Aa
25 year herpes
48 y/o female… I have had HSV II for approx 25 years. I have infrequent episodes and have only taken suppressive therapy when suspecting an outbreak, or, during an outbreak. I seem to suspect possible outbreaks during stress, after sexual activity and dry friction, hot sweaty summer days (I ride horses) and will begin taking my acyclovir before or during those times. Sometimes I still suspect symptoms, but, as the years click by, the episodes are questionable that they are even HSV at times, are less painful and heal more quickly. I would say less than 4 actual episodes a year, but, I am careful not to have sex with the slightest suspicion of an episode (I suspect typically a psychological worry, especially in a new relationship). I am dating someone now that I really like and we have not had sex yet. I WILL have THE TALK with him and I would like to be able to tell him I am a low risk for infecting him. (He had been married for 25 years and I suspect he has had very few sex partners) I have never had a sex partner tell me they have become infected after a relationship with me. My husbands never even used condoms and did not, to my knowledge, ever become infected by me
I guess my questions are: 1) what is the frequency of asymptomatic shedding for someone who has not been on daily suppressive therapy during all these years. I realize the shedding may last 1-5 days when it occurs, but, how often does it actually occur? Monthly? A few times a year? And does is continue to be less and less often as the years click by. 2) How much greater is the risk for infecting my partner if we don’t use condoms as long as I use Valtrax or acyclivor daily.? (which is better Vatrax or acyclivor)
(I’m so afraid of rejection…any tips on breaking the news without the yukky stigma of this disease!!!)
sorry for long post, thanks in advance for replies.
I guess my questions are: 1) what is the frequency of asymptomatic shedding for someone who has not been on daily suppressive therapy during all these years. I realize the shedding may last 1-5 days when it occurs, but, how often does it actually occur? Monthly? A few times a year? And does is continue to be less and less often as the years click by. 2) How much greater is the risk for infecting my partner if we don’t use condoms as long as I use Valtrax or acyclivor daily.? (which is better Vatrax or acyclivor)
(I’m so afraid of rejection…any tips on breaking the news without the yukky stigma of this disease!!!)
sorry for long post, thanks in advance for replies.
Cowgirl, I've dated men like yours before. They come out of long marriages totally clueless about STDs and testing in general. my current lover was having unprotected sex with his last partner (within the past year, I believe) because she told him she couldn't get pregnant since she was in menopause! That's all it took, and he's off and running without protection. Unbelievable. No testing, no discussions, no nothing. Statistically, that woman probably has a higher chance of having herpes than a woman much younger simply because of her age.
My honesty about my HSV-2 really added another intimate connection between us. It wasn't the least bit detrimental to our communication or our desire for one another. He said no woman had ever discussed any STDs with him, let alone acknowledged having one. He's been really terrific about it - got tested, has no problems with it sexually or psychologically - it's as if I don't have it as far as he's concerned. We use condoms and I take medication since his HSV-2 test was negative. Now I just need to get him comfortable with the idea of anal sex, which I love. :o)
I don't use lysine because my acyclovir is so cheap - I get about a year's worth of antivirals for 10$ through my health care plan.
If you are worried about shedding, use one of the antivirals. It really will help put your mind at ease about prevention. Passing it is my biggest fear. Actually, it's the only down side to having HSV-2. Otherwise, I could care less about this virus. It hasn't caused me any grief in my life in any other ways. The medication really makes me feel so much more comfortable about having sex. And so far I haven't passed it to any man I've been with.
My honesty about my HSV-2 really added another intimate connection between us. It wasn't the least bit detrimental to our communication or our desire for one another. He said no woman had ever discussed any STDs with him, let alone acknowledged having one. He's been really terrific about it - got tested, has no problems with it sexually or psychologically - it's as if I don't have it as far as he's concerned. We use condoms and I take medication since his HSV-2 test was negative. Now I just need to get him comfortable with the idea of anal sex, which I love. :o)
I don't use lysine because my acyclovir is so cheap - I get about a year's worth of antivirals for 10$ through my health care plan.
If you are worried about shedding, use one of the antivirals. It really will help put your mind at ease about prevention. Passing it is my biggest fear. Actually, it's the only down side to having HSV-2. Otherwise, I could care less about this virus. It hasn't caused me any grief in my life in any other ways. The medication really makes me feel so much more comfortable about having sex. And so far I haven't passed it to any man I've been with.
Shedding doesn't necessarily only last 1-5 days. I assume you mean this is prior to an obvious outbreak. You can be shedding virus many times and not have outbreaks.
I'm not convinced that "swabbing studies" will be accurate for advice or interpretive purposes. My guess is that shedding is all over the map for virtually anybody with GH. Hell, you could probably swab yourself in the a.m. and be shedding, and then swab yourself later in the day and you're not. That's not even one day of shedding.
I have two friends who contracted HSV-2 from men who had had it for over 20 years. My feeling is that you should assume you are infectious simply because you have it and take whatever precautions you and your partner deem appropriate.
But that's just me. I tend to err on the side of being more careful. Every guy I hook up with is negative, so I'm in the condoms+medications camp pretty frequently.
I'm not convinced that "swabbing studies" will be accurate for advice or interpretive purposes. My guess is that shedding is all over the map for virtually anybody with GH. Hell, you could probably swab yourself in the a.m. and be shedding, and then swab yourself later in the day and you're not. That's not even one day of shedding.
I have two friends who contracted HSV-2 from men who had had it for over 20 years. My feeling is that you should assume you are infectious simply because you have it and take whatever precautions you and your partner deem appropriate.
But that's just me. I tend to err on the side of being more careful. Every guy I hook up with is negative, so I'm in the condoms+medications camp pretty frequently.
even though you've had hsv2 for 25 years now - I recommend reading the herpes handbook at www.westoverheights.com. It's also a terrific resource to recommend to a potential partner so that they too can increase their herpes knowledge.
1) what is the frequency of asymptomatic shedding for someone who has not been on daily suppressive therapy during all these years. I realize the shedding may last 1-5 days when it occurs, but, how often does it actually occur? Monthly? A few times a year? And does is continue to be less and less often as the years click by.
We are waiting for a study to be published that specifically looked at shedding patterns of hsv2 in folks infected for more than 10 years. Since it's not published yet - I can't talk about it unfortunately. Hopefully it comes out in the next couple of months.
What we do know is that in folks infected with hsv2 between 1-10 years ( you shed more during the first year so that's not included ) - is that folks shed about the same amount whether they have 0 ob's a year or 10 ob's a year. It averages out to about 6-8% of days ( this is from an ad hoc analysis of the valtrex study ). That includes obvious lesions and asymptomatic shedding. As I said though that's just an average - some folks are still shedding very frequently even 25 years into it while others aren't shedding much at all even 2 years into it. The only way to know better what your own shedding pattern is would be to do serial pcr swabbing which unless you are in a research study - really isn't affordable :(
2) How much greater is the risk for infecting my partner if we don’t use condoms as long as I use Valtrax or acyclivor daily.? (which is better Vatrax or acyclivor)
On average if you two do nothing but avoid sex during obvious lesions in yourself - your partner is about 96% likely each year NOT to contract hsv2 from you. If you take daily suppressive therapy with valtrex - the risk is cut in half. Throw in condoms to boot and your male partner is about 99% likely on average each year NOT to contract hsv2 from you. Pretty reasonable odds for the most part.
So which is better? Well since acyclovir is generic and there's no money to be made - we'll never know how they compare when it comes to reducing transmission to a partner. Both work about the same though - you just have to take acyclovir more often. The valtrex prescribing info on their website actually has a chart that compares acyclovir to valtrex.
Hope that helps :)
grace
1) what is the frequency of asymptomatic shedding for someone who has not been on daily suppressive therapy during all these years. I realize the shedding may last 1-5 days when it occurs, but, how often does it actually occur? Monthly? A few times a year? And does is continue to be less and less often as the years click by.
We are waiting for a study to be published that specifically looked at shedding patterns of hsv2 in folks infected for more than 10 years. Since it's not published yet - I can't talk about it unfortunately. Hopefully it comes out in the next couple of months.
What we do know is that in folks infected with hsv2 between 1-10 years ( you shed more during the first year so that's not included ) - is that folks shed about the same amount whether they have 0 ob's a year or 10 ob's a year. It averages out to about 6-8% of days ( this is from an ad hoc analysis of the valtrex study ). That includes obvious lesions and asymptomatic shedding. As I said though that's just an average - some folks are still shedding very frequently even 25 years into it while others aren't shedding much at all even 2 years into it. The only way to know better what your own shedding pattern is would be to do serial pcr swabbing which unless you are in a research study - really isn't affordable :(
2) How much greater is the risk for infecting my partner if we don’t use condoms as long as I use Valtrax or acyclivor daily.? (which is better Vatrax or acyclivor)
On average if you two do nothing but avoid sex during obvious lesions in yourself - your partner is about 96% likely each year NOT to contract hsv2 from you. If you take daily suppressive therapy with valtrex - the risk is cut in half. Throw in condoms to boot and your male partner is about 99% likely on average each year NOT to contract hsv2 from you. Pretty reasonable odds for the most part.
So which is better? Well since acyclovir is generic and there's no money to be made - we'll never know how they compare when it comes to reducing transmission to a partner. Both work about the same though - you just have to take acyclovir more often. The valtrex prescribing info on their website actually has a chart that compares acyclovir to valtrex.
Hope that helps :)
grace
The answer to your question is no. At least for diabetes and heart disease. Immunocompromise would come with something like HIV positivity.
I just wanted to give you my experience with ambivalent men. It doesn't sound like you have any feedback yet on how it is going to go with this guy. My feeling is that I give the guy a time frame to "work out" whether he wants to proceed. For me, that would be about a week. (If he's serious about you, he'll do the reading and educate himself and go and get himself tested, which he should be doing.) You might want to stretch it out longer, but I can tell you that in my very limited experience with men who are unsure about it in the beginning, they are usually unsure about it in the time thereafter.
These days, I really need a "yes" or a "no" right off the bat from the guy, and if I don't get that, I move on. (And I tell him why.) I've only had a few men who were "unsure" about proceeding. One I dumped after a week because he was still unsure at that time; the other I never heard from when I told him I'd be seeing other men while he "made up his mind."
Ambivalence doesn't cut it for me. But everybody's different. Just think very carefully about how you want to proceed with him. He needs to get tested, too, for your peace of mind (especially since you are HIV-). If he refuses to get tested, you should definitely dump him. I'd also lose him if he shows any disrespect, fear, or ambivalence about touching or treating your body in ways that make you feel disparaged or disrespected. You deserve to have your body respected and touched in ways that make you feel comfortable and desired, and if he can't do this, just move on.
There are plenty of men out there who will love you the way you want! Trust me on this. I'm 48, and out there dating, and there is no shortage of them around. The ball should not only be "in his court." You have a "court," too, and you have choices about how to proceed, with respect to your time, your feelings, your emotional and sexual needs. Make sure you take care of all of those by not just "waiting around" for him to make a decision.
I just wanted to give you my experience with ambivalent men. It doesn't sound like you have any feedback yet on how it is going to go with this guy. My feeling is that I give the guy a time frame to "work out" whether he wants to proceed. For me, that would be about a week. (If he's serious about you, he'll do the reading and educate himself and go and get himself tested, which he should be doing.) You might want to stretch it out longer, but I can tell you that in my very limited experience with men who are unsure about it in the beginning, they are usually unsure about it in the time thereafter.
These days, I really need a "yes" or a "no" right off the bat from the guy, and if I don't get that, I move on. (And I tell him why.) I've only had a few men who were "unsure" about proceeding. One I dumped after a week because he was still unsure at that time; the other I never heard from when I told him I'd be seeing other men while he "made up his mind."
Ambivalence doesn't cut it for me. But everybody's different. Just think very carefully about how you want to proceed with him. He needs to get tested, too, for your peace of mind (especially since you are HIV-). If he refuses to get tested, you should definitely dump him. I'd also lose him if he shows any disrespect, fear, or ambivalence about touching or treating your body in ways that make you feel disparaged or disrespected. You deserve to have your body respected and touched in ways that make you feel comfortable and desired, and if he can't do this, just move on.
There are plenty of men out there who will love you the way you want! Trust me on this. I'm 48, and out there dating, and there is no shortage of them around. The ball should not only be "in his court." You have a "court," too, and you have choices about how to proceed, with respect to your time, your feelings, your emotional and sexual needs. Make sure you take care of all of those by not just "waiting around" for him to make a decision.
I really am happy to have stumbled on to this forum and have a place I can go to clear up questions. I enjoy reading most of the posts and am impressed with the knowledge, suggestions and answers you provide. I also get a kick out of slackers contributions...he is funny.
anyway, i have told the guy I have been dating of my status. (we still have not had sex...so frustrating LOL) he is not a big fan of serious talks so I gave the info to him in a letter to read. (sort of nice doing it this way as there were no interruptions. :) I let him know I understand if he needs some time to digest the information. He was a little nervous after reading it. I didn't pull any punches and included some of the stats on transmission and risks with the use of suppressive therapy and condoms. He really had NO knowledge about herpes and I suggested he do some reading about it and ask me any questions he may have. Anyway, the ball is in his court and we haven't had any alone time since then to discuss the matter (that was Friday). I also had some current blood work ran as I really had never typed the virus before. I am confirmed HSV2 + and HSV 1- with the IGG ....am ignoring the IGM results :) Also, peace of mind all other std tests were negative (had a suspected unfaithful husband 1 1/2 years ago)...ya just never know!!!
Anyway, I do have another question........are there any concerns about people with diabetes (or any other medical challenge with weak immunity) being more susceptible to the risks of picking up HSV?
Thanks
anyway, i have told the guy I have been dating of my status. (we still have not had sex...so frustrating LOL) he is not a big fan of serious talks so I gave the info to him in a letter to read. (sort of nice doing it this way as there were no interruptions. :) I let him know I understand if he needs some time to digest the information. He was a little nervous after reading it. I didn't pull any punches and included some of the stats on transmission and risks with the use of suppressive therapy and condoms. He really had NO knowledge about herpes and I suggested he do some reading about it and ask me any questions he may have. Anyway, the ball is in his court and we haven't had any alone time since then to discuss the matter (that was Friday). I also had some current blood work ran as I really had never typed the virus before. I am confirmed HSV2 + and HSV 1- with the IGG ....am ignoring the IGM results :) Also, peace of mind all other std tests were negative (had a suspected unfaithful husband 1 1/2 years ago)...ya just never know!!!
Anyway, I do have another question........are there any concerns about people with diabetes (or any other medical challenge with weak immunity) being more susceptible to the risks of picking up HSV?
Thanks
It's not listed exactly as a helicase primase inhibitor - http://www.clinicaltrials.gov/ct2/show/NCT00486200?term=genital+herpes&rank=5 is the study. never a bad idea for anyone interested in contributing to herpes research to periodically go to the website and plug in genital herpes to see what research is going on near them :)
Yes it is a **** shoot as to when you are shedding the virus or not. You are not contragious 24/7 though. don't ever allow yourself to start thinking of yourself as a walking biohazzard!
As for lysine - in the best studies done on it so far - it didn't really help a lot to reduce ob's . the only dose that showed any effect was the 1000mg 3x/day dose which is more expensive than generic acyclovir for most folks and also more of a pain to take than once daily valtrex or twice daily famvir or acyclovir. there have been no studies at all on its effects on shedding which is the most important part if you are in a discordant relationship.
grace
Yes it is a **** shoot as to when you are shedding the virus or not. You are not contragious 24/7 though. don't ever allow yourself to start thinking of yourself as a walking biohazzard!
As for lysine - in the best studies done on it so far - it didn't really help a lot to reduce ob's . the only dose that showed any effect was the 1000mg 3x/day dose which is more expensive than generic acyclovir for most folks and also more of a pain to take than once daily valtrex or twice daily famvir or acyclovir. there have been no studies at all on its effects on shedding which is the most important part if you are in a discordant relationship.
grace
thanks guys....i appreciate your knowledge and information. now i can only pray that the "talk" will go smoothly. waringblender, I too wonder if i will ever meet a hsv2...LOL ..strange isn't it? with the statistics what they are, the age that I am, and never matching up with another. I have often wondered if some partners just didn't own up to being HSV+ after I told them about myself. I have always been the "lets talk" instigator. Really makes me wonder how many HSV folks do NOT behave responsibly and fairly to new partners. who knows, maybe this time I will be suprised with an HSV partner???? I am relieved to learn that the risk is actually as low as it is. I am a little more consciencence (sp) about exposing this guy since I suspect he has had so few partners and has probably not been exposed prior to now (then again, maybe he has??). Anyway, I will certainly let him make his own decision about whether or not he wants to take the risk....when the time is right.
I looked up the gov website...found this study.........HSV-2 Shedding Resolution After Acyclovir Treatment.......still recruiting....unfortuneately, I live too far away to participate. I was unable to find the helicase-primase study on the site either.
I am still a bit unclear when and how the "shedding" actually occurs. Sounds like it must be a little bit here and there all the time and it is a **** shoot as to whether it is occurring at an inopportune time.
How do you guys feel about taking Lysine as a supplement for cases like ours? I have taken it on and off for years......seems there were no ob's during those times....may be coincendental....
thanks again
I looked up the gov website...found this study.........HSV-2 Shedding Resolution After Acyclovir Treatment.......still recruiting....unfortuneately, I live too far away to participate. I was unable to find the helicase-primase study on the site either.
I am still a bit unclear when and how the "shedding" actually occurs. Sounds like it must be a little bit here and there all the time and it is a **** shoot as to whether it is occurring at an inopportune time.
How do you guys feel about taking Lysine as a supplement for cases like ours? I have taken it on and off for years......seems there were no ob's during those times....may be coincendental....
thanks again
Okay, that's understandable. If I have a negative partner, there's no way I'd go off medication in order to "benefit science." :(
That must be what Dr. Handsfield is referring to in terms of the "design of the study." He always alludes to higher than 50% protective efficacy from suppression based on the study. And it looks like the factor they didn't tease out was *compliance.* It's very interesting. And promising. :)
I couldn't come up with any hits at the clinical trials website in a search for "helicase-primase." I'd be interested in reading about it though.
Thanks for the insights. Okay, I feel better. A little. :oB
That must be what Dr. Handsfield is referring to in terms of the "design of the study." He always alludes to higher than 50% protective efficacy from suppression based on the study. And it looks like the factor they didn't tease out was *compliance.* It's very interesting. And promising. :)
I couldn't come up with any hits at the clinical trials website in a search for "helicase-primase." I'd be interested in reading about it though.
Thanks for the insights. Okay, I feel better. A little. :oB
Why haven't they replicated the valtrex and transmission study? Well first of all it was a freakin expensive study to do. They actually cut the study short at 8 months because the results were so positive and it had gotten so expensive and they were starting to have a higher drop out rate than they wanted to have. It's incredibly hard to get couples to participate in studies and stay in them. Ask discordant couples to not use suppressive therapy and your pool of applicants gets even smaller. Famvir did a similar study ( that also looked at oral and genital shedding as well as hsv1 and hsv2 in both areas ) that was published nov 2007. It wasn't as well publicized as the valtrex study because it's results weren't quite as nice ( in couples where the infected partner had never had an ob - or wasn't able to recognize the signs of ob's - the rate of transmission wasn't significantly decreased but it was in infected partners who had obvious recurrences ). Unfortunately we'll never see these studies with acyclovir unless some sort of benevolent foundation sponsors them for use in 3rd world countries :( Oh and trust me - a lot of the standards of medical care we have today are based on 1 study!
Should be some good studies coming out with the helicase–primase inhibitors in trials now. Anyone interested in participating check out www.clinicaltrials.gov to see if any are near you. I think the valtrex and transmission study really set the bar higher for all future medications so that we'll get a lot more info in our studies because of it!
And of course the most important thing that was noticed during the valtrex and transmission study ( you and I have already talked about this privately waringblender ) is that remembering to take your medication is the important part! About 3/4's of the couples in the valtrex and transmission study who transmitted the virus to their partner were not remembering to take their suppressive therapy at least 80% of the time.
grace
Should be some good studies coming out with the helicase–primase inhibitors in trials now. Anyone interested in participating check out www.clinicaltrials.gov to see if any are near you. I think the valtrex and transmission study really set the bar higher for all future medications so that we'll get a lot more info in our studies because of it!
And of course the most important thing that was noticed during the valtrex and transmission study ( you and I have already talked about this privately waringblender ) is that remembering to take your medication is the important part! About 3/4's of the couples in the valtrex and transmission study who transmitted the virus to their partner were not remembering to take their suppressive therapy at least 80% of the time.
grace
Well, it'll be interesting to see studies for the 10+ year people. My guess is there won't be a difference, but maybe they have techniques now, like you are saying, that can pinpoint more accuracy.
Handsfield has discussed the shedding v. transmission issue as well.
Also, why has no one replicated the Valtrex transmission study? Sometimes I think it's sort of scary to be relying on one study funded by the drug company, especially when we are talking about a virus that a person has for life. I guess though that if people are being infected in huge numbers even when the partner is on suppression, we'd be hearing about it.
After years with this virus and numerous negative partners (will I *ever* meet a positive person?!), none of whom appear to have been infected by me, there is still part of me that fears infecting my partner. The science is comforting, but it would be great to have numerous studies to draw on, not just one. :(
Handsfield has discussed the shedding v. transmission issue as well.
Also, why has no one replicated the Valtrex transmission study? Sometimes I think it's sort of scary to be relying on one study funded by the drug company, especially when we are talking about a virus that a person has for life. I guess though that if people are being infected in huge numbers even when the partner is on suppression, we'd be hearing about it.
After years with this virus and numerous negative partners (will I *ever* meet a positive person?!), none of whom appear to have been infected by me, there is still part of me that fears infecting my partner. The science is comforting, but it would be great to have numerous studies to draw on, not just one. :(
"My guess is that shedding is all over the map for virtually anybody with GH. Hell, you could probably swab yourself in the a.m. and be shedding, and then swab yourself later in the day and you're not. That's not even one day of shedding."
Yep - that's why the studies are starting to look more at swabbing 4x/day to catch those shorter periods of shedding ( see you really were onto something! ). There are some people who in normal once daily shedding studies weren't shedding at all but when you have folks swab 4x/day you find that almost everyone sheds at some point or another even for short periods of time. It's all rather interesting to read though kinda boring. Of course recruiting folks to stick Q tips up all their genital orifices 4x/day is proving to be rather hard too :( Of course that doesn't mean that you are more likely to transmit to a partner - it just means that it's more reason to support the use of suppressive therapy regardless of the number of ob's if a couple is interested in it. I've always been a fan of suppressive therapy even before any of the studies on reduction of transmission in discordant couples came out. These studies cure my insomnia and give me good reason to continue it :)
grace
Yep - that's why the studies are starting to look more at swabbing 4x/day to catch those shorter periods of shedding ( see you really were onto something! ). There are some people who in normal once daily shedding studies weren't shedding at all but when you have folks swab 4x/day you find that almost everyone sheds at some point or another even for short periods of time. It's all rather interesting to read though kinda boring. Of course recruiting folks to stick Q tips up all their genital orifices 4x/day is proving to be rather hard too :( Of course that doesn't mean that you are more likely to transmit to a partner - it just means that it's more reason to support the use of suppressive therapy regardless of the number of ob's if a couple is interested in it. I've always been a fan of suppressive therapy even before any of the studies on reduction of transmission in discordant couples came out. These studies cure my insomnia and give me good reason to continue it :)
grace
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