Updating Knowledge for long-time HSV2+ female

[Long-time HSV2 positive]

Thank you for hosting this forum.

I’m female, late 60s, diagnosed HSV2 45+ years ago. I do not recall any lab work or if the diagnosis was just visual. I’ve taken suppressive meds off and on for years and started up daily Valacyclovir 500 mg 2-3 years ago. Without meds, I’ve experienced 1-2 outbreaks per year max; with meds, none. The few outbreaks I do have appear over my sacral dimples and upper buttocks.

I was in a monogamous relationship for 37 years, celibate for 5 after our divorce. My ex never displayed symptoms. Last year I had a brief relationship with a man who believed he was an asymptomatic carrier due to his ex’s HSV2 + diagnosis, so we used no protection. Neither of us had any outbreaks.

I recently began seeing a man who was married for 38 years. He had one brief sexual encounter earlier this year. He does not think he has been infected, though has not been tested. We had unprotected sex two weeks ago, which we now agree wasn’t wise. We will now use condoms, at least for the next 3 months.

After reading many forum entries, I still have a few areas which aren’t clear to me:

1. Unless my new partner exhibits symptoms, in which case he’d get a culture, is there any value to him testing for antibodies in advance of the 12 week interval after our initial interaction?
2. What, if anything, would be learned by my being tested for antibodies?
3. After so many years of me being HSV2 positive, if he doesn’t contract the virus after our initial three months of having sex (when I understand the virus is most often transmitted), what is the impact of reducing or stopping the use of condoms?
4. What is the risk of my partner acquiring the virus as a result of him performing oral sex on me? As I understand, there’s little risk of him acquiring the virus from my giving him oral sex. Is this correct?
5. Given the long-term predictability of my outbreaks only in the sacral area, can I assume sloughing in my genital area is now minimal or non-existent?

[Terri Warren]

1. Unless my new partner exhibits symptoms, in which case he’d get a culture, is there any value to him testing for antibodies in advance of the 12-week interval after our initial interaction?
The advantage would be to know if he is already infected and doesn’t know it, yes.

2. What, if anything, would be learned by my being tested for antibodies?
Well, if you’ve had outbreaks all these years, you probably have herpes but if only 1-2 per year, I suppose you might have HSV 1 genital infection if you don’t recall a specific lab test being done to make the diagnosis. Sometimes, in the “old days” anyone with genital infection was presumed to have HSV 2, but that wasn’t always the case.

3. After so many years of me being HSV2 positive, if he doesn’t contract the virus after our initial three months of having sex (when I understand the virus is most often transmitted), what is the impact of reducing or stopping the use of condoms?
condoms reduce transmission from females to males by about 60% so if you don’t use them, there is some increased risk. But you are likely not shedding much virus at this time, given the long duration of your infection.

4. What is the risk of my partner acquiring the virus as a result of him performing oral sex on me? As I understand, there’s little risk of him acquiring the virus from my giving him oral sex. Is this correct?

That is correct.

5. Given the long-term predictability of my outbreaks only in the sacral area, can I assume sloughing in my genital area is now minimal or non-existent?
It is minimal, but it is not zero if you were continuing to have outbreaks over the year. Daily suppression would reduce that transmission risk by half. I think that’s your best bet if you are truly positive and he is truly negative.

Terri

[Long-time HSV2 positive]

Thank you, Terri.

I’m still interested in clarification about my partner’s risk of acquiring the virus from doing oral sex on me (see #4).

Interesting thought re getting tested after so many years to see if perchance what I have is HSV1. I’ll do so and see.

What a valuable service you’re providing to us all.

[Terri Warren]

We don’t have any data on the risk of transmission by someone giving you oral sex, sure wish we did. I can say it’s quite uncommon but I can’t give you number.

Terri

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