Herpes Confusion...

[jondavids]

Okay, I recently had a full STD screen and came back positive with HSV-1.  I do not remember getting cold sores, but I am pretty sure I have had at least one/two in the past.  I have never had any sores on my genital area.  

My girlfriend and I have been dating for over a month.  I have had protected vaginal intercourse and performed oral sex (orally on at least three occassions.)  I did not have any clue about the possible spreading of HSV-1 to the genital area until this week, while reading this site.  I thought that it was just a "cold sore" thing that basically almost everyone had... if that makes sense.  

Well, I really care about this one and would not want to hurt her by giving her HSV-1 genitally through oral sex.  I have read many of the posts and just want some clarification if possible:

1)  If she has oral HSV-1, how likely is it that I would give her HSV-1 genitally through oral sex.
2)  What are the chances she would she have already had symptoms of HSV-1 genitally from me previously giving her oral sex?
3)  What are the chances of giving/spreading genital herpes through rubbing of the genitals (penis rubbing the outside and touching the vaginal fluid but no intercourse)?
4)   I know it is a personal decision, but would having HSV-1 orally be something that a doctor would recommend always telling a partner?  Part me of does not want to freak her out...

Thanks again for all your help on this site,

Regards,

Jondavids








    

[Terri Warren, RN, Adult Nurse Practitioner]

1).  Very unlikely.  Her immune response will most likely keep her from getting herpes in a new location.
2)  Three times isn't very many, I think the risk is low.  Has she reported anything unusual genitally?
3)  Do you mean if she has HSV 2 genitally and you both don't know it?  Because you aren't going to spread your HSV 1 from your mouth to her genital through genital to genital rubbing.  Has she actually been tested for HSV?  If not, I think it good if she is also tested for all STDs, just like you were.  
4) as you can see from all of this HSV 1 can be a sexually transmitted infection (by giving oral sex).  Though HSV 1 has a much better prognosis genitally than HSV 2, it can still cause a nasty first episode infection, and some people do recur more often than the typical one outbreak every year or two.  So I come down on the side of disclosure.  Not everyone, even expert professionals in the business, agree.  I think this is guided by the guilt and anger that I've seen from people on both sides of this process over the years.  If your partner is negative for both HSV 1 and HSV 2, then I would recommend that you consider taking daily antiviral therapy to reduce the risk of infecting her.  It costs about $16 per month with acyclovir taken twice per day.  Testing will also reveal if she is positive for HSV 2 and doesn't know it.  That happens more often than one might think.

By the way, if you've EVER had a cold sore, you will have HSV 1 antibody your lifetime.

If you asked someone else, you might get different ideas about this.  Its clearly not black and white.  This is just me, and what I would like to happen to me if I were in her situation.  

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, it can be transmitted via rubbing and no, it probably isn't harder to acquire HSV 2 if you have HSV 1, though the research is actually mixed on that quesiton.

Terri

[jondavids]

Thanks for the comprehensive answer to my questions.  I plan on telling her and see how it goes...

Regarding question 3)  I was just curious how easily HSV-2 can be spread.  Can it be spread by rubbing genitals (penis rubbing the outside and touching the vaginal fluid but no intercourse?)  And piggybacking, is it harder to aquire HSV-2 if you already have HSV-1?

THANKS again!!!

Jondavids