HSV 2 transmission risks

[KB7474]

I have had HSV-2 for about 18 years.  I was never tested but my ex-husband had it. Shortly after we began dating, I developed an itchy blister on the back of my upper thigh after having unprotected sex (he never took suppression therapy).  He was able to tell it was herpes based on the appearance.  I suffered with a lot of outbreaks (mostly on buttocks and thighs…have only had 1-2 genital OB’s that I am aware of) until I went on suppression therapy several years ago.  I take 1 gram of Valtrex daily for suppression and have for several years.  

Fast forward to now and I am in a new relationship with a coworker.  I am extremely worried about him contracting it from me (we have not had sex yet but plan to in a few weeks when we take a trip together).  
What exactly are the risks to him for contracting HSV 2 from me if he wears a condom every time, we abstain when I have symptoms and I continue taking the meds?  Also, what is his risk of getting it orally if we engage in oral sex?  
From what I’ve read, the risk is about 2% given the above but is that 2% per encounter or per year or what?  So I take that to mean there is a 98% chance he won’t get it?  We don’t live near each other so if we do end up having sex, it will be infrequent.

I’m also worried about shedding.  Are there any tests that can confirm when/how often you shed?  I frequently get burning/shooting pains in my buttocks and thighs so I don’t know if that means I am shedding (but never actually get an OB).  

[Terri Warren, RN, Adult Nurse Practitioner]

Your recurrence history is more consistent with HSV 2 than HSV 1, but we shall see.  

Terri

[KB7474]

I am actually going for an IGG test today.  I decided it would be helpful to know for sure what exactly I have since I was never officially diagnosed.  I'm not actually certain my ex h ever was tested either or if he was just diagnosed based on visual exam.  I assume it is HSV 2 but would be nice to know for sure.  He never got that many recurrences (every year or two and that was without meds).  It would be nice if it turned out to be HSV 1 instead since the transmission rates are lower.

I have not told the new guy yet but plan to.  I am praying he has it too so it will be a non-issue.  If not, we will for sure use condoms 100% of the time and I am already on Valtrex anyway.  

[Terri Warren, RN, Adult Nurse Practitioner]

The 2% figure comes from research from couples that are discordant, that is, one is infected and the other is not.  If 100 couples in a study where one has herpes and the other does not, and the woman has HSV 2 and the man does not, and they have sex an average of twice per week and she takes daily antiviral therapy and they use condoms infrequently, at best and they avoid sex with any outbreak signs or symptoms, 2 men in that group will get infected.  

I am assuming your are on daily suppression and you will be using condoms and he knows about the herpes, right?  Has he been tested to determine if he is or is not infected already?  If not, he should be tested to see if there is really anything to worry about.

Terri