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Sexually Transmitted Diseases/HSV 2 symptoms on lips different than....?


QUESTION: I am male and  have the occasional fever blister on the mouth, so already have the herpes simplex virus 1, I've never had gential herpes. If I have cunnilingus with a female who has genital, herpes simplex  virus 2, it would be transferred to my lips. But other than getting fever blisters in that area, since it would be the HSV 2 kind transmitted from her genitals, would the symptoms on my lips be more severe or any different than the regular cold sore I get from HSV 1?  Thanks

ANSWER: Hello Lee,
It is difficult to say whether HSV 1 would be more or less severe than HSV 2 in any site-- the lips, genitals, or elsewhere. It depends on the virulence of the virus as well as the effectiveness of your immune system to fight off recurrences of the infection. As far as I know, it is not possible for a person already infected with one strain of the virus to get re-infected with the same strain of virus. Virus transmission and spread may only occur if the virus is being actively shed. If your partner is not actively shedding virus than you cannot acquire the infection.

Hope this makes sense!  Good luck!

---------- FOLLOW-UP ----------

QUESTION: I'm confused. If I have HSV 1 (the cold sore kind) already in my body and a female has active herpes on her vagina (HSV 2) and I have cunnilingus wth her, and I then get the lesions on my lips from that, would I have HSV 2  or would it still be considered as HSV 1, since it would be on my lips and not the genital area?  Thanks

Hi Again, Lee,
Herpes type 1 and type 2 are two distinct viruses. Either one can infect any body part-- the mouth or lips, the genitals, etc. If a person has one type, then they typically are not thought to be able to get that same type in a different body part. However if you have one type in one area, you can get reinfected with the other type in that same body part. Both type one and type two herpes have periods of activation and remission. They usually occur at different times, but  not simultaneously, although there may be rare exceptions. So a person may have one or both herpes viruses, in different body parts, that may be actively shedding virus and "active," or they may be in remission, not capable of being infectious or transmissible to others.

Hope this offers some clarity!

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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