Genital Herpes on Buttocks

[worried217]

I was just diagnosed with HSV2 based on a blood test (elevated levels of type HSV2 noted) and a small area of infection located on the upper portion of my right buttock.  I have never had any genital symptoms.

My Doctor said that given the location, it is possible I contracted it from something other than sexual activity.  The first symptoms (in the same spot) appeared over 12 years ago and I was mis-diagnosed, given some hydrocortizone and sent home (twice).  

My doctor stated it was unlikely that I would pass on the virus during sexual activity, given the location of my symptoms.  However, I have read conflicting information on the web.  Here are my questions:

1.  Will the virus only shed at the sight of infection (my buttocks)?  
2.  During an outbreak is it possible for me to transmit the virus during protected (condom) sex?  How likely is it for me to transmit the virus during protected or unprotected sex when the virus is not active?
3.  Is it necessary for me to disclose this virus given its' location.  My doctor likened the situation to having it on my face.  She basically stated that it was up to me, but not the same as having herpes on my genitals.  Please elaborate.  

Thank you.

[Alan Rockoff, MD]

I don't agree with your doctor.  Outbreaks on the upper buttocks are a common manifestation of genital herpes.  You most likely contracted that some years before the first episode 12 years ago.  (Just as most people don't know where they were exposed to oral cold sores when they get their fist attack, the same is true of genital lesions.  As of now, where you got it from the first time doesn't matter.)

Genital herpes can spread from the front as well as the back.  Therefore, it's necessary to use condom protection when having sex with a partner who doesn't have genital herpes.  It is not the same in this respect as having herpes on the face.  Likewise, it is appropriate to disclose the herpes to a prospective partner.  If that partner already has genital herpes, then it's less imprtant, since you can't spread it to someone who already has it.

Herpes doesn't mean the end of sexual contact.  Get the counseling you need (about herpes and its implications) so you'll know what to worry about and what not to worry about.

Best.

Dr. Rockoff

[newguy22]

You might also want to check on the type of test you had, if it was a Herpeselect IGG. Instead of the IGM.

Also check out the STD forum, there are lots of info posted there about transmission info, including drug treatment info and condom usage. Just to a search up top on a few of these topics.

All the best