Transmission Odds

[floridian25]

Hi Terri:

I have a question about transmission odds. I am a 29 y/o Caucasian male who received a second indeterminate for HSV-2 in 2018 (I am HSV-1 positive). Since then, I have been extremely careful about sex – I have only had sex a few times since then. I am seeing a 28 y/o Caucasian woman, who’s HSV-2 status I do not know.

I am wondering what the risk is for me to get HSV-2 from her if we start having a sexual relationship – but always use condoms. She was sexually active in the past. If I had to guess, she probably has had over 20 sexual partners in her life. I am reluctant to ask her to get tested based on the conflicting advice about getting tested without symptoms.

I am aware of the statistic that the odds of a female passing HSV2 to a male is 4% per year (2% if condoms are always used), but I view that statistic to be somewhat unhelpful in my case. That is because that statistic involves no sex during outbreaks, but my potential partner is unaware of her status; if she has HSV2 symptoms, its possible she has unrecognized, mild outbreaks. (Do condoms protect men when their partners are having an unrecognized outbreak?).

With all the above in mind, what are your thoughts on how safe it will be to have a sexual relationship – with a woman who’s HSV2 status I do not know – while always using condoms?

Thank you!

• This topic was modified 1 year ago by floridian25.

[floridian25]

Just making sure the above did not fall through the cracks.

Thank you so much!

[Terri Warren]

Condoms reduce transmission from males to females by 65%. Clearly, condoms are not as efficient of protecting men as they are for protecting women. Most transmission of herpes happens within the first three months of a sexual relationship. The statistics that we have on transmission, 4% per year from females to males, is based on people who have enrolled in clinical trials of discordant couples, that is, people who are in a relationship and one is infected with HSV two and the other is not. Obviously, people don’t meet in a bar say I have herpes, let’s enroll in a clinical trial. They’re together for a while before they enroll in the trial. I say all of this because I think it’s important for you to know who the population is that gave us that statistic. I also think that you could reasonably ask this person to get a herpes antibody test, knowing that if she tests in the low positive range that you would move onto the herpes western blot. But that’s your call.

Terri

[floridian25]

Thank you, Terri. A couple follow up questions:

1) Even though condoms offer more per-act protection to women than men, assuming 100% condom use, isn’t it still less likely that a male would contract from an infected female than vice versa?

2) Do you have any reliable data on the odds of having hsv-2 by sexual partners? I’ve found a few studies online, but I’m not sure how accurate they are.

Thank you!

[Terri Warren]

1) Even though condoms offer more per-act protection to women than men, assuming 100% condom use, isn’t it still less likely that a male would contract from an infected female than vice versa?
Interesting question. And I’m not a math person at all. But if the statistic is, on average, male to female transmission, in an established relationship, having sex about twice a week with no condom or meds, is 10% and female to male with the same conditions, about 4%, and condoms reduce transmission from men to women by 96% and women to men by 65%, you do the math. Seems pretty close to me but again, I’m not a math eprson

2) Do you have any reliable data on the odds of having hsv-2 by sexual partners? I’ve found a few studies online, but I’m not sure how accurate they are.
I don’t understand this question

Terri

[floridian25]

To clarify question 2 above, I am wondering the odds of a female having HSV2 based on the number of sexual partners she has had in her life. Obviously, more sexual partners = higher chance, but I am wondering if there is a dramatic difference based on the number of partners.

For example, how much of a higher percentage change is there of a woman who has had 20 sexual partners having HSV2 as opposed to a woman who has had 10 sexual partners. Is there data on this?

[Terri Warren]

Sorry, we don’t have numbers that are that specific. Certainly, more partners more risk and certainly more partners without using condoms, have significantly more risk.

Terri

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