Sexually Transmitted Diseases/Follow up to HSV question


Hello Mark,

Thank you very much for the time you put into my inquiries.  You are very kind and generous.  I do apologize for the long post.  I was wondering about the length.  What made me decide it was probably ok was that when you go to post a question the max characters is something like 65000, otherwise I would have changed the posting to whatever the max characters said.  I thought that was above and beyond and I will break it down into multiple posts in the future, after this follow up, if I need guidance.  I do thank you for answering my concerns anyway, that was very considerate of you.  I didn't see the link for follow up questions, so I am just posting this to be certain I understand and I will feel complete with this.

I feel I understand these viruses/bacteria more from your explanation of things.  I understand blood and urine do not transmit hpv or hsv.  Am I correct to assume that pus from a wound (not an hsv lesion) also does not transmit hpv or hsv?  You talk about colds with children, so does sneezing/runny noses transmit hsv? Would it be the right thing to do to tell people that I have only kissed about my herpes II since I am asymptomatic and do not know where I shed?

Regarding massage, you state massage is ok and of course to cover any chapping/cuts/abrasions.  Assuming I have intact skin, I understand you believe it is ok for me to give massage.  I guess I am truly struggling with this on an ethical level because I do not get lesions or symptoms of any kind, so I do not know if I shed from my hands, arms, mouth, genitals.  If it were genitals I would not be concerned.  But I could be one who sheds from another location and I guess I feel that obligates me to stop doing massage.  I am wondering if you can please let me know why you think it is ok for me to keep doing massage?  You are the professional in this realm and I value your input.  I’d rather do what is right rather than what is easy.

Thank you very much again for your service and time,
35 years old
Oklahoma City, OK

Hello Again, Star,
Blood and urine do not transmit HPV or HSV, however blood may spread blood borne infections such as syphilis, and hepatitis B, both of which are STDs.  A lesion containing pus or blood adjacent to a herpes or HPV lesions if present, may be co-contaminated and thus spread the viruses to someone else, if those people may have an entry point for the virus.  Since a cough, sneeze or runny nose from an upper respiratory infection may similarly be co-infected with herpes virus, and an unprotected sneeze may propel contaminated secretions directly into an uninfected person's mucous membranes. That's why its important to always cover a cough or sneeze with the arm sleeve of your clothing. It is not helpful to freak people out telling them your past history, because almost everyone has already been previously infected with herpes viruses, the risk to others is extraordinarily low (almost zero), and many people do not have the sophisticated understanding of how germs are spread to understand their very low likelihood of being at risk.

Regarding massage, there is nothing to worry about. If you ever develop a typical herpetic lesion somewhere, than keep that area covered if it comes in contact with others, and don't sweat the small things. Keep doing your massage, and quit worrying about it!

Good luck!

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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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