HSV2 and Oral Sex

[10048817]

Hi Terri,

I have had HSV2 for almost 7 years and have had normal sexual relationships since. I have taken medication every single day since finding out and have had very few outbreaks. I have always been upfront with guys, and so far, it hasn’t been a problem, until recently. I just told a guy I was seeing that I had it. I thought I was doing the right thing by telling him before we had intercourse, but he is furious with me, because we had already had oral sex. I had gone down on him and he on me. He says that I put him at risk and should have told him before any clothes came off at all. I feel horrible. The reason I didn’t is because I have had 3 different doctors tell me it isn’t a concern. I even saw that you had said you have never seen this happen in your 33 years of practice. He said that this is not the truth and that I could absolutely have passed it on to him orally, even when I am not showing symptoms, and to stop acting innocent. Can you provide any help for me? I’d say the relationship is over at this point, but going forward, I want to make sure I am doing what is right. Thank you for providing this service!

[Terri Warren]

Yes, I can provide help to you. Dump that jerk. He isn’t worth your time. Furious? Are you serious?
While, yes, it is conceptually possible that he could acquire HSV 2 by giving you oral sex, in reality, as I said, I have never seen it happen in 33 years of practice.
You did what you had been told is OK. And in terms of real risk, I think it is OK. Do I think it would be best to inform people before receiving oral sex or having intercourse? Probably, so you won’t encounter this kind of response again.
Let me say that someone who reacts in this very mean way is likely not someone with whom you would be at all happy in the long run. It makes me sad that someone was mean to you about this.
Give yourself a break and let this go.

Terri

[10048817]

Wow. Thank you for your advice. I have to say, I have given him the benefit of the doubt because he had an ex girlfriend with hsv2 who never once let him give her oral sex in their two year relationship because she didn’t want to put him at risk. So in his eyes, he saw me as someone who put him at risk right away. I guess in follow up to your response, how do you have your patients handle a discordant situation. If the girl has it and takes medication, do you tell her it’s ok to have oral sex given to her without using any protection? Do you tell the couple to use condoms every time they have sex? I wish there were studies that have percentages of all the risks while on medication.

[Terri Warren]

Well, we do have studies about overall transmission on medication, but all the transmission was genital, as I recall. If you take daily medication and have sex about twice per week with irregular condom use, the risk for 100 uninfected men having sex with 100 women who have HSV 2 will be that about 2 of them will get HSV 2. There are no studies on transmission to the mouth only.

I tell people that giving someone oral sex who has HSV 2 is very low risk in terms of transmission. And the good news is, if they happen to get it orally, it will protect them against getting genital infection and it will rarely if ever recur or shed. I have had women who wish to become pregnant who are uninfected in relationships with infected men give oral sex when their partner has an outbreak so they get it and are essentially vaccinated against genital infection thereby reducing the risk of infected a baby. Sounds like a reasonable plan to me!

He’s a fool and I think a pompous one at that. Makes me wonder what he might do if you had a really serious medical problem.

Terri

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