Indecisive

[ocd]

I was recently tested and came out negative for herpes. I have been seeing a woman for several months and we care very much for each other. I am early 60’s, she is late 50’s. She has HSV2 which she contracted many years ago. She has only had one outbreak, and that was the initial one. I’m assuming that this may be because she is in very good physical condition. She does not take antiviral meds and would prefer not to because she does not have outbreaks and is reluctant to take any medications unless absolutely necessary.

I have been beyond stressed out about this. I’ve read your handbook and I suppose I should simply take my chances. But I seem to be obsessed with this so I’m writing you.

Does her low incidence (none) of outbreaks make her even less than normal a risk for passing the virus to me? Should I insist on her taking antiviral regardless?

The most important: If she didn’t take antiviral and we have unprotected (no condom) sex, what are my chances of infection? I understand that a condom does offer 30-50% better chances, but if I stay with this woman for the long term, my assumption is that I will probably get herpes at some point, yes?

[Terri Warren]

It is really quite unusual to have HSV 2 and a single outbreak. Do you know how long she has had HSV 2 and how exactly she was diagnosed? Sometimes people are told that they have HSV 2 just because it is genital without actually being typed.

So my opinion about this: Taking daily antiviral therapy is a small price to pay (and she can do it for $16 a month) to reduce the risk of transmission to an uninfected parter by almost 50%. The medicine is not activated unless there is active virus present, which is when she really needs it. On other days, it is simple excreted, unchanged. Perhaps she does not understand that.

Her low incidence of outbreaks does mean she likely sheds less than someone who does get outbreaks. But if she does actually have HSV 2, then she does shed at times.

Condoms do reduce the risk of transmission by 30-50%, yes.

Even with no meds and no condoms, if you avoid sex during outbreaks, which is always for you two, then there is about a 4% chance in a year, having sex about twice per week, of you getting infected. So even if you both nothing, the risk is not huge. I would not assume you will get herpes at some point, no.

Terri

[ocd]

This topic is very difficult for she and I to discuss. I think that her diagnosis was over 10 years ago and she does not know the type of the test. She remembers that she was told that she had herpes. She has had other partners over the years and none of them was concerned about becoming inflected and to the best of her knowledge, none of them were. Apparently one partner also had herpes. I’m the first man to have any concern and maybe I shouldn’t have.

She is certain that she had only one outbreak and was surprised when I shared your response that it was very unusual. She has read that many people can go for years without knowing they are infected due to their having are no symptoms or they appear in ways not associated with herpes. I believe the percentage of those is 80%

Can you tell me where the statistic that 80% of those inflected do not know they are? And, with a disease as prevalent and infectious as herpes is, how can my chances of getting it with no antiviral
and no condoms be so low as 4% per year?

Thank you for your time. I’m sure you get tired of answering the same questions repeatedly.

[Terri Warren]

Yes 80% of those infected with HSV 2 don’t know.
My strong suggestion is for her to have a type specific IgG antibody test. She may not have HSV 2 at all. If she was diagnosed by clinical exam only, it could be an error or it could be HSV 1 which is not every contagious. Have you been antibody tested yourself to see what you status is?

The statistics are 4%, with sex twice a week, no antivirals no regular condoms, sex twice per week

Terri

[Author]

Posts