Transmission rates

[KRGus]

Hi, I am confused about transmission rates verses viral shedding rates. I’ve been told for example that oral HSV-1 has 10% at most odds or less transmission rate to genital and that it would actually be lower because sexual contact while shedding is going to be less. The viral shedding rate is different from the actual transmission rate. I’ve read that the viral shedding rate is higher in particular for HSV-1 which can be up to 18% so why would actual transmission be lower? Is it really because the odds of shedding and having enough virus on the skin be lower upon sexual contact be that much less? What would this rate be off meds verses on? Also, antibodies play a roll, correct? Thanks so much, I appreciate it!

[Terri Warren]

I’m very unclear about your questions.

People with genital HSV 1 shed on about 5% of days sampled. We have no data on HSV 1 genital or oral transmission rates.
People with genital HSV 2 shed on about 15% of days sampled, and antiviral therapy reduces that to about 7% of days.
The transmission rate, male to female, without antiviral therapy and without condoms, is about 10% per year. With antiviral therapy, it is about 5% per year. Add condoms and it is reduced to about 2-3% per year. Female to male transmission is about 4% per year, add antiviral therapy and it is about 2% per year, add condoms, better.

As I said I don’t understand what you are asking or where you get your numbers.

Terri

[KRGus]

Hi,
Sorry about my questions. What I’m really wondering is what is the transmission rate to an uninfected partner contracting genital HSV-1 from a partner whose infected with HSV-1 oral with meds and without and without visible signs-I.E viral shedding. It sounds like there isn’t data for this though? My numbers come from mainly the H opportunity website which match up to yours, but I think I’m misunderstanding things and obviously getting confused. Here’s the link to the chart I’ve looked at.
http://herpesopportunity.com/downloads/herpes-opportunity-disclosure-handout.pdf
I’m concerned because though I’m taking meds I am wondering how likely is it for a partner to contract HSV-1 genital from an infected partner with the virus whose performed oral sex on them. Thanks so much! Hopefully this makes a little more sense now. Sorry for the confusion on my part making it confusing for you.

[Terri Warren]

Correct, we don’t have the data on that question.
Let me be sure I have the question right: you have oral HSV 1 and are taking daily meds for suppression and wonder how likely it is for you to spread the virus from your mouth to the genitals of a person to whom you are giving oral sex? Has that person actually been tested to know that they do not have HSV 1 infection? Remember that the typical screening test misses at least 1-2 out of 10 cases of HSV 1.

Terri

[KRGus]

Hi Terri,
Thank you so much for your response. Yes, that is what I would like to know. They say they have been tested but I’m not sure they’ve actually been tested for HSV since you have to ask for it as it’s not part of the regular screening panel. I’ve been told at most it’s less than 10% odds but this is what a friend told me who has HSV. Though she knows her stuff I wanted to ask someone in the medical field about it however, I’m thinking she may have been going by the shedding rate you state above.
Thanks again for your help.

• This reply was modified 7 years, 9 months ago by KRGus.

[Terri Warren]

So “they” are the person you want to give oral sex to?
10% odds of what – transmitting virus from your mouth to their genitals? We don’t have that statistic and it varies so much depending upon how often, how long you do it, etc. I just can’t answer that question. If they are indeed uninfected then you taking daily medicine will likely reduce the risk of transmitting virus from your mouth to their genitals.

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Terri

[KRGus]

Hi Terri,
Thanks. Yes, I wanted to know what the likelihood of me (a female whose infected) giving oral sex to him whose uninfected would be of him contracting the virus. I was told at most 10% would be the odds of him contracting the virus from my mouth to his genitals but I get that this isn’t an actual statistic since there aren’t any statistics on this and that it varies. I didn’t do it for very long between 2-5 minutes and it was once. I just know 50% of new genital cases come from oral sex, correct? This worries me since the last thing I would want to do is to pass this to another person however I figure the risk would be about the same as me (whose infected) kissing him who doesn’t have HSV-1?

[KRGus]

BTW..I did purchase follow-up questions yesterday. Thanks.

[Terri Warren]

I don’t know where you got that statistic because we don’t really have those statistics and that one seems very high to me, but I don’t know what it is referring to – in a year, one time, in a lifetime? I think if you gave him oral sex for 2-5 minutes once the odds are very low that you infected him. I would suggest that you try to get clarification on whether he has actually been tested for herpes before. Also, the standard screening test misses at least 1-2 out of 10 cases of HSV 1 infection – the western blot picks up far more.

Terri

[KRGus]

Hi Terri,
My friend as I’ve come to realize and went back to look at the messages from her that she was referring to shedding rates. I’m unaware of where she got the number from or if the number refers to a year, one time or a lifetime. I understand and know that there aren’t actual statistics oral to genital transmission. Thank you for your patience with all of this, I appreciate it. I honestly have been stressed out about the situation and wound up calling and speaking with someone at UW virology research clinic today. They were helpful as you have been and have put my mind at better ease that the possibility of infecting him is very low. Thank you for your suggestion and to get clarification from him. I have found this forum and website very helpful as it can be frustrating reading things on the internet.

[Terri Warren]

Well, 10% is a little closer to the oral shedding rates of HSV 1. They range, in reported studies, from 9-18% of days swabbed. So if you swab the lips and mouth for 100 days, you will find virus on 9-18 of those days.
Glad you have found the website helpful.

Terri

[KRGus]

Is that statistic without antivirals? Could you shed some light on how much antivirals help with viral shedding? I know they help significantly but is there a varying degree to how much?

Another question, I’ve read although more research needs to be done but that if the uninfected partner washes with soap and water after sex that this helps? Is there any validity to that?

Lastly, I happen to watch your YouTube video last night and it helped me out. I was diagnosed with HSV2 genital in 2008 and was never diagnosed or tested for oral. I had my first outbreak orally in 2013. I still get down about it. I do have friends and support around me who have it as well which has been an absolute blessing but there are still those times, so thank you for reminding me that it doesn’t define me. 🙂

[Terri Warren]

I actually don’t have data on how much antiviral reduce the viral shedding of HSV 1, but with HSV 2, it reduces viral shedding by about 70% and type 1 should be similar.

We have no idea if washing is helpful but I can’t imagine that it is going to make things worse.

Glad to know that you are recognizing that herpes is only one characteristic that you have, among many! Everyone has stuff they wish they didn’t or partners wish they didn’t. In the big picture, trust me, this is a small one compared to issues about money, inlaws, sex, etc.

Terri

[KRGus]

Thank you, Terri. I appreciate all your help.

[Terri Warren]

You are most welcome.

Terri

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