, 2010
It is true that having HSV of either type makes one immune, or at least highly resistant, to a new HSV infection with the same type, anywhere on the body. Therefore, your postive HSV-1 blood test and presumed oral herpes means you're never going to get genital HSV-1 [from your girlfriend who has genital HSV-1]. . . . It is true that an increasing proportion of genital herpes in recent years is due to HSV-1, largely the result of rising frequencies of oral sex. But with few if any exceptions, those catching genital HSV-1 are believed to be among the 50+% of the population without prior oral HSV-1. . . . there is another reason genital to genital HSV-1 transmission is uncommon. Both recurrent outbreaks and asymptomatic shedding are uncommon in genital HSV-1 -- so the odds are good your genital area will never be exposed to the virus, even with frequent unprotected sex [with your girlfriend who has genital HSV-1]. . . . In summary, for several reasons you can be confident you'll never catch your partner's (or anyone's) HSV-1 infection.
[url]http://www.medhelp.org/posts/STDs/HSV-1-Genital-After-HSV-1-Oral/show/1204872[/url]
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"The Truth About HSV1, HSV2, and Oral Sex"
by Charlotte Grayson, M.D.
Wednesday, February 28, 2007
. . .
[Q]You have genital HSV-1 and your partner has genital HSV-2 and you have unprotected sex.
[A]There is a small risk that you will get HSV-2. However, it’s not very likely that your partner will get genital HSV-1. It’s rare for a person with genital HSV-2 to get HSV-1.
[Q]Your partner has genital HSV-2 and you perform oral sex on him or her. Will you get oral HSV-2?
[A]Not likely. Almost 100% of HSV-2 infection is genital. Part of the reason is that most people have oral HSV-1 - providing some immunity against infection against HSV-2.
[url]http://www.healthcentral.com/genital-herpes/c/86/6903/hsv1-oral-sex[/url]
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[b]SURVEY
(1) If you or someone you know face-to-face acquired [u]genital[/u] HSV-[u]1[/u] despite a prior [u]oral[/u] HSV-[u]1[/u] infection, (disproving the statement, above, that "your postive HSV-1 blood test and presumed oral herpes means you're never going to get genital HSV-1"), please post a report or PM me.
(2) If you or someone you know face-to-face acquired genital HSV-[u]1[/u] despite a prior diagnosis of genital HSV-[u]2[/u] (despite the above statement that "It’s rare for a person with genital HSV-2 to get HSV-1"), please post a report or PM me.
(3) If you or someone you know face-to-face acquired [u]oral[/u] HSV-2 (despite the statement, above, that "Almost 100% of HSV-2 infection is [u]genital[/u]"), please post a report or PM me.
(4) If you or someone you know face-to-face acquired HSV-2 despite a prior diagnosis of HSV-1 (despite the above statement that having HSV-1 provides "some immunity against" HSV-2), please post a report or PM me.
(5) If you or someone you know face-to-face acquired genital HSV-1 from vaginal intercourse from someone with whom they did not also have oral sex ( contrary to the above statement that "recurrent outbreaks and asymptomatic shedding are uncommon in genital HSV-1"), please post a report or PM me.[/b]
How Not To Bring Home A Disease
I am not a health professional. I am simply trying to gather the facts.
I welcome comments (especially those referencing a reliable source) on what I've gathered below.
There is an excellent and authoritative summary table of risks from various sexual activities at [url]http://www.sfcityclinic.org/stdbasics/stdchart.asp[/url]
THE BOTTOM LINE (as best I can decipher, from my reading):
Gonorrhea, syphilis, chlamydia, and human papilloma virus (HPV) can be transmitted in both directions by unprotected fellatio. Facials can infect the eyes with gonorrhea or syphilis. Cunnilingus is very unlikely to transmit anything in either direction (except when there are open sores, e.g. syphilis or herpes, but half of us have herpes anyway). Kissing, even with lots of deep tongue, is extremely unlikely to transmit anything, even if one person has pharyngeal gonorrhea. Finger fucking is safe (assuming no cuts or open sores). Inserting the penis into the vagina or anus (without a condom) can transmit all STD's including HIV, the anus being much more risky. Even with a condom, anal/vaginal intercourse is not risk free, although the risk is tiny. All of the above are less safe or unsafe if either partner is bleeding or has sores or recent cuts or wounds.
[A few basic facts vis a vis the above: Gonorrhea and syphilis are bacterial infections that are usually cured by antibiotics. Chlamydia is also antibiotic curable but often goes undetected. HPV and HIV are virus infections that are not curable. Anti-HIV medications, given early enough to HIV+ people, extend lifespan and postpone the development of AIDS.]
Opinion: I used to think it was a bad thing for sex workers to give BBBJ (uncovered fellatio). Now I conclude that it is not so bad for the sex workers, given that the main risk is a treatable bacterial infection (gonorrhea or syphilis) as long as they get tested regularly and treated when infected. Since I really*really don't want to bring anything home, I've decided to always cover for fellatio. I'm happy to learn that deep kissing and cunnilingus are relatively safe as long as there are no obvious open sores. I have on occasion cut open a condom to make a barrier for use in cunnilingus. From now on I don't think it is necessary, unless you have a cut or sore in your mouth or on your lips. Of course if you have a sore throat or cold sore, I would avoid kissing anyone until you're well again.
MORE DETAILS WITH SOURCES
Licking the anus (rimming) has never been known to transmit HIV. However, it can transmit a variety of nasty diseases unless the person being rimmed has washed very thoroughly beforehand. Licking or sucking objects that have penetrated the anus is very unsafe -- don't do it! [url]http://www.sfcityclinic.org/drk/oralsex5.asp[/url]
People with multiple sex partners should get vaccinated for Hepatitis A and B, both of which are serious and uncurable and can occasionally be transmitted by sex. There is no vaccine or cure for Hepatitis C (which is very serious) but recent studies found that it is almost never transmitted by unprotected sex -- it is transmitted by blood or sharing needles.
A study of 301 female sex workers in Israel in 2001 found that 9% had pharyngeal gonorrhea. None had sore throats. "In two thirds of the cases, oral sex (fellatio) was the most probable route of acquiring the disease. Because there is a general misperception that STIs cannot be transmitted by oral sex, these individuals either engaged in unprotected oral sex solely or had unprotected oral sex followed by protected vaginal intercourse. A similar observation was reported from Japan, where cases of gonococcal urethritis [in male clients] acquired by oral sex with new, expanding types of sex workers who offer only nonvaginal, usually unprotected sex." [url]http://journals.lww.com/stdjournal/Fulltext/2006/08000/Pharyngeal_Gonorrhea_in_Female_Sex_Workers_.10.aspx[/url]
More on oral sex: [url]http://www.medhelp.org/posts/STDs/Oral-Transmission-of-Gonorrhea/show/360541[/url] [url]http://std.about.com/od/riskfactorsforstds/a/oralsexsafesex.htm[/url] [url]http://www.medhelp.org/posts/STDs/female-received-oral-sex-and-is-concerned-about-stds/show/1028292[/url] [url]http://www.medhelp.org/posts/STDs/cunnilingus-on-CSW/show/951678[/url] [url]http://www.medhelp.org/posts/STDs/Can-oral-sex-pass-STD/show/694435[/url]
A study of 320 prostitutes in London for 675 person-years found Baseline prevalence: HIV 1.3%, hepatitis C 6.7%, hepatitis B 6.6%, syphilis 2.3%, HTLV-I/II 0.4%, gonorrhoea 3.0%, chlamydia 8.2%, genital herpes 16.8%. Incidence (per 100 person years): HIV 0.2, hepatitis C 0.3, gonorrhoea 5.6, chlamydia 12.6, genital herpes 6.5. Bacterial infections were mostly acquired not from clients but from boyfriends. "This study shows that it is possible to have a larger number of sexual partners and remain free from sexually transmitted infections provided that condoms are used consistently." Most but not all in the study remained free of STD's. (Item #41 at [url]http://lib.bioinfo.pl/meid:33093[/url]).
Syphilis: >14% (>33% in another study) of cases came from unprotected fellatio. These may be underestimates b/c most people having oral sex also have vaginal/anal sex, and these percentages are for those whose only risk factor was oral sex. Syphilis can often be asymptomatic, so carriers don't know that they have it. Untreated Syphilis is very serious. [url]http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5341a2.htm[/url]
Gonorrhea can infect the mouth or throat (pharyngeal gonorrhea), as well as the genitals, anus, and eyes (so even facials are dangerous). Often gonorrhea is asymptomatic, so people don't know they have it. It is easy to treat when diagnosed. If left untreated, it can lead to serious health problems including infertility. Infection with gonorrhea increases susceptibility to HIV infection. [url]http://www.cdc.gov/std/Gonorrhea/the-facts/default.htm[/url]
Even with a condom, there is a low rate of HIV transmission. The rate with a condom is highest for receptive anal sex. [url]http://www.cdc.gov/hiv/topics/treatment/PIC/pdf/chart.pdf[/url]
HIV infected people who are taking anti-HIV medicines have low amounts of virus, but can still infect others. [url]http://www.cdc.gov/hiv/topics/treatment/PIC/pdf/brochure.pdf[/url] However studies have shown that the rate of transmission is much lower when the infected person is being properly medicated.
Chlamydia is the most prevalent STD, and can be transmitted by fellatio. It is usually asymptomatic, so people don't know that they have it. 40% of women with untreated chlamydia may get pelvic inflammatory disease, which can lead to chronic pelvic pain, infertility, and potentially fatal ectopic pregnancy (pregnancy outside the uterus). Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed. [url]http://www.cdc.gov/std/Chlamydia/STDFact-Chlamydia.htm[/url]
You can get genital herpes and human papilloma virus (HPV, may cause cancer) from oral sex, or contact of your genitals with secretions from an infected person ("massage, privates to privates"). The Gardasil vaccine protects against infection with HPV, and against cancer from such infection. [url]http://www.cdc.gov/std/Herpes/the-facts/default.htm[/url] [url]http://www.cdc.gov/std/HPV/STDFact-HPV.htm[/url]
Fellatio Not Safe Anymore
Gonorrhea is becoming resistant to the antibiotics used to treat it. This is a very good reason for sex workers and clients to use condoms during fellatio.
[url]http://www.cbc.ca/health/story/2010/03/30/gonorrhea-antibiotic-resistant-superbug.html[/url]