Transmission of HSV 2 in Asymptomatic Female x 10 + Years

Infected with HSV 2 late 1970's-early 80's. Approx 5-6 outbreaks (R buttock). None since early 90's. No prodromal symptoms (treated with acyclovir) since then either. Risk of transmission (intercourse and oral sex) to new male partner (not yet tested for HSV 1 and 2 which I will recommend) with and without suppressive therapy and/or  with and without condoms. Thanks


This discussion is related to chances of transmission.

[gracefromHHP]

there is no difference in the risk of you transmitting to a partner as someone who was just infected say 2 years ago. You are still shedding at the same rate even after all these years.

did you ever pursue any testing to confirm that you have hsv2?  lesion cultures weren't always typed 20+ years ago.

grace

[Daniela22]

Firstly, apologize for multiple posts but first time using this format. I did not get serologic testing but my symptoms (vesicular lesions, burning, itching in same area R buttock approx 5-6x were classic + had HSV+ partner (unbeknownst to me until I was inected) and years later one LTR monogamous partner infected in mid 1980's). No outbreaks and no partners infected since then. I was hoping to get answers to my questions above though. Also, from everything I have read this is the first time it was indicated that both reoccurrences (outbreaks) and viral shedding did not decrease over time...esp decades in most cases. I am confused by your response and any clarification appreciated.    

[gracefromHHP]

it used to be thought that over time, less ob's would occur and therefore less shedding. We have much better info now though and know that that isn't the case.  we now know that you shed about the same amount over time whether you've been infected 1 year or over 20 years.  whether or not you keep having obvious recurrences or not isn't an indicator of shedding either. you shed about the same whether you have 0 ob' s a year or 10 's a year.  

keep asking questions!

[Daniela22]

Gracias Grace. I appreciate this info. Fortunately, no partners infected since one LTR in the 80's. I want to be able to share with my new HSV neg partner who is concerned the % risk of HSV transmission (1) with intercourse (2) with oral sex both with and without me being on antiviral prophylaxis and also when infected individual is on AV prophylaxis and no condoms used and condoms used (ideal obviously). Appreciate this info.

[gracefromHHP]

if you are female and a partner is male, if you do nothing but avoid sex during obvious genital symptoms, they have a 96%  odds each year of NOT contracting hsv2 from you. If you take daily suppressive therapy with valtrex and use condoms on top of those precautions, your partner is 99% likely each year NOT to contract hsv2 from you.

[Daniela22]

Gracias for the response Grace. It is so interesting with these odds that so many people are infected with HSV from viral shedding (or o/b).

[gracefromHHP]

well most of the reason why so many folks are infected is because it's not a part of routine testing so most folks have no idea they are infected. Know you are infected with herpes and you are more likely to avoid sex when you have redness or itching down yonder.  Not know you are infected and you'll chalk those symptoms up to something else and will likely have sex during active symptoms which does result in higher risk of transmission to a partner.    One study found that just knowing you are infected, reduces transmission to a partner by 1/2!

[Daniela22]

Very interesting but makes complete sense since I believe one in five do not know they are HSV+.. I can't help but think that since I have had no outbreak and no prodromal symptoms in at least two decades that my viral shedding is prob very low too but I do not know if there are studies to support this?. Truthfully, I do not think about it much (since asymptomatic and no partners infected except one LTR in the early 1980's shortly after my diagnosis) but I have a new sexual partner who is really concerned (and rightfully so) but moreso, than any partner I have been with in the past. Thus, my questions. You mentioned 96% of no HSV transmission if no o/b at time of sex and 99% chance of no HSV transmission if I am on antiviral meds and condoms. OK - last question - what % of transmission if I am on antiviral meds and NO condoms (he has never worn a condom but suggested it...due to his concern and first and foremost I am going to suggest he get checked for HSV. No symptoms but...and I understand if even HSV 1 + he may have some immunity for protection of HSV 2) or condoms and NO HSV transmission. Pregnancy (due to my age) and other STD's not a concern as we have both been previously tested so, I know the "party line" about safer sex but trying to assess the worse of two "evils" (being honest and real here) to protect/reassure him. Gracias!  

[gracefromHHP]

A couple of my friends with herpes and I participated in the home shedding study of folks with hsv2 infected for >10 years.  I have more ob's than any of them on average but shed less than they did. the one fellow rarely has ob's any more and he was shedding more than any of us who got ob's fairly regularly yet. we all had fun comparing our results to each others after the study was completed ( yeah we don't get out much evidently...he he he ).  Also the valtrex and reduction in transmission sub study on shedding  took daily swabs for 2 months I think it was from folks and showed similar results - shedding about the same between years 1-10 of being infected ( you shed more the 1st year of infection ) regardless of how many ob's you had.  

it's a 2% risk of infection yearly with no condom use and you on daily suppressive therapy with valtrex for a male partner.  

hsv1 doesn't provide any significant protection against hsv2 acquisition. it does however make it less likely you'd have a "classic" initial ob if infected with hsv2.  

I totally understand the condom issue - especially once you hit your 40's it seems between issues with erections and coming out of ltr's where they had gotten used to not using condoms , sometimes hard to get a fellow to wear one but remember this is as much for your protection as his if it's a new relationship !  female condoms sometimes work better - males don't have to have a full erection to use one. I've never tried them but I've been told the "squishy stirring macaroni's" sound is entertaining...he he he

[Daniela22]

Gracias Grace

Appreciate you taking the time to post this info.

[Daniela22]

Well, he broke up with me last night even tho I have not had an o/b in 25 + years. Too scared that he would contract it during viral shedding. So much for honesty. Never have had a partner have this reaction in all my years. Irony is he has never used condoms in his life! and even got treated for chlamydia once but of course there is a "cure" for chlamydia. End of story.

[gracefromHHP]

it happens to most of us at one time or another :(     Some people hear herpes and that's all it takes. Even though a 1% risk of contracting it is about as low as it gets, some folks just can't get past hearing the word herpes :(

Call your gf's up and tell them you need a girls night out and get them to tell you how much this guy didn't deserve a gal like you :)

[Daniela22]

Gracias Grace - Hard to believe but true especially since he has never worn a condom in his life but c'est la vie.

[gracefromHHP]

odds are that he's never been properly tested for herpes to know his own status either. hopefully the discussions with you gets him to make sure he does that so that he can protect his own future partners.

[Daniela22]

Yea, trust me I tried to educate him. I was HIV medical provider x 16 years. Still do international HIV consulting and training etc. Kind of a "plant the seed". He is not a player or sleep around a lot but does not really "get it". Hopefully, his eyes are wider open now.  

[gracefromHHP]

well we all know that std's only happen to "other" people right? he he he

do you hang out on the hiv forums here at all? I know they'd love to have you chime in on posts there if you are interested :)  

[Daniela22]

No, I have not hung out on HIV forums. I wanted to have the STATS on HSV for this partner that came from someone besides me so, more unbiased. I never had the op to share this forum with him tho before the breakup. It is important for me to keep my anonymity at this point for personal and professional reasons. Thanks for all your assistance and support
.  

[Mistakeguy789]

Hanging out there won't make you lose annoymity at atll.  :-)  Just more people being helped.  :-)  Glad you got the info from us.  

[Daniela22]

Please write me offline. Give me your personal e address. You will understand more when I write then