Understanding transmission rates – multiple partners

[anonymous]

Hi Terri,

I am in a polyamorous relationship with two men. I have been in a relationship with Male A for 11 years, and with Male B for nearly 2 years. We all recently underwent STD testing and know each others’ status.

– Male A is negative for both forms of HSV.
– I am positive for antibodies to HSV 1 with an index of 3.5. It is impossible for me to know how long I’ve had this, and whether I contracted from Male B.
– Male B is positive for antibodies to both HSV 1 (not sure index) and HSV 2 index of 7. He has had cold sores in the past, but never had a genital herpes outbreak. He does not know how long he has had either form.

I understand from reading through your handbook that the chance of me contracting HSV 2 from Male B is about 10%, (infected male to uninfected female, assuming no condoms or antivirals). I have read elsewhere, that because I already have antibodies for HSV 1, the likelihood that I contract HSV 2 is reduced by 40% (please confirm). If that is true, I might extrapolate that my likelihood of contracting HSV 2 is reduced down to 6%.

Further, if I were to contract HSV2, the chances of Male A getting it from me are about 4% (infected female to uninfected male).

Given these probabilities, it seems that the real risk to Male A of contracting HSV2 is very low. According to my math, the probability of Male B to me at 6% and the probability of me to Male A at 4% (if I were to get it), means that Male A has a .24% chance right now of getting it (.06 x .04=.004=.24%).

In your handbook, it also mentions that taking antivirals reduces transmission by 48% – does this hold true for asymptomatic carriers of HSV2?

Bottom line, given that Male B is asymptomatic, what are the chances that I can contract HSV 2, or that Male A could contract it through me? Would you recommend antivirals in this situation, given that Male B is asymptomatic?

If yes to antivirals, what would be the best drug for this situation, and what are the side effects?

• This topic was modified 8 years ago by anonymous.

[anonymous]

I should clarify my math: (.06 x .04=.0024=.24%). Obviously can’t be this precise about it in any case, but I am trying to get a better ballpark.

[Terri Warren]

I understand from reading through your handbook that the chance of me contracting HSV 2 from Male B is about 10%, (infected male to uninfected female, assuming no condoms or antivirals). I have read elsewhere, that because I already have antibodies for HSV 1, the likelihood that I contract HSV 2 is reduced by 40% (please confirm). If that is true, I might extrapolate that my likelihood of contracting HSV 2 is reduced down to 6%.

It is not accurate that having HSV 1 offers any protection against the acquisition of HSV 2. This has not proven to be true. So that part of your math needs to be discarded

Further, if I were to contract HSV2, the chances of Male A getting it from me are about 4% (infected female to uninfected male).

And this is correct

Given these probabilities, it seems that the real risk to Male A of contracting HSV2 is very low. According to my math, the probability of Male B to me at 6% and the probability of me to Male A at 4% (if I were to get it), means that Male A has a .24% chance right now of getting it (.06 x .04=.004=.24%).

Again, that math is incorrect given no reduction of HSV 2 risk because you have HSV 1

In your handbook, it also mentions that taking antivirals reduces transmission by 48% – does this hold true for asymptomatic carriers of HSV2?

We don’t know for certain that the benefit is the same of people who are asymptomatically infected because the study was done on people with symptoms. I would GUESS that is also applies.

Bottom line, given that Male B is asymptomatic, what are the chances that I can contract HSV 2, or that Male A could contract it through me? Would you recommend antivirals in this situation, given that Male B is asymptomatic?

If yes to antivirals, what would be the best drug for this situation, and what are the side effects?

I would think strongly that male B would benefit all of you from taking daily antiviral therapy. acyclovir 400 mg twice daily or valacyclovir 500 mg once a day both work equally well when taken as directed.

Terri

[Author]

Posts