Question re: HSV2 transmission via oral, vaginal sex

[Apple2]

Hello Terri. I am a 52-year-old woman who has had HSV 2 for 20 years. I have never had classic symptoms that tell me I am having an outbreak, but I have tested positive for both HSV 1 & 2 (two previous partners had HSV2). Having had the virus for a long time, I have done a lot of research and I am familiar with prevention methods, transmission odds, etc., but because my last two partners were positive, it has not been a concern for me for years. I am now seeing someone new, but it is not an exclusive relationship. I am finding my lack of symptoms problematic in that I have no clues to tell me I might be shedding or having an outbreak. I find myself overanalyzing any sort of irritation “down there” as a possible clue re: an outbreak, such as dryness, irritation etc., which, because I am postmenopausal, essentially means that I could be having an “outbreak” every day.
I take 1,000 mg of Valtrex daily. My question is, in the absence of signs that can alert me to “risky” transmission times, I am worried about transmission to my new partner, both via oral and vaginal sex.
My questions are:
–Are the odds of transmitting HSV2 orally truly minimal? My new partner is, understandably, concerned about getting HSV2 orally and passing it on to other partners. I have not been able to find any concrete information out about oral transmission of HSV2 other than it is “uncommon.”
— We have not had vaginal sex yet. If this happens, we would use condoms at all times. Everything I read says “avoid sex during outbreaks.” But in the absence of symptoms of an outbreak, is there anyway at all that I can determine the “less risky” times to engage in vaginal sex WITH a condom?

[Terri Warren]

First, it would be good to confirm that the testing you had done does not need confirmation – what were the index values of your positive tests?

–Are the odds of transmitting HSV2 orally truly minimal? My new partner is, understandably, concerned about getting HSV2 orally and passing it on to other partners. I have not been able to find any concrete information out about oral transmission of HSV2 other than it is “uncommon.”

That’s because we don’t have any good statistics about this. I would say it is quite uncommon.

— We have not had vaginal sex yet. If this happens, we would use condoms at all times. Everything I read says “avoid sex during outbreaks.” But in the absence of symptoms of an outbreak, is there anyway at all that I can determine the “less risky” times to engage in vaginal sex WITH a condom?

There is not. Since you are asymptomatic, there is no way to know when you might be shedding virus. You will simply have to rely upon the condoms and daily antiviral therapy to reduce the risk to your partner (and let me know the index values of your testing)

Terri

[Apple2]

Thank you for the quick reply. I was not given any IGG values. I had an test done about 10 years ago called Immunoblot. I was not given any index values, only told that the test differentiates between HSV 1 and HSV2 and that results showed I was positive for both. Given that my partner at the time showed symptoms for HSV2 for the first time only after being with me (which was when I had the test done; I had a previous partner who has HSV2) I had no reason to doubt the results.

A follow up question: Based on my initial post, what, in your educated opinion, are my “odds” of transmitting to my new partner? I have seen stats that say Valtrex reduces transmission by 50% and condoms by another to 30 to 50%; are these still accurate?

Thank you!

[Apple2]

One last question: Because the virus is active in the “boxer short area”does this mean that even with a condom on there can be no lap sitting, spooning, lying on top of each other or any skin-to-skin contact at all because of the risk of transmitting the virus? Does this mean that he or I must have underwear on at all times or a sheet between us when we are in bed due to the risk of transmission? And that even with a condom the risk is there because the base of the shaft and the scrotum are exposed? Thank you in advance for any information you can provide.

[Terri Warren]

So your history is consistent with HSV 2 as you said. And your statistics on transmission are spot on with condom and antiviral use.

Asymptomatic shedding only occurs from the very skin thin like genitals. While outbreaks of herpes can occur anywhere in the boxer short area, shedding does not happen from thick skin like legs,thighs, buttocks.

The area of the penis not covered by a condom is still at small risk of becoming infected, yes

Terri

• This reply was modified 5 years, 6 months ago by Terri Warren.

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