1: My doctor told me that when it comes to OHSV1 if the carrier did not have a sore that it was unlikely they can pass the virus on. She told me that it is sort of the same for GHSV1 except it would be a little more difficult as you could have bumps appear and not be aware. How true is this?
We see people all the time acquiring HSV 1 genitally from receiving oral sex from someone who has no cold sore present. HSV 1 genital infection is rarely transmitted via intercourse, though it has been reported in the literature.
2: As far as condom use, my gynecologist who I had seen at the beginning of my outbreak unknown at the time had done a pap smear and found lesions and tested them as well. She told me that when having sex would need to use condoms and that things would be okay. How true is this?
Condoms reduce transmission of HSV 2 from females to males by 65%. We don’t know the statistics on HSV 1 transmission but it is likely even better than 65% with condoms.
3: I am unsure of when I contracted HSV1. I have an idea but I am unsure if this is my first outbreak would you be able to roughly tell me what my transmission risk is?
No, not if you don’t know how long you’ve had this.
4: As far as shedding goes, I know that the virus can be in the nerves on the top of the skin from what I have heard. Does this mean if I or someone else were to touch my genitals and then touched their genitals or mouth/face, that they would contract the virus as well?
No, touching is not a normal means of transmission as the skin of the hand is thick and virus is lost between touching you, then perhaps touching something else, then touching ones self.
5: My doctor did not put me on daily antivirals. Some people get on them when they’re in serious relationships but would that be necessary for casual flings or in general seeing as its not ideal to be on them in the long run.
I would agree that most people who have HSV 1 genital infection do not require daily antiviral therapy as shedding rates are low as is transmission. However, if you have a partner who is truly HSV 1 negative and would feel better is you are on suppression, there is no down side.
6: Lastly, as far as disclosure goes. My PCP told me that it was up to me. I am morally conflicted as I would not want this to happen to anyone else and take away their right to choose. I also know that some doctors have differing opinions on the matter. What is your opinion, what would you suggest?
There are indeed different opinions about this. And the reason there are differing opinions is that after someone has been infected with HSV 1 genitally for two years at least, they shed virus on about 4 days out of one year. That’s very infrequent. There is no perfect answer on this one.