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I am starting a new relationship with someone who tested + for a combined HSV1/2 serology. His only symptomatic outbreak was in Oct 2014 which occurred on the bottom of the penile shaft but the lesions were not swabbed. He has had some vague urinary issues in the past and is not sure if herpes was the cause. It is his MD’s assumption that it is HSV 2 since he has never had any cold sores, etc. He started Acyclovir 400mg once a day at the time of the lesions and has remained on that dose. He has had no additional physical symptoms since that time. I had myself tested to get a baseline after he told me which came back neg for both hsv1 and hsv2. I was told the transmission rate with the use of a condom combined with him taking antivirals would be around 5% as a guestimate. Would you agree with that assumption. I am concerned about the viral shedding and the potential of me getting it during sex even with a condom. I’m assuming I should use a condom while performing oral sex on him as well? Can you give me a better idea of the transmission rates? What about me touching his genitals? OR him touching me after touching himself? Would the virus transfer to sex toys?
He is planning on getting tested for both hsv1 and hsv2 instead of relying on the combined serology result. Also, would the transmission rate be decreased if he was prescribed acyclovir 2x/day vs 1x/day? Or switching to a different medication?
Thank you for your time
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Until he has a type specific antibody test, he cannot know if he has HSV 1, HSV 2 or both or neither. I’m not sure about the lesion at the base of his penis. It may or may not be herpes.
You guys are making some big assumptions without adequate evidence. You could be right, but you can’t know quite yet.
If he does have HSV 2, and uses daily antiviral medication and uses condoms, the risk of you acquiring HSV 2 having sex twice per week is about 4-5%, or maybe a little less, you are correct.
Acyclovir should be taken twice a day, 400 mg. But let’s see what he really has before going that route.
Terri
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1)Since he tested + for type 1(but never had a cold sore), what are the risks associated with him performing oral sex on me? Is HSV 1 only transmittable with an open sore? I am hoping that this is the case. I feel no reservations kissing him since he has never had an outbreak and most of the population is + for this. Does the level 5 mean anything?
My guess is that there is a “>” sign before the 5, in fact, I’m virtually certain of it.
If he has never had a cold sore, you cannot know if his infection is oral or genital. People who have oral HSV 1 can shed virus from their mouth with no symptoms. But would you decide never to receive oral sex from him if there was a risk of you acquiring HSV 1 genitally? There is a risk, but the decision to take the risk or not is yours.2) He was taking 400mg acyclovir daily(after initial 5/dayx1week) since Nov, 2014, when his initial outbreak occurred(not swabbed but pcp put him on after saying herpes outbreak and had prior +hsv combined serology). He has not had an additional outbreak but it has only been 7 months. Since testing he has switched to valtrex 500mg 2x/day-one in the am and one in the afternoon. Is there a better option?
No, that’s fine.
3)My main concern is that his outbreak was at the base of his penis and the condom rides up and that area may come in contact with my genitals. We have thought about using rings of some sort to keep it in place better. Do you have any thoughts/suggestions on ways to make penetrative sex safer? What about female condoms? Would they have better coverage? I have never used them but have read that they cover the vulva which may decrease risk? And even if we are able to keep the area of outbreak covered, couldn’t the virus be shedding from other parts of his genitals? And shedding tends to decrease the longer you have the virus? I have minimal concern regarding giving him oral sex as we use a condom and I can keep it in place myself/control where my mouth goes. From what I have read on this forum, you don’t have concern with hand jobs as long as I don’t touch myself on my genitals after? And he can do the same for me as long as he doesn’t touch his genitals before?
Female condoms likely offer a bit more protection for you. Shedding happens from the penis and the anus and perhaps the top of the scrotum, but mostly the penis and anus. I have no concerns about masturbation no. Assuming the skin on your hands is intact.
4) Does the hsv II serum level 5 tell you anything? Does a lower # mean less likelihood of transmission? Do hsv2 neg partners of HSV2 + ever take the antivirals to prevent transmission?
The number means nothing except that his infection is well established. And no, having the uninfected partner take anti virals has not been studied much and would likely not work. Sorry about that. Again, the “5” is likely not exactly five.
Terri
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