HSV-2 Contracting Chances

[Purple]

Let’s see if I can get this under 750 words and give you all the important data.

I am a female in a (recently) polyamorous relationship and am beginning a relationship with a male who is HSV-1 and HSV-2 positive (his test result numbers are below). My primary partner (male) and I have been together for over 10 years and understandably he doesn’t want me to “bring anything home”. So in the search for knowledge and for respect to both of my partners and to myself, I am writing to you.

I know based on IgG typed blood tests, I am positive for HSV-1 and negative for HSV-2. The blood test that was ordered did not assign any numeric values just read “positive” and “negative”.

He was type tested as well and got the following values:
HSV1 IgG (CIA) 49.30 IV (this indicates a positive result)
HSV2 IgG(CIA) 10.50 IV (this indicates a positive result)
HSV I/II IgG >22.40 IV (this indicates that it was detected)
HSV I/II IgM .70 IV (this indicates that antibodies weren’t detected)

He contacted his doctor to ask about antivirals, we had read that it decreases asymptomatic shedding by 50% and were intrigued, she left a voicemail saying
“It looked like you had evidence of a past infection with genital herpes. Its not current and can be passed through sexual contact, it’s a virus in the bloodstream in the body but mostly in areas of any lesions. There isn’t any need for any antiviral medication since it is a past infection and not current so you are fine.”
I think this led to more questions than answers. Why would a “past infection” have anything to do with not needing antivirals? Does that decrease my risk of infection?

He has never had any below the belt outbreaks but believes he has had cold sores around his mouth. What is my risk of contracting HSV-2 through kissing on the mouth or his kissing my nipples? I’m just trying to gather as much information as possible so we are both able to have a safe and good time.

[Terri Warren]

His physician is uninformed – terribly. There is no such thing as a past infection. Once infected, this is a lifetime infection and can be shed with and without symptoms from the genital tract. It is not in the bloodstream, it is in the skin and nerves. She is totally messed up about herpes. Wow, this is the worst I’ve seen so far. Is she in another country?

Suppression reduces transmission by 48% (New England Journal, 2004, Corey et al) It does not eliminate the possibility of shedding – it reduces it. If he has never had a genital outbreak, he sheds less often than someone who has had an outbreak but he will still shed virus from time to time.

Terri

[Purple]

Thank you for your reply, Terri. From all the reading I have done I thought the doctor was majorly misinformed as well. Unfortunately she is not in another country but in Oregon. I understand if the other questions I asked counted as “follow up” questions but they went unanswered:

What is my risk of contracting HSV-2 through kissing on the mouth or his kissing my nipples?

A new question: Should be have any new oral outbreak swabbed to see if HSV-2 is being expressed orally?

[Terri Warren]

Neither mouth kissing nor kissing nipples will transmit HSV 2.
He could have oral lesions swab tested but I would bet they are HSV 1. HSV 2 out breaks can be genital, on the thigh, on the buttocks,on the lower belly or around the anus. He could just be missing them?

I am totally shocked that a physician in Oregon where I live and practice would say such things. OMG

Terri

[Purple]

Terri, I applaud you in educating so many people about something that is so misunderstood. I pride myself in reading to understand things and I read and read until I am pretty certain I understand whatever it is I am reading about. I feel like now I am at square one again with my understanding.

There is a lot(!!!!) of (mis)information on the web and apparently being spoken by doctors about HSV-2. There were times, during my research and doctor appointments (with my primary doc, gynecologist, and Planned Parenthood all in California) that I felt the only way to interact with my new partner with 100% safety was with a hazmat suit.(Yes, he lives in Oregon and I live in California. This has definitely helped us take things slow.) He went through a period of time where he was afraid to touch his son based on things we had read. I was under the assumption that one could acquire HSV-2 through kissing, hand holding, basically any skin to skin contact because of asymptomatic shedding and the fact that herpes can live (be expressed? I’m not familiar with this terminology) in the eyes, hands, etc. I think I need clarification here.

Are there reputable sites or journals you can also point me to that would give me correct information? I know you have written books which I am tempted now to buy as well as The Herpes Handbook which I have read. It seems as if you are telling me that as long as we avoid his “genitals,thighs,buttocks,lower belly and around the anus” we are safe; is that correct?

Again, thank you so much Terri. This has been well worth the subscription!

[Terri Warren]

All you have to avoid is his genitals and anus – thighs, buttocks and lower belly do not shed virus. The skin is too thick.

This is your final post on this subscription. If you have more questions, feel free to renew.

Terri

[Purple]

Here are some additional questions I have:

*How is oral HSV-2 diagnosed?
*What are typical symptoms of oral HSV-2?
*How is oral HSV-2 transmitted? I’m assuming through mucus membranes becoming in contact with his saliva.
*Above you mentioned that thighs are too thick to shed the virus. How is it that there can be HSV-2 lesions on the thighs but that the virus isn’t shed? (Or am I misinformed about outbreaks on thighs?)
*If the above is true, that one can have herpes lesions on the thighs but that the thighs don’t shed the virus, than does that mean the only way I could potentially contract the virus via thighs is when there is an active outbreak?

Thank you, Terri.

[Purple]

Update: He had one oral lesion swabbed and the results came back positive for HSV-1, should we just assume at this point that he doesn’t have HSV-2?

And I think I know the answer to this but his HSV-1 wont cause me to have oral outbreaks if I haven’t experienced HSV-1 outbreaks before, correct? (I am positive for HSV-1).

[Purple]

***Rephrasing of “update”: assume that he doesn’t have oral HSV-2

[Terri Warren]

HSV to oral infection is diagnosed by a swab test that has been typed. The symptoms of oral HSV-2 are the same as a cold sore. It is transmitted by direct contact where the mucous membranes or thin skin of another person.

Outbreaks can happen on the thigh when the virus comes to the surface of the skin and breaks through the tissue, causing a blister. But the skin is too thick for the virus to come to the surface without causing a break in the skin. If there is an outbreak on the thigh and someone’s genitals comes in contact with that outbreak then transmission can occur. There would have to be some pretty interesting gyrations occurring for that to happen.

I would assume that if there is a positive swab test for HSV one from an oral lesion that he does not have HSV-2 orally. Obviously we cannot be 100% certain about that but I think it is a reasonable and well thought out conclusion. You are correct, his HSV one would not suddenly cause you to start having outbreaks.

You have one question left on this subscription

Terri

• This reply was modified 5 years, 3 months ago by Terri Warren.

[Purple]

Last question: Is there anything we could do to raise our percentage of knowing closer to 100%? (ie If he got a typed throat swab while he was asymptomatic would/could that tell us anything?)

Thank you.

[Terri Warren]

I don’t really think that swapping without any symptoms is going to give you any more information. It is true that we can recover virus from asymptomatic people in our research studies when we have them swabbing every day, even when they have no symptoms. But you’re talking about something different here. You’re talking about doing a single swab when he is asymptomatic and I just think that’s unlikely to give you the confidence that you seek. Wish I had a better answer for you.

This is your final post on the subscription. If you have more questions, feel free to renew.

Terri

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