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I am 58 and have had HSV2 for 34 years. I have never had an outbreak except on the upper shaft of my penis or in one location on my buttocks. I have not had an outbreak on my penis in years and always know when one is coming. I am HSV1 negative. I am in a relationship with a 52 year old woman who is positive for HSV1 but never knew it until recently tested. She is negative for HSV2. She is generally very healthy but has been told that she has some immune system issues that are not understood. For example, she can have great difficulty curing a normal yeast infection. She is very worried about HSV2 risk. Wouldn’t we be extremely safe with oral sex? What about condoms for intercourse combined with Valtrex?
What is the risk if she were to get HSV2? I understand that Valtrex still works when someone has some immune system issues. -
Even though you have not had any penile outbreaks lately, you may still be shedding virus at times that you are not aware of. I’m not clear that having a hard time curing a yeast infection constitutes an immune disorder. You giving her oral sex would be safe in terms of transmission of your HSV 2, yes. Condoms combined with antiviral therapy would yield a 2-3% chance in a year of her acquiring your HSV 2, assuming sex about twice per week. And yes, if she did acquire HSV 2, Valtrex would work for her.
Terri
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While you are correct that few people used condoms 100% of the time, other studies have shown us that condoms greatly reduce transmission but don’t eliminate it altogether. Given all of the conditions of the study (and I am an author on that paper), the 48% reduction of transmission by those using Valtrex, on average, is accurate. She could acquire HSV 2 orally by giving you oral sex and if she did, it would look just like a cold sore and would essentially vaccinate her against HSV 2 genital infection. Whether she wants to take that risk is up to her. The problem is you can’t know if you are in the 50% that don’t shed ever or in the other group where shedding still happens.
Terri
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HSV 1 does not protect against HSV 2, no. Having HSV 1 first often suppresses symptoms of HSV 2 when it is acquired. About 10% of people who acquire new genital HSV 2 also have oral lesions – they have intercourse with and give oral sex to the same person. What is uncommon is reactivation of HSV 2 orally – both shedding and clinical recurrences. I would say we likely have no real idea of how common it is to acquire HSV 2 orally, honestly, because it rarely recurs and most cold sores are not swabbed and typed.
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Terri
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