HSV-1 Safe Sex Practices

[richardson]

I have read quite a bit online regarding safe-sex practices for those diagnosed with genital herpes, but there’s not a really clear cut resource for safe sex practices for those with HSV-1 oral. I did also read the book “The Good News About the Bad News….” and I found it very useful and filled with really excellent information; however, I did have some specific questions so that I can understand how best to be safe in a situation where HSV is not genital.

-Is it safe for the infected partner to kiss lips, nipples, and the overall body of the uninfected partner if no cold sore is present?

-Is it safe to have unprotected intercourse/genital to genital contact?

-Is it safe for the uninfected partner to perform oral sex and kiss and touch the body of the infected partner?

-Is it safe for both parties to masturbate each other/touch each other’s genitals?

– Is oral sex performed by the infected person on the person uninfected out of the question regardless of whether there is a sore present, since the virus can shed with no symptoms, therefore putting the uninfected partner at risk for HSV-1 genital?

– Touching in general is a question for me because some resources say that if the infected person touches their cold sore and then touches your body, it could transfer the virus. (Or what if they touched their own body and then you touched them?) Or they could autoinoculate themselves, etc. This seems to me to be a bit (or a lot) over the top, so I would prefer to verify it with a professional.

There is a lot of focus placed on HSV located in the genital region and the oral region seems a bit left out in regards to sex beyond noting that oral sex performed on the uninfected is not advised! I just want to make sure I understand (and be reassured by more than anecdotal information) regarding what is generally safe practices when dealing with HSV-1 oral. I would prefer to think of this as something that, while it may have its challenges, can certainly be overcome while still maintaining healthy sexual activity.

Thank you in advance for your response and for this forum!

[Terri Warren]

We are in New Mexico and I have to do something but will answer in about 2 hours.

Terri

[Terri Warren]

-Is it safe for the infected partner to kiss lips, nipples, and the overall body of the uninfected partner if no cold sore is present?

Its clear you’ve given this all quite a bit of thought and I think that’s refreshing. As you likely know, 56% of the US population between 14 and 49 are infected with HSV 1. And as people age, the percentages increase. That means that the chances you would encounter, either sexually or through kissing, there is 50% chance that the other person has it. Likely most of that infection is oral but more often, genital.

-Is it safe to have unprotected intercourse/genital to genital contact

If a person only has HSV 1 orally, then they can only transmit it from the facial area. It is not infectious through the genital area.

-Is it safe for the uninfected partner to perform oral sex and kiss and touch the body of the infected partner?

Same anser. If someone has HSV 1 orally only, then another person can give them oral sex without risk of infection. Same goes for touching all over.

-Is it safe for both parties to masturbate each other/touch each other’s genitals?

Absolutely. If there is a worried person, you can avoid saliva in favor of other kinds of lubricants.

– Is oral sex performed by the infected person on the person uninfected out of the question regardless of whether there is a sore present, since the virus can shed with no symptoms, therefore putting the uninfected partner at risk for HSV-1 genital?

I think the best way to answer that is to say that a person can give off virus from their mouth even when there are no cold sores present. In that sense yes, if someone with HSV 1 gives oral sex to someone who does not have HSV 1, there is a small risk of transmission. There is no perfect solution to that small risk. Probably if the infected person took daily antiviral therapy, the risk would be reduced greatly.

– Touching in general is a question for me because some resources say that if the infected person touches their cold sore and then touches your body, it could transfer the virus. (Or what if they touched their own body and then you touched them?) Or they could autoinoculate themselves, etc. This seems to me to be a bit (or a lot) over the top, so I would prefer to verify it with a professional.

Autoinoculation almost always occurs, when it does, which is not often, within days or weeks of acquiring a first infection. After that, autoinoculation is extremely unusual because the immune system has mounted a substantial immune response that keeps that from happening. I encourage my patients to take that one off the worry plate.

[richardson]

Thank you so much, Terri, for responding to all of my questions (and so promptly). I think these answers, combined with the information in your book, covers it fairly well for me. I appreciate that there are people such as you who are working to educate the public on this matter.

[Terri Warren]

You are welcome. So here is my personal opinion about this:

I already have cold sores so I can’t really speak as though I don’t.
However, knowing what I know about herpes, if I didn’t have HSV 1 and I was single again (heaven forbid), and met someone who had tremendous potential for me, I wouldn’t hesitate to both kiss and have sex with someone who has HSV 1 and would also receive oral sex from that person. I would certainly test to determine my real status, and for HSV 1, that would probably be western blot, and then was still negative, I would ask my partner to consider antiviral therapy daily to reduce the risk of transmission. Then I wold live as fully, sexually, romantically and emotionally as I could, with an acyclovir prescription filled and available should I become infected so I could treat right away. If I had to make a choice between a life with a loving partner and the risk of getting herpes, that would be a slam dunk.

Terri

[Terri Warren]

ONe more thing – sorry. With mouth to nipple contact, don’t be rough. if the skin is broken by teeth, virus can get in more easily. I actually have seen that happen. Kissing is different than biting.

Terri

[richardson]

Thank you for such a candid response. That is really very, very helpful to hear. After having given this much thought (as you can probably tell!), I believe that I feel the same way about the matter. I am grateful to be able to make an informed decision, weighing all the pros and cons.

Also, I greatly appreciate the extra comment regarding nipple contact. It was a question I had. I had heard about the not being rough. I wondered if even saliva alone coming into contact with the nipple would be cause for concern. I thought maybe I would have to give up the idea that my partner would be able to lick/kiss any part of my body without a latex barrier, and I have been trying to come to terms with that. 🙁

[Terri Warren]

You definitely don’t need to come to terms with that! If you only have oral herpes, only your oral area is infectious. The regular intact skin of the face is not infectious without a lesion.

Terri

[richardson]

Well, I was gratified that *I* would be able to kiss and touch THEM, but as the uninfected partner, less thrilled with the notion that they would not be able to kiss me/my body without transmitting. lol!

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