Herpes Expert Forum
Help on transmission, please
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Help on transmission, please

We a healthy couple (me female with male partner) over 50 and have conferred with someone in your office who was helpful and I think she mentioned us to you.  We have both read The Good News About the Bad News and found that to be helpful. Still, we struggle- like to have some questions answered by you.

I have genital herpes 2 (confirmed igG). I've had it for  20+ years. I was one of those people who did not realize I had it. I have never had anything on my mouth.I have been taking daily  500mg Valacyclovir for 1 year and 7 months with no outbreaks. Before, had 3 to 4 outbreaks a year.  
We are in a serious (and we both want lasting) relationship.  He is very concerned about contracting herpes2 from me and certainly I do not want this to happen.  He has been tested and his results were negative. He was given information from his physician who told him herpes2 was serious and could have very serious consequences for him (he is healthy). I have told him although I would not chose to have this, it is not a serious situation for me. His doctor's information is very conflicting and he remains scared. We have a strong relationship, discuss this openly, compatible otherwise, but this remains a struggle.    
I realize this is spread by intercourse and genital to genital contact.
1.What are the chances that I will transmit this to him via intercourse if I take medication and we have no contact if I do have an outbreak?
2.With my medication, should we use a condom? Does it significantly lower the risk of transmission further?  
3.What are the chances he will get it by putting his finger in me?
4.Giving oral sex to me?  
5.Can I safely perform oral sex on him (I have no oral symptoms at all)?  
6.Is it inevitable that he will eventually get this since we plan to stay together?
7.What advice would you give a couple in our situation who want to stay together?
Thank you for your help as we both want really want to work out our relationship.
Tags: committed couple needs help
55646_tn?1263664409
The chance that you will transmit this to him if you have sex an average of twice a week, take medicine and don't use condoms is about 2% per year.  If you do use condoms it drops it slightly lower than that. Condoms reduce the risk of transmission by about 30-50%.  
If he has intact finger skin, there is virtually no chance he will get it from you on his hand.  If he gives your oral sex, there is a small chance he could get herpes on his mouth, but if he does, it would be a virtual vaccine against him getting it genitally and would like recur extremely infrequently.  You will not give him HSV 2 by giving him oral sex.  It is NOT inevitable that he will get this from you, even after years of having sex.  The percent acquisition is not cumulative over time.  
My advice is simple:  he needs to decide clearly if he would rather be with you and assume the small risk that he would get herpes or would he prefer not to be with you.  Once he actively assumes a small risk and truly accepts it, you can move on as a couple.
Herpes is in no way, whatsoever, a serious medical problem.  That is pure rubbish from an uninformed health care provider.  Sixteen percent of the population in the US has this.  If it was a serious medical problem, don't you think we would hear much more about the serious consequences?  We don't, and it isn't serious.  It can be emotionally challenging and some people are bothered by outbreaks, but medicine can largely control this.  
If you are a good match in ways other than this, and we know that good matches, especially at our age are hard to find, he needs to take a deep breath, put this into perspective and move along with you by his side.  In the big picture, this is a minor skin problem.  Just my two cents worth.

Terri
7 Comments
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Avatar_f_tn
Good day... Can you get hsv from a single oral encounter?
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Avatar_n_tn
Thank you so much for your reply and the factual help and understanding you are giving people.  
Please share some further info on this. You said there was a “small chance” that he could get HSV2 on his mouth from giving me oral sex.
1.  In your experience, how often does this actually happen?
2.  A dental dam is not particularly appealing, but do you recommend using one?
3. Are outbreaks usually present when transmission happens?
3. Since I have had no outbreaks while on meds, does it happen less often because of this?  
4. If transmitted, would the symptoms be the same as HSV1…that being outbreak on the outside of the mouth?
Again, thanks for your help  
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Avatar_n_tn
One more question, please.  I have not and hopefully will not have an outbreak on medication, but if I did when would it be safe to resume sexual contact?
Thank you!
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55646_tn?1263664409
1)  I have  not seen this happen in my practice in 32 years
2) For greatest protection, that would be an effective option
3) No.  The majority of transmission in people who KNOW that they have herpes appears to happen when no symptoms are present.
3a) I don't think I understand your question
4) Are we still talking about HSV 2 orally?  If yes, then yes.

Terri
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Avatar_n_tn
Thanks, and I'm sorry I was not clear with the questions.
  Please disregard questions 3 and 3a as they do not matter since you have not seen a person get HSV2 orally from giving oral sex to someone with HSV2 in your practice in 32 years

Please comment on this questions:
1.  I have not and hopefully will not have an outbreak on medication, but if I did when would it be safe to resume sexual contact?

Thank you for all you do to give accurate information to people like me!
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55646_tn?1263664409
There is no specific time that it is safe to resume sex since there is always a small chance of asymptomatic viral shedding occurring.  I would certainly wait until new skin has replaced completely an outbreak.

Terri
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Westover Heights Clinic
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