Newly diagnosed HSV1

[msj36]

37 year old woman in a non-monogamous marriage, currently have 4 other partners.

I thought I was being tested for HSV in my routine STD testing and it turns out I was not. In my most recent test I asked specifically for HSV 1 and 2 and tested positive for HSV1 with a IGG index of 40+. I have never had an outbreak on my mouth or on my genitals and don’t recall having a coldsore as a child.

Husband (no condoms): 12+ years. HSV1 negative, August 2022.
Male Partner 1 (condoms for PIV): 1.5 years. HSV1 negative, October 2022. His wife is negative.
Male Partner 2 (condoms for PIV): 3.5 years, long distance. HSV1 Positive, November 2022. He was negative in 2016 and had not been tested since. No history of outbreaks. His wife is negative.
Male Partner 3 (condoms for PIV): 1.5 years. Unable to obtain a test due to insurance issues. No history of outbreaks.
Female Partner: 6 months. Unable to obtain a test due to insurance issues. No history of outbreaks.

I started anti-virals (Valacyclovir) last week in order to decrease transmission possibility.

Since I haven’t had any physical symptoms (namely sores on my mouth or genitals) is there any way to confirm or speculate if I have OHSV1 or GHSV1? I understand that typing can happen by testing from a sore or lesion but that’s not applicable here.

Can you also confirm my breakdown of transmission risks (without condoms, no suppressants):
GHSV1 – Asymptomatic/no outbreak (transmitting genitally): <1%
GHSV1 – Asymptomatic/no outbreak (transmitting orally): 25%
OHSV1 – Asymptomatic/no outbreak (transmitting genitally): 4%
OHSV1 – Asymptomatic/no outbreak (transmitting orally): 25%

With a 40+ IgG I understand that it doesn’t mean that I got HSV1 in childhood or 10 years ago. However you’ve mentioned in the forum that counts do go up over time (with HSV2) and that HSV1 is its most-transmissible during the first 1 – 2 years. Would you feel comfortable stating that its likely that my infection is 5+ years old?

[Terri Warren]

Sorry, we have no data on transmission rates of genital HSV 1 nor oral HSV 1. I have no idea where you got these numbers but they don’t seem at all correct to me.
Remember that about 47% of the population has HSV 1 infection so very common. Since we don’t know the location of your infection, we really can’t address transmission risk, though we do have some shedding data. But you don’t fit that information either as you’ve not had an outbreak anywhere. And we cannot know if you’ve been infected 3 months or 30 years. I’m sorry, but you are going to have to life with some unknowns here.

What we do know is that you likely aren’t shedding very often if a partner of 12 years is still uninfected.

Terri

[msj36]

Given my situation, do you have advice on when I should disclose to new partners? Should I disclose before kissing? Oral sex? Vaginal Sex?

[Terri Warren]

That’s a very tough one. I think I would do it at you giving oral sex. That’s what I would do anyway.

Terri

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