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STDs  (Expert Forum)
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Confused and Concerned
Answered by
University of Washington Seattle - WA
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Confused and Concerned

by infskr, Sep 20, 2006 12:00AM
Dear Dr.



Thank you in advance for your advice and help.



I have been with my current girlfriend for over 2 years in a monagamous relationship. We were both married prior, for over ten years each.  Just this week she asked me to pick-up a couple of perscriptions for her, one was Acyclovir.  I didn't question her, but later my curiosity got the best of me and I googled the medication. Obviously, you know what I found, and now I am perplexed. I don't want to ask her directly why she is on the medication, but on the other hand, I am extremely concerned.  First and foremost, we have always been open and honest and I can't believe she wouldn't mention such a condition to me.  In our two plus year relationship we have engaged in sexual intercourse on a very frequent basis, never using condoms as she is on the pill and has never asked me to use a condom. Further, I can't recall ever having to cease activities for any length of time longer than 5-7 days and that would only be a result of travel.  Also, I would assume that I would have seen something indicating the genital herpes condition.  



My questions are as follows:



1. Could the medication have been perscribed for something else (recently she decided to take a break from the pill and she is experiencing "breakthrough bleeding" and irregular periods). I know she doesn't have shingles or chickenpox.



2. She does have very infrequent oral fever blisters, would Acyclovir be perscribed for that (seems a little agressive).



3. Is it conceivable that she could have this condition in check for all this time without incident, and can she be in such control, so as to know when I am at risk. Is that a plausible course of behavior.  



4. Or is it too late, could I already be infected.  



Thank you in advance for any information.



by H. Hunter Handsfield, M.D., Sep 20, 2006 12:00AM
I'll go straight to your questions.



1) Acyclovir is prescribed only for herpes infections--herpes simplex virus (HSV) types 1 and 2, or herpes (varicella) zoster virus (VZV), the cause of shingles and chickenpox.



2) Acyclovir is commonly prescribed for oral herpes.



3) Given the nature of the relationship, including its obvious mutual commitment, it seems very unlikely she has genital herpes and didn't tell you.



4) If she has genital herpes, the odds are you aren't yet infected, especially if she takes acyclovir continuously as suppressive treatment.  But it's possible.  If so, you need to ask yourself whether it matters.  If you have other partners or are uncertain about your current relationship, i.e. if you expect to be dating in the future, then your concern is valid.  If not, since you have no symptoms it doesn't much matter from that aspect; and you cannot re-infect your already-infected partner.



As someone already suggested before me (below), you need to ask these questions of your partner.  My bet is she in fact uses the acylovir for her cold sores.  Perhaps you'll have a good laugh over it--but only if you're careful not to start the conversation in a way that conveys your apparent fears and your apparent doubts about her honesty.



Good luck--  HHH, MD



Member Comments (5)

by Jerefrancis, Sep 20, 2006 12:00AM
My guess is the perscription is geared for her oral outbreaks......dude I think your wife would let you know if she had the herp.....if she kept that information from you...I would hire an attorney and get a divorce.

by sparkeler, Sep 20, 2006 12:00AM
Why are you asking the doctor?  Just ask your girlfriend.  Your partner and you are very close, why the hesitation?

by infskr, Sep 20, 2006 12:00AM
Dr.



Thank you for your prompt and complete response.  Given the serious nature of our relationship, I would agree that #2 is the plausible explanation. I can't imagine her to be someone who would keep something so important, and potentially damaging, a secret. Ultimately, I will ask the question, but at an appropriate time and in a non-threatening manner.



Thank you

by H. Hunter Handsfield, M.D., Sep 20, 2006 12:00AM
To: infskr
I'm not a relationship counselor, but I suggest you talk to her right away.  The overall tone of your question etc suggests that the issue may gnaw at you until the air is clear.  And if you raise it later, she might have reason to question your trust in the relationsip. ("Why did you wait so long?  You saw the acyclovir ___ weeks ago.")



HHH, MD
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