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Hello Terri,
Thank you for your time. I have been dating a wonderful man with hsv 2 and I have been tested and do not have hvs 2. As such, I just had a few questions as we are a discordant couple. He has had hsv 2 for 4 years now, always gets his outbreaks in the same area (on the tip of the penis) and gets an breakout once a year since the primary outbreak. We have not had intercourse yet until we know where the relationship is going.
1) as the outbreak is always in the same area and can be covered with a condom, if we did engage in intercourse and used a condom, would I be completely protected against contracting hsv 2?
2) in terms of viral shedding, would he be shedding only around the area where breakouts occur, or does the entire genital area shed?
3) if i contracted hsv 2 orally, would I then be protected against getting it genitally?
4) we do engage in some sexual activity. If i do masturbate him, we use a condom. Before he touches me, he washes his hands. What are the odds of transmission in this case if no visible sores are present? (Ie if the virus was shedding, and he touched himself and then touched me, could the virus be transmitted to me this way?)
Thanks.
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1. I would say that you are largely protected against HSV 2. Men shed virus mostly from the shaft of the penis. However, they can shed from other locations like the rectum so though you would be largely safe, I couldn’t say you would be 100% safe.
2. See question 1 for that answer
3. Yes, oral infection with HSV 2 would basically be a vaccination against getting it genitally. Once you have one type of HSV in one location, you are extremely unlikely to get it in a new location.
4. You don’t need to use a condom with masturbation, that’s not necessary if you have intact skin on your hands. The odds of transmission via masturbation are very close to zero. I wouldn’t worry about that particular risk. It takes some quantity of virus to infect another person and in the scenario you are describing, the risk is again, very very low.
If you do decide to have intercourse, it would be best if he was taking antiviral therapy daily, like valacylcovir or acyclovir as it reduces transmission by almost half over no medicine at all. Does he currently take medication?
You have two more questions to ask, please feel free.
Terri
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I do have words of wisdom!
I’ve been where you are. If you are fortunate enough to find a great guy, herpes or not, and you feel that the relationship has real potential, I say go for it. Let’s face it – we all bring some negatives to relationships. His is herpes, I’m sure you have some too. In the big picture, things like sex and money and inlaws and children and work problems are far bigger problems than herpes possibly could be. Herpes is a minor medical problem though a bigger social and psychological one. Some people even feel that having herpes help them sort out the wheat from the chaff when it comes to partners who will stick by you through tough times. That is not to say you should rush into this. Taking your time and getting to know each other is important for many reasons.When condoms and daily antiviral therapy are both used, the risk of transmission from men to women, having sex an average of twice per week, is about 2-3% per year. That is, if there were 100 couples in the same situation, 2-3 women would become infected in a year. viral shedding does not occur through semen and blood, normally, but rather skin to skin.
When it comes right down to it, the question is would you rather be with him and risk getting herpes or not be with him. It may be way to early to know the answer for you and that’s OK. Remember that herpes is only one of his qualities so try to balance the whole picture. All in all in my relationships over the years, I’ve had sex for a total of 18 years with men who have had herpes and never acquired herpes. The men involved took daily suppressive therapy and no condoms were used (well, maybe the first week or so). And I know a lot about herpes and was very willing to take the risk.
You’ve got one more question to ask.
Terri
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Neither blood nor serum are good carriers of HSV, no.
If you give your partner oral sex without a condom, it is possible though not likely that you could contract this orally. If you do, it vaccinates you against getting it genitally.I’m glad this board was helpful for you. If you feel like it, we could use some good reviews on Yelp. Just a thought.
Have a great holiday!Terri
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Yes, hypothetically speaking that is correct. I have heard Dr. Anna Wald, considered the nation’s expert in genital herpes, make this statement on more than on occasion at professional meetings. And I have had female partners of men with HSV 2 genitally tell me that they did this exact thing to avoid getting it genitally since oral HSV 2 is such a very limited problem and if it recurs, looks just like a cold sore. Their purpose was to avoid getting hSV 2 genitally and having to deal with the possibility of infecting a baby at birth. There are no clinical trials that have looked at this issue.
HSV 1 is more easily transmitted to the genitals by giving oral sex than HSV 2, that is correct.
Terri
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I don’t know, I never heard the follow up.
My opinion is that it would work well. And really, when Anna Wald says she thinks it is true, I believe that it is true. Also, in 32 years of practice, I have seen perhaps one person who reported a history of cold sores that acquired HSV 1 genitally, and I’m not even positive about that person having cold sores to begin with.Terri
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I understand the question. I think the risk of transmission in that way is very low indeed.
Terri
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