HSV-2 Question...

[TryingNotToPanic]

Hi, Doctors, Grace, and Other Community Members,

I posted a few weeks back, but only got one response, and I'm assuming it was because the post was so long, so I'm re-posting a much briefer version of my query in hopes for a better response...Please Help!

I have been dating my current partner on-and-off for about two+ years.  She has only been with two other men in her whole life (other than myself) sexually--one of whom was her husband of 20 years with no history of STDs. The other has had multiple partners and does not always practice safe-sex.  

Recently after a six-month-break (during which she had unprotected sex with this person) she was diagnosed with HSV-2 by visual exam by a dermatologist, and by a late-culture swab several days later near the end of the first outbreak, after she was already on Valtrex... She never saw the results of this in writing, but was simply told by the nurse who called: "Yes, it's Herpes..."

We are now back together, hopefully for good, and we want to work it out long-term, but the new diagnosis/Hsv-scare is presenting a huge challenge emotionally and intimately.

While I am Hsv1-antibody-positive, I am Hsv2 negative (I blood-tested negative both after my previous partner, and 8-weeks after learning my current partner's diagnosis), and my partner's new Hsv2 diagnosis has made it difficult to "allow things to unfold naturally" between us since getting back together...

I already know from other info on this forum that consistent condom use, avoiding contact during outbreaks, and ongoing suppressive therapy is the suggested three-fold approach

But then there seems to be a good deal of debate over some of the more non-intercourse possibilities, which, because of the diagnosis, seem to be a slightly safer alternative, and I wanted to check in on those as well...

Firstly, oral sex (cunniligus) from me to her.  I am clear that I cannot receive her genital Hsv2 on my genitals from her giving me oral sex. Also, at least one of the doctors elsewhere on this forum was quite adamant that, as long as I am not performing oral sex on her when active, open sores are present, it is a "very low risk" activity and that in 25+ years as a doctor at an STD clinic "for practical purposes it just doesn't happen" that one receives Hsv2 orally from giving an infected partner oral sex when lesions are NOT actively present... The same was said about handjobs/fingering her/mutual masturbation.  Can you confirm this?  How Safe/Risky are these activities? Especially in the first year or so, when re-current outbreaks are said to be more frequent??

(Again, it gets confusing when you read this, and feel a little safer, but then read elsewhere ANY SKIN-TO-SKIN-CONTACT CAN SPREAD the virus--EVEN WHEN THERE ARE NO ACTIVE SORES PRESENT because of invisible viral shedding...)  

This also brings me to the questions of naked (non-protected), non-penetration rubbing of genitals--when no active outbreak is happening... Before the diagnosis, we often really enjoyed the foreplay of nude "dry-humping"...Again, the grey-area seems to be the "invisible viral shedding" that sometimes occurs, but once again, at least one of the doctors on your team seems to speak fairly confidently that Herpes/Hsv2 is, by definition, a SEXUALLY TRANSMITTED DISEASE, which means actual penetration, not perhaps simple skin-to-skin bumping and grinding... Can you clarify this opinion?

This seemed to be further debated by several patients that questioned whether it might be safer to wear a condom THROUGH the hole in one's boxer-briefs for added protection.  This seems to me, while certainly NOT ideal, might add another whole layer of protection, but seemed to be largely dismissed several times on the forum as unnecessary as a precaution at all... Can this be expanded upon?

Finally, I'd like to address the diagnosis itself... Her initial outbreak occurred a day after she had shaved her pubic area for the first time in a year... She said she had used an old, dull razor and was in a hurry, so much of the irritation that brought the trauma to the skin on initially came from that... She had had both Staff infection AND Shingles in the past (as well as chicken-pox) so she wondered if it possibly it could have been one of these misdiagnosed.  She had never had an outbreak with the former partner, and neither had he, and they often used protection, though not always.

Also, I DO have Hsv1 antibodies, and the initial outbreak occured a day after our second time together intimately, when I performed oral sex on her several times, after she had just shaved the area... I have never had an active cold-sore as far as I know, but it did begin me wondering if also there could have been an unrealized Hsv1 oral transmission to her genitally and misdiagnosed as Hsv2 simply because it was on her genitals... Technically speaking, would this scenario be any "better" for her (i.e. genital Hs1?) What would the advantages be to having genital1 over genital2? Would any of these be likely misdiagnosis?

And ONE FINAL QUESTION:(Sorry!)  Can you talk just a little about the EFFECTS of ongoing Suppressive (Valtrex) therapy on HER body, if any?

The health practitioner at Planned Parenthood I spoke to said it targeted ONLY the VIRUS in the body, and had NO ILL EFFECTS at all on any other part of it--i.e. no side-effects, no weight gain (like a steroid), no buildup of tolerance, just simple combating of the shedding and multiplying of the Virus...  

I would like my girlfriend to know all she can about ongoing suppressive therapy so she can make an informed decision--I have seen many times on this forum folks saying of ALL the steps, it's probably the greatest single step you can take to protect your partner, and YOURSELF for less outbreaks--especially in the First Year or Two...

I'm so, SO sorry for SUCH a (STILL!) LENGTHY post, but as you can see, we are dealing with a LOT, and I really care for this girl and WANT it to work, but we have several "other" hurdles as well, and we are fighting the battle on SEVERAL fronts, and would at LEAST like to be as Safe as we can, while also enjoying the MOST free, unrestricted Intimate Life we are able to!!

Thank you in advance for ALL of your Time, Answers and Insight!