I guess I understand there are just no real answers with regard to HSV1 genital to genital transmission… the risk seems to be very small, but still there. Do you consider the risk of HSV1 genital-oral to be the same, or more or less possible than genital-genital?
I honestly just don’t know.
I understand your hesitancy to give direct advice about HSV 1 transmission. By way of contrast, how do you advise couples where one has HSV2 G and one has no HSV? What is the level of transmission risk, and do you have strong opinions about how to mitigate it? You have said previously you have seen “a handful” of HSV1 genital-to-genital transmissions. How many have you seen with HSV2?
How many times have I seen someone with HSV 2 transmit the virus the someone? Hundreds of times. I advise these couples that daily antiviral therapy, condom use and awareness of symptoms are all ways to reduce the risk of transmission. Some couple do everything, some do nothing.
It makes sense that the same practices that can reduce the risk of HSV2 transmission could further reduce whatever that base risk of HSV1 transmission is, theoretically by the same percentages, but still nothing is perfect. Speaking of which, do you agree with these base numbers I have found? A) The risk of male-to-female transmission of HSV2 genital for discordant couples is about 10% per year. B) Condoms can reduce this 10% by 30-50% (to 5%) C) Suppressive therapy can reduce the risk by a further 50% (to 2.5%)?
I don’t think you can make that extrapolation. and yes, I totally agree with your statistics.
Terri