Transmission question

[KRGus]

Hi Terri,
I recently disclosed to a potential partner and I had the handbook printed out for him to read. He asked then asked about the study in the book concerning transmission. I had told him that the chances of getting herpes from me is about 4% referring to the study. When he read more about the study he then said well that 4% sounds good, but the study was done with couples who had partners that were considered “herpes survivors”. I then told him they were also studied using the following criteria:
1) No sex during outbreaks,
2) No daily antiviral medication and
3) No regular use of condoms.
4) The people involved know that one of the people has genital herpes
I also in particular pointed out that this is why if we were to be together anti-viral medication and condoms would be used which greatly decreases the chances of transmission. Was this a correct assertion? Do you have a better way of answering to this kind of comment?

[Terri Warren]

You are totally correct. The approximate 4% transmission rate can be significantly reduced by the use of antiviral medicine and condoms and you being able to recognized outbreak symptoms. On the other hand, if he has sex with someone who says “no, I don’t have herpes”, but actually does (80% of those infected don’t know they are), then the transmission rate if going to be way higher because they don’t know they are infected they are doing nothing to reduce the risk of infecting a partner. And since 1 in 4 women in the US between 14 and 49 have HSV 2, the odds that he will encounter this situation are quite high. You are a much safer bet 😉

Terri

[KRGus]

Thank you, Terri. 🙂

[Terri Warren]

You are most welcome. You hang in there with this. If this relationship doesn’t work out because of herpes, others will. Promise.

Terri

[KRGus]

Well thank you, I appreciate your words and encouragement. 🙂 I do have another question if I’m allowed. Not sure where I’m at with payments. I’m wondering if those who were part of that study were considered “herpes survivors” because there was no transmission to the uninfected partner within the average time transmission usually occurs and whether the couples initially used protection i.e. condoms and anti-viral therapy before not using them? Thank you, again.

[Terri Warren]

Yes, that is why they were considered survivors. We don’t have specific information about condom or medicine use for them, no.

Terri

[KRGus]

Thank you for that. I had a very long talk yesterday with the person I speak of above and it went well. We are continuing to see each other. I do have a couple more questions and I have paid for more just an FYI to you. 🙂 I am wondering about HSV-2 transmission orally i.e he gives me oral. I realize this is rare and I don’t believe there is research data on this, but would you say its about as likely as genital to genital with meds etc.? Also, he has two children and he was concerned if he ever got it orally what impact that would have as he and his daughter in particular peck each other on the lips. Because it sheds so little I would say its pretty rare it would transmit? Lastly, I’m quite frustrated with the imaging portrayed of herpes especially when you google it. He had googled it after I told him not to and saw the images and many of which I even wonder what they are. Though I know some cases can be severe what is percentage of those cases? I told him for most people the symptoms are so miner that its often misdiagnosed etc. or there are no symptoms at all and it looks nothing like the images portrayed. He had images in his head of having horrible outbreaks etc. which I to explain is not how the virus is or works. I had specifically given him websites to read etc. but he still googled it. Any advice on this would be greatly appreciated. Thank you, Terri. As always I appreciate your help immensely.

[Terri Warren]

Genital to mouth transmission has not been studied statistically, no, but I do believe it is unlikely. If he does get oral herpes or already has it, a peck on the lips for his children is not a risk for herpes unless there is an active sore. Do you know if he has oral herpes? If he does and acquires HSV 2 the chances are high that it would be asymptomatic. To be very very honest, I have not seen a severe herpes outbreak as a first infection in about 2 years, and I see a ton of herpes. And my colleagues say the same. I’m not sure what’s going on – we used to seem them all the time. I think with antiviral therapy, people that are getting infected are getting less virus and maybe that’s why.
If you and he ever want to do a phone consult with me, I do do that.

Terri

[KRGus]

Hi Terri,
So with Oral HSV-2 transmission its unlikely transmission would occur because its rare and the virus doesn’t like the mouth? Genital to genital would be more likely. He has yet to be tested and he is unclear if he’s ever been tested for herpes. So, if he already has HSV-1 oral he can acquire HSV-2 oral too? Should that be the case it would be asymptomatic if he has oral HSV-1 already and acquires HSV-2 oral? Does HSV-2 oral usually have an initial outbreak and then nothing after? I’m a bit confused as I never knew you could acquire both orally, thanks!
Very interesting about the outbreaks. That sounds like a good thing at least in terms of the virus. If need be yes a phone consult might be good. What fee would be involved? Would insurance cover it by chance or no? Thanks so much for your help.

• This reply was modified 6 years, 8 months ago by KRGus.

[Terri Warren]

That’s correct about oral HSV 2 transmission, yes. If he has HSV 1 orally, he could acquire HSV 2 orally, yes, not likely, but he could and it would look just like a cold sore and would essentially vaccinate him against genital infection. It may well also be asymptomatic, yes. It rarely recurs orally.
A phone consultation of 10 minutes is $75 and no, we don’t bill insurance and phone consultations are not normally covered by insurance. Sorry about that

Terri

[KRGus]

Hi Terri,
Thank you for the information and offer to have a phone consultation. I may need it after all that’s said and done. HA! At least I’m laughing. Yesterday was tough. The person I speak of through out this thread told me on Friday when we visited that he wasn’t feeling well but he still came over anyways. He complained of a sore throat and feeling worn down. He’s a firefighter so his shifts are long plus with two kids and an ex that has been causing him stress lately he’s already dealing with a lot. We’ve used precautions (condoms, meds etc.) whenever we have been intimate. He went down on me Friday however with no dam but again I’m on suppressive meds and have HSV-2 genital. Yes we spoke of all the risks involved and we were never intimate btw before I disclosed. Its unfortunate though because even with all the education and the talks we’ve had I’ve learned he hasn’t accepted the risk because yesterday he told me his throat was worse after his shift and he complained of white spots on his throat, tender lymph nodes and a general feeling of malaise. He immediately thought he had “throat” herpes. We haven’t been seeing one another for that long just maybe a month with only being able to get together once a week due to our schedules etc. so our time together has been limited. I told him that he should get tested soon so that we would have a base line to work from. I then told him that should the test come back positive it would show that he acquired herpes before meeting me even though we’ve been intimate because it typically takes 12-16 weeks to get a good reading on an IgG test due to seroconversion . I also told him to contact as I suggested and told him before the University of Washington Virology clinic so he could get a medical professionals insight/advice. In addition I said that the symptoms he spoke of didn’t sound like herpes symptoms. I’m just sad as I like him a lot, care for him and his well-being. Do you have any advice for a worried partner?

[Terri Warren]

People can seroconvert more quickly than 12 weeks, for sure, but one should wait about 12 weeks for a reliable negative.
It would be good for him to get a baseline, yes. It’s possible he is already infected and doesn’t know it and it would make your lives a lot easier if that was the case. It would also be good to know his HSV 1 serostatus.
Also it is pretty normal for someone who has newly having sex with someone with HSV 2 to be scared like this often. If the relationship continues, this fades but it might take a while. Be patient and supportive but don’t let this bring you down, OK?

Terri

[KRGus]

Hi Terri,
Thank you for confirming the seroconversion time frame. I’ve since spoken to him and things are okay. I appreciate you telling me the normality of someone whose newly having sex with someone whose infected being scared often despite acceptance. Makes complete sense but I think because those of us who are and go through the emotional stages of disclosing and educating that we can forget what it feels like to the person on the other side of things even if they’ve accepted it etc.. There’s a lot to deal with and I appreciate you getting me to recognize that again. We’ll see where it goes from here. Thanks so much!

[Terri Warren]

You are most welcome. Keep your emotions as cool as you can about that – if you act upset and alarmed, he will likely be more scared. And remember – everybody’s got stuff – you aren’t the only one, he does too.

Terri

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