June 26, 2019 at 9:36 pm #39552
I am sexually active with a woman who has HSV-2. We have been consistently using condoms, and I have not contracted HSV-2.
My question has to do with condoms, and their efficacy. If I understand HSV—2 correctly, it can be contracted by skin to skin contact in the pelvic area, and not just with genitalia contact. It can also spread via genital to genital contact.
When I have sex, there is plenty of body fluid coming into contact with body parts. The condom slips down to half way, exposing a portion of my penis.
So, now we have vaginal fluid on a portion of my penis, and pelvis rubbing together.
I can’t help but wonder whether the condom is really doing any good, with so much fluid and body parts rubbing?
June 28, 2019 at 8:02 am #39687
The condom is definitely offering some protection and the studies show it reduces transmission by about 50% or so from female to male – maybe even more. Is your partner taking daily antiviral therapy? If not, that reduces transmission by about 50% as well. And the transmission rate from females to males on average is about 4% per year, having sex twice a week, with neither intervention. I think your risk of transmission is low (not zero).
June 30, 2019 at 9:58 am #39772
Thank you for your reply.
Yes, my partner is taking antiviral therapy. She takes it twice a day when we are going to be together, as we are involved in a LDR. The rest of the time, she takes a regular daily dose.
All of this is so curious to me. As I mentioned in my original post, the fact that body parts and fluid are coming in contact, the efficacy of a condom seems marginal…unless it is the entry to the urethra that serves as a conduit for HSV-2.
Also, as the antiviral medication prevents outbreaks, but does not account for sloughing of the virus (the unseen), I’m so confused as to the value of the condom.
Then of course there is the oral sex, where no protection is being employed (oral dams, cut condoms, etc.)
As you can see from my line of thought and questioning, I’m wondering whether the condom is accomplishing much at all…or are they really designed to be effective when there is an outbreak and intercourse is occurring?
If you would comment on these thoughts, I would appreciate it.
July 4, 2019 at 3:47 pm #40755
She is doing all the right things to help to protect you. And no, herpes doesn’t go in through the urethra. It’s favorite thing is to penetrate the skin of the penis (in your case). But the more surface area you cover, the less penis skin there is to infect so definitely the condom reduces that risk. Do you see what I mean here? The are NOT to be used when an outbreak is occurring – no intercourse should happen then as that is the one time you can be certain that virus is being shed. And antiviral medicine reduces shedding by about 70% so very useful for that as well.
July 18, 2019 at 3:50 pm #44147
Hello Dr. Warren,
As my last follow-up (not sure if it has to be directly related to the original question).
My girl is interested in shaving or waxing her pubic hair. Does this increase the likelihood of transmitting of HSV-2?
July 23, 2019 at 12:01 pm #44346
Well, shaving likely wouldn’t be waxing is quite traumatic and could irritate the nerve resulting in increased viral shedding. That is just a guess, we have no research on that. But given the two alternatives, I would chose shaving or clipping.
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