Confusing Answers Regarding Transmission

I have followed this forum for the Q and A regarding HSV since finding the website sometime in August.  Having HSV for the last 25 years I have found it to be very helpful and informative.

I am extremely interested in the transmission Q and A due to the fact that I am in a discordent relationship, I am femaled, he is male.. He is HSV negative and upon reviewing what we thought were accurate risk assesments, he does not use condoms.  I rarely have outbreaks and have not "seen" an outbreak in several years.  I have been on Suppressive therapy for about one year.  I have had more "genital" symptoms since becoming sexually active again about 7 months ago, than I ever have the entire time I have had HSV. Just some BV, redness, itchy, that increasing my Valtrex dose does not seem to improve.

My question is..I read about the risk while on suppressive therapy then I read, upon several comments, that "HSV will be transmitted, it is just a matter of time-whether it is 2 weeks, 2 months, or 2 years..even on suppressive therapy."
I know there is no way of knowing for sure, but why stay on the suppressive therapy unless there is a significant guarentee that transmission will not occur?  If my partner does get HSV, will his symptoms be less severe?

Even though he says he is not concerned about it and seems very understanding, I am an emotional wreck.  I worry so much about transmitting this to him.  I have tried to talk with him and it is crazy that I seem more concerned than he is..He has HSV1 orally and says that it is only a little skin irritation and is really no big deal to him.

Please let me know about the transmission risk if I had few OB's before beginning therapy, am on suppressive therapy, and if he has some immunity since he has HSV1 orally..

Sorry for the long comment and thank you for any helpful responses.

[life goes on]

Hello,

In the last seven months you’ve noticed a change in your symptom while on suppressant.  When taken suppressant you must take them accordingly as prescribe by your doctor.  You take your dose every day at the same time.  This is important because inconsistency can lead to changes from an imbalance intake according to my doctor.  The suppressant minimizes your symptoms and is more for preventive measures.  Nothing is 100% effective.  

My concern is with you.  You are under a lot of stress.  These reoccurring symptoms are due to your fear of infecting your partner, and because of this you put yourself in an emotional rollercoaster.  Stress!  You need to relax.  Your partner is not concerned and he obviously is informed of the risk involved, and he is comfortable with not wearing any protection.  

Now discontinuing suppressant intake increases your chances of infecting your partner; more so with your reoccurring symptoms.  Speak with your partner and ask him if he is okay with you stopping your intake, and take it from there.  Stress is the number on cause for your symptoms not the suppressant.  Valtrex comes in 500mg and 1000mg.  Consult your doctor regarding your symptoms and he/she can better advise you on alternative measures.    

[TC405]

Thank you for your response..You are correct..I am very stressed about possibly infecting my partner..I feel that if he did aqquire the HSV then He will feel differently, and I am an emotional wreck!  I am so deligent on taking my Valtrex, I never miss a dose! Sometimes I take double dose just to make sure it is in my system!  You think stress is causing these symptoms?  If so am I contagious since it is "in my head"?
When my ex-husband gave me HSV, I was devastated! I can't imagine putting anyone else through this and have seriously considered breaking off the relationship, even though I am the happiest I have been in years!  I guess I am wanting someone to tell me how "low the transmission risk are" if taking this suppressive therapy..and I guess I am hoping the risk are low..The whole 20 years I was married I maybe had 4 outbreaks, and I never even saw a rash!  Only one time on my right upper buttock!  This is So Very Frustrating!  Thanks Again.

[ABE648]

Here is the Female to Male rate of transmission.

If you have 100 couples where the female has HSV 2 but not the male (these figures are over a year)  the odds of female to male transmission are if you do nothing other than avoid sex during an outbreak 4 men out of a 100 will get herpes in a year or 4% If you do go on a suppressive therapy then it drops to 2 men out of a 100 in a year or 2% and if you use suppressive and a condom the chances are 1 man out of a 100 will get herpes in one year or 1%.

The valtrex and transmission study stats are based on having sex 2 times/week.

So you can now see how small the risk is even if ne does not use a condom and you are on Valtrex it is still only 2%. Or put another way he has a 98% chance of not getting herpes.

Like the PP said you are stressed of thinking you are going to give it to him. If he has told you and you believe him that if he gets herps it will be OK then believe him.

I presume he knows the risk if not show this to him. Have a herat to heart talk and if his postiosn is still the same he is not concerned then remember now that you have told him and he is aware that you have herpes he accepts some of the risk since he knows.

So let go of the fear and let him love you. Your own words said it best. "I am the happiest I have been in years!"  Just let him love you and relax and the stress will go and you will have less ob like the PP said. And stick to your Valtrex to best protect him.  

[gracefromHHP]

If you are having troubles with bv, that's a totally different thing from your herpes.  No amount of valtrex will help with bv symptoms of which your redness and itching appears to be a part of.  How often are you getting bv? How is your provider treating it?  If this all started with your new partner you might want to consider using condoms so that his sperm isn't getting into your vagina and altering your ph enough to allow bacteria to overgrow. This sometimes helps women who are getting vaginitis frequently.  Continue to follow up with your obgyn to try to get a better handle on the bv issue.  

His risk overall is very low. I know you've never, ever heard me say that a partner will eventually get hsv2 from you in time!!!  I know many discordant couples personally  who have stayed that way for 10-20 years so far.  Precautions really do work.  And if he ends up getting hsv2 from you when he's like 70 - he'll be able to brag about it because it'll mean that he's still getting lucky :)

grace

[TC405]

It definately was not your entry that I read regarding him eventually getting HSV, but I did read it and it stated that "eventually whether it was 2 months or 2 years, it would be transmitted".  That was just very upsetting, especially for people like me who are hsv positive and doing all we can to keep from transmitting it..although I know that he has assumed some responsibility, I would still blame myself if he does contract hsv from me.  I just want to do all I can to prevent.  Thank you for your response and your advice to me and others on this Q and A forum, it is very much appreciated.

In your opinion, through all of this stress, could my hsv be "breaking through" so frequently even taking my Valtrex..I know stress can affect a person in different ways..or is it "all in my head"?

I have been treated with flagyl for the bv, I am just not sure it completely clears up or it is the hsv..I continuously "check things out" down there and never see any type of lesions or rash..just a little redness, and discomfort.

In my mind, since I never had many OBs before starting the Valtrex, and I started it mainly for the transmission risk factor, could my hsv all of a sudden turned into "monster" it has become.

[gracefromHHP]

I'm betting it's all bv related and not your herpes. The suppressive therapy with valtrex is keeping hsv2 under control for the most part.  

grace

[cbw1]

What is the % for male to female transmission?

[gracefromHHP]

8-10% a year if you do nothing but avoid sex during obvious genital symptoms.

grace

[ABE648]

grace is correct but I will give you a bit more details that I got from grace that I hope  will help you better.

Male to Female Transmission Rate
If you have 100 couples where the male has HSV 2 but not the female (these figures are over a year)  the odds of male to female transmission are if you do nothing (other than avoid sex when there is an outbreak) 8-10 females out of a 100 will get herpes in a year or 8-10% If you do go on a suppressive therapy then it drops to 4-5 females out of a 100 in a year or 4-5% and if you use suppressive therapy and a condom the chances are 2-3 females out of a 100 will get herpes in one year or 2-3%.

abe

The valtrex and transmission study stats are based on having sex 2 times/week