Voice of Reason

[crossroads]

Terri,
I’m a male in a monogamous heterosexual relationship since Jan 2014. Recently, my female partner tested positive for HSV2 via an IGG type specific HSV blood test with an >5. value and has had several outbreaks including recently.
I’ve never used a condom or other protection methods and have had male to female oral sex and vaginal sex on a regular basis over the course of our relationship.

I have several questions for you:
1) What are my odds of having contracted HSV2 already?
2) How and when should I follow up regarding future HSV2 testing and when can I be assured that I’m truly HSV2 negative?
3) Does using a condom, in conjunction with a daily anti-viral, further decrease the transmission risk from female to male (ie. concept of diminishing return)? I read that condom use is more effective for decreasing transmission from male to female.
4) Are their any statistics on female to male transmission of HSV2 to the mouth region from oral sex?

Specific testing facts:
STD blood testing panel (including IGG type specific HSV test) Dec. 2013 – all negative
STD blood testing panel (including IGG type specific HSV test) June 2015 – all negative
IGG type specific HSV test 9/22/2015 – both types negative with <.90 value

[Terri Warren]

If you have tested negative up until now, are you saying that she just started having outbreaks in June and you are wondering if your status has changed since then? Has she had other partners since you got together in 2014? You can do more testing at any time, of course, but it is always going to be a moving target, that is, your results will reflect about 12 weeks and backwards.
While condoms are more protective for women than men, they are also useful for men who are infected. Also daily antiviral therapy is going to reduce the risk for you by almost half.
We have no statistics on female to male transmission with the male giving the female oral sex. Obviously, she can give you oral sex with a risk.

Terri

[crossroads]

Terri,
She’s had several outbreaks over the course of our relationship. I don’t believe that she’s been with another man since our relationship started. I’ve just recently discovered her hsv2 status. I’m trying to accurately determine my status. My last test was end of september. I’ve read varying testing time windows. If I test again at 12 weeks after the last unprotected encounter, will that be enough time to accurately determine status?
Thank you

[Terri Warren]

If you stop having sex with her right now, a test done at 12 weeks will be accurate. We like 16 weeks for the western blot but for the ELISA, I think 12 weeks is adequate. If you continue to have sex with her, this will be a moving target.

Terri

[crossroads]

Terri, I think that I have one more post left.
Thank you for your help.
How accurate is the IGG Elisa test at 6 weeks?
Based on your experience, If she’s on anti-viral medicine, we use condoms, and avoid sex during outbreaks, how likely am I to contract HSV2 from her?
Also, how likely am I to contract oral HSV2 from her if I perform un-protected oral sex on her?

[Terri Warren]

The ELISA is 70% accurate at 6 weeks.
You are very unlikely to acquire HSV 2 from her – about 1-2 men out of 100 in a year, having sex twice per week with the circumstances that you describe will get herpes in this situation. We have no data on transmission through oral sex but it is also very low, maybe even lower, given that HSV 2 does not like the oral area and we don’t see if often there.

Terri

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