Valtrex dependency

[helpanswer]

Hi,

I am currently dating a guy who has hsv2. I've been tested and do not have it. I've written to this forum before when I was going through all the different emotions and not sure if I wanted to risk acquiring herpes. Well, I've continued with the relationship and since we've just been very careful--- use condoms throughout and limit skin exposure. I know the base of the penis can never be completely covered, so that is my main concern. He has never had an apparent outbreak so it is hard to know when he is shedding the virus. I've just been trusting condoms. He is willing to go on Valtrex, but his concern is that if he goes on it, his body will become dependent. For example, if he goes on it then decides to discontinue, will his body be more susceptible or prone to an outbreak because of taking it? He has always been symtpom free and would only take valtrex to reduce transmission to me, not because he has discomfort or outbreaks. Will taking Valtrex change his immunities against the virus when he is off the pill?

Thanks

[gracefromHHP]

None of my ltr partners have ever contracted hsv2 from me. I'm usually on suppressive therapy all the time. I use condoms in the begining of a relationship most of the times but then once they are comfortable without them - so am I ( unless I have doubts about if I"m the only one they are sleeping with of course ).   Most of the discordant couples I know - have stayed that way.

As for the herpes vaccine - no it's not going to be available anytime soon ( if ever even - this dang vaccine has been around for years now and in testing just keeps not living up to the expectations though from phase 2 trials this time in testing it gave a 40% rate of protection in otherwise completely hsv negative females for hsv2 - it'll probably be a year or so yet until we hear the results of the phase 3 trials which still haven't finished up ).

Most of the women I know who have herpes - don't get c sections.  I had them myself but that was because I had back to back ob's my entire 1st pregnancy and my 2nd pregnancy even though I tried to deliver vaginally - my baby had other ideas.  

Helpanswers.....hang in there :)  It seems you've been reading all our replies and thinking about them seriously and using them to work your way thru these decisions which is a terrific thing :)  It's ultimately your choice what to do - we just like to make sure folks have an educated picture of what herpes is really like so that it's not a typical knee jerk reaction to hearing a partner has herpes.  Keep us posted and let us know how things are going :)  

grace

[helpanswer]

In response to the last couple of comments:

Agreed regarding complications of dating in general and that if you find a good guy, he is worth keeping! We have been friends for the past five months and have other issues to mend, thus, my concerns. I guess I've just been quite lucky with other boyfriends. They have gotten tested and been clear. This was the first time I've encountered someone with any type of herpes believe it or not, but it has been a learning experience and opened my eyes a bit.

I'm always impressed to hear that there are married couples where one person never acquires the virus. Do you use protection still? Or maybe just valtrex? t

So with that said, if herpes was the only issue in my friendship/relationship with this person, perhaps it wouldn't be such an issue. But, this isn't a counseling forum so I won't go into more details:)

Regardless of what happens with my current guy, the next guy may have herpes also. Being informed about the virus certainly helps and if more people were educated on the matter, I don't think it would be such a social stigma. I respect what both you ladies said and hope for those who are still in the dating world, that things get easier! In the meantime, best of luck and thanks again:)

[helpanswer]

In response to the last couple of comments:

Agreed regarding complications of dating in general and that if you find a good guy, he is worth keeping! We have been friends for the past five months and have other issues to mend, thus, my concerns. I guess I've just been quite lucky with other boyfriends. They have gotten tested and been clear. This was the first time I've encountered someone with any type of herpes believe it or not, but it has been a learning experience and opened my eyes a bit.

I'm always impressed to hear that there are married couples where one person never acquires the virus. Do you use protection still? Or maybe just valtrex? t

So with that said, if herpes was the only issue in my friendship/relationship with this person, perhaps it wouldn't be such an issue. But, this isn't a counseling forum so I won't go into more details:)

Regardless of what happens with my current guy, the next guy may have herpes also. Being informed about the virus certainly helps and if more people were educated on the matter, I don't think it would be such a social stigma. I respect what both you ladies said and hope for those who are still in the dating world, that things get easier! In the meantime, best of luck and thanks again:)

[waringblender]

Wow, ataglance said some really good stuff there. Not much to add except to piggyback onto that:  Herpes is really common in its various forms. If you are a single person out there dating, there's no way to avoid herpes in its several variations, unless you want to be celibate and never even kiss anyone ever again. The bizarre tap dancing that a person would have to go through to completely avoid dating a person with herpes would go something like this:  You would have to request that the person get tested for both types. You would then have to tell them that they wouldn't be allowed to kiss anybody or have any kind of sex with you, or anybody else, for the next 3 months. You would then have to ask them to retest for both types of herpes. And you would have to inform them somewhere along the line that if their tests are positive, you would be rejecting them anyway. (But thanks for playing!) (At least maybe you could buy them a drink for their cooperation.)

See where I'm going here? If you've met a decent honest person who is willing to take whatever precautions are necessary to protect your health, you're off to a good start right there. Because a lot of folks are not going to do that. A lot of folks don't even know they have herpes in the first place to be able to do that. And those gestures indicate good faith on the part of your partner. Good faith that can translate into other supportive and loving behaviors in other aspects of the relationship in terms of your intimacy together.

I've had more men reject me because I'm a workaholic than because I have herpes. I wish that my herpes were the least of my problems when I'm seeing someone. It takes a back seat to bigger issues for both of us, and that is the case no matter who I'm dating.

[ataglance]

This is for both helpanswer and sicwithworry - A woman with herpes does not need to have c-section.  That is not a requirement so whoever told you that is greatly mislead.  I have  known plenty of hsv2 + women that have had regular vaginal births and their babies are healthy and happy.   The only time they will recommend a c-section is if there is OB.  Also a woman's ob are not worse than men.  Mine are barely noticeable and clear up usually within a few days.  That's even without medication. Oh, and I haven't had an OB in a few years too.

Helpanswer,  I just wanted to add here that this guy sounds like a really decent, caring person.  He  has been honest with you, cares about your health and is willing to do whatever it takes to keep from transmitting herpes.  You haven't mentioned any major character flaws like  being  liar or cheater or criminal so from what I hear you describing, he sounds like a good catch.  Herpes is just a benign skin virus that is preventable when condoms and meds used.  Actually, condoms will often just do the trick but meds can add extra insurance.

Now think about this: A lot of people will lie to get someone into bed, not caring about anything but themselves.  But this guy put you first, before his needs.  I really caution you not to throw this away.  A nice, decent, honest guy who you click with is hard to come by these days.  I'm lucky that I am married to my best friend (I'm hsv2+ but he's negative) but I know dating, even if you take herpes out of the picture, is hard these days.  Everyone seems to be going in different directions that to actually meet someone you're attracted to and have common interests, that's what matters a lot more than herpes!

I also hope you tell him about medhelp.org so that he can get more educated too.  The dr's forum also has wonderful information.

[waringblender]

Grace, I let them keep the boxers on if we are backpacking and out in the woods, but it's just so his a&& won't get cold. :o) It's probably best that he's not mooning any bears wandering around nearby, too. :P

[gracefromHHP]

When you chose to be in a relationship with someone who has herpes - as long as you are in that relationship or don't have obvious symptoms - no reason to get tested frequently.  If you want just to keep an eye on things - get a blood test every year at your yearly exam - otherwise as long as you are with your man and aren't pregnant - no symptoms means no reason to get tested. Does that make sense?

Should you become pregnant - be sure to get tested for hsv2 at the start of your pregnancy as well as at the 3rd trimester start.

Should you and your man break up - get yourself tested again 3 months after the last time you had sex before moving on to a new relationship.

Condoms and your man on suppressive therapy means a 2-3% risk each year of acquiring hsv2 from him.  If someone told you you had a 2-3% chance of wining the powerball tonight - would you run right out of work and go buy a ticket?  At the price of gas - that small chance isn't worth it is it?

I'm with waringblender in that my man wearing a pair of boxers during sex just doesn't do it for me. Besides I'm cheap/lazy enough that to me it's just more laundry that needs done ...he he he.  Females are better protected by condoms from herpes than males are.  Plus it still leaves the base of the penis exposed unless he's wrapping a hunk of duct tape around the boxer short opening to keep it stuck to the condom ( please get it on video when he pulls that off!!! I'd watch that on u tube!!!! ).  

Try to relax more about all this ( I know - easier said than done!! ).  Enjoy your sex life with your man :)   Don't "do it" once in a blue moon - do it whenever you can !!!  before you know it the "newness' will  wear off and he won't look near as attractive to you as he does now...he he he  

grace

[helpanswer]

Thanks for all your time, you have a good head on your shoulders! If he had been on medication before, I probably wouldn't have been so worried.

You are right about everything you say. I think we are going to chill out for now. We know that if dating doesn't work out, we are close enough to be able to stay as friends. If we feel the time comes where we really want to be together for the long hall, then these worries/barriers will drop. Ultimately, I do want to be uninhibited with the person I'm with (no condoms,etc), herpes or no herpes. Im not going to get tested for a few months now unless I get an outbreak.

Thanks again for all of the advice/information. It helped a lot:)

[waringblender]

Wow. Okay, your running and getting tested after every sexual episode doesn't bode well. I suggest counseling. Again, start educating yourself. Even if you guys don't use condoms or medication, your risk is low. But it sounds like you really can't resolve this aspect of your relationship. Maybe you should move on.

I've never had a man I slept with say "I need to get tested before we  screw again just to be sure." Actually, if any man I was sleeping with said that, I'd tell him to bugger off and find somebody else. Yeesh.  

[waringblender]

I know several women who did not "have to have" C-sections because of their herpes. C-sections are not de rigueur because you have herpes. I'm not a medical professional but it's just not true that this is the case with women and pregnancy with herpes.

I also don't believe women get more painful or frequent outbreaks than men. Outbreak patterns are very individual and not gender-specific. Again, it would help to get some facts about herpes before making generalizations about it.

The OP still sounds like she is doing selective reading on here, though. (Sorry, but that's my interp of your comments in response up above.) You don't need to worry about "where" your boyfriend is shedding  if he is using medication. That's the whole point of the medication. If you can't wrap your mind around the idea that the medication is highly effective on its own for prevention, and if the two of you use condoms religiously then you have an extremely low risk, then you probably shouldn't be dating the guy. Extract yourself and let him find a partner who accepts this about him. You aren't doing yourself or him any favors by defining your sexual relationship around wearing boxer shorts or not touching him in certain areas because of your fear.  

If you continue to struggle with it, either get counseling around it, or leave him and find somebody negative. It's ultimately not fair to either one of you, and you should not be fearful when you get into bed with your partner. That's a surefire way to destroy intimacy, not build it.

I'll add in closing that, as a single woman living with herpes for quite a while, it is not the life-altering scary thing that many folks make it out to be. In fact, I would have to say that it's not changed very much about my social life, and it certainly doesn't affect me physically or medically. 90% of people with herpes don't even realize they have it, so it certainly isn't changing people's medical health for the worse. On the social aspects, I've only had a few rejections, and every man I've been with has been negative via blood test, and they still want to screw me, even the guys going in knowing it's casual sex. In short, it's not that big a deal to a lot of people, and it certainly isn't a big deal to me.

Just my 2 cents, though. Good luck to you. Again, if you can't work through your fear, get therapy for it, or leave.

[helpanswer]

Sicwithworry-

So you haven't gotten tested yet to see if you contracted the virus? Yes, it certainly is a nerve-wracking thing to have to wait. But, as you probably have read from this thread and others, he may not have been shedding the virus at the time. Did you use protection? I had sex twice with my partner before his blood results came back that showed he was positive. I was worried sick for about six weeks, then I got tested and I was negative. I've had sex since and still have to wait to see. I'm more chilled out about it now after having done all the research and frankly, I just got to the point hwere I was emotionally drained. We were very careful these last couple of times, but I wish he was already on Valtrex, then I really wouldn't worry. Anyway, chances are you are fine and that boy should have told you! On the other hand, my guy never wold have tested for it if I hadn't made him.

Regarding this vaccine, I know there was a trial period for it, but I hear there is limited funding at this point, which has delayed the research process. If anything, I thought it would be another couple of years before it came out?

Best of luck and I need it to. I think I'll refrain for now until he 1. gets valtrex and 2. I get tested again. That is the best way to see if what we've been doing so far has been effective against transmission.

[sicwithworry]

There is a herpes vaccine in the works that is expected be available this year. It can be used by anyone who has not been exposed to hsv1 and hsv2.  You could wait till the vaccine is out and got for it..

[sicwithworry]

There is a herpes vaccine in the works that is expected be available this year. It can be used by anyone who has not been exposed to hsv1 and hsv2.  You could wait till the vaccine is out and got for it..

[sicwithworry]

There is a herpes vaccine in the works that is expected be available this year. It can be used by anyone hwo has ot been exposed to hsv1 and hsv2.  You could wait till the vaccine is out and got for it..

[sicwithworry]

My impression is that herpes outbreaks are much more painful and more recurrent in females. In addition if you have it you will probably need to have a c-section to avoid passing it to your child.  Overall its a lifelong disease with worse implications for women.
That said...  if i was really  in love with a guy and knew for sure i wanted to be with him long-term i would take the disease on.. and deal with..  -- but if i am not sure about the guy ... i would not get sexual.
Your boyfriend seems like a nice guy. He was honest with you and is concerned about your health and willing to take steps to protect you ...   -- thats very responsible and thoughtful of him.
I was exposed to herpes (orally and genitally) by a guy who didnt tell me until after the 3d time i slept with him that he was infected. I slept with him last Dec 1st. I have spend the last month and a half in hell paranoid that i may have caught it ....

If you are not sure about him...  there are ways to connect in a non-sexual way and see if  you really love him and want to be with him..  
No point getting paranoid after everytime you have sex -- that wont be good you you , him or the relation.
Point is ... if and when you decide to be sexual with him...  you have to reconcile yourself to the risk (however small) that you will get it...
Sorry if i am negative... as i said your BF seems like a relaly nice person.... -- just try to talk things thru, build trust and do what you are comfortable with. We all have to take care of our own health.

[helpanswer]

Waringblender,

I admire your honesty! haha. And I really think its admirable that you are upfront with your partners and take necessary precaution. As you know, not many do.

Do you think that more times than not, most females DO get a primary apparent outbreak? I've tested twice now negative after having waited 8 weeks and then 6 weeks after intercourse. We hae had sex since, but Im not going to get tested again for a while. Also, I know you said it is ridiculous to wear boxer shorts....I agree, but, if herpes can shed in areas that aren't protected by the comdom, theoretically, couldn't wearing boxers help? Its a tough situation because I do like who I'm with and he likes me, but he doenst want to give me herpes and I do't want to get it. I may have other partners after this and I think it would be too emotional if we break up and I contract herpes. On the other hand, it is hard to resist feeling and not be with the person you spend a lot of time with. He feels the exact same way as me so by no means am I being demeaning. We have a good understanding and realize that this has created a wall. I do feel confident that with the proper measures, we can prevent transmission, but it is still scary...I get tested, we dont have sex for a while, then we do and I think, great, now I have to get tested again. I know, we should probably just stay as friends because I'm not comfortable with this, I guess Im in denial of it because I've never had to deal with it before and other bfs. Thanks for listening

[waringblender]

It's not your responsbility to recognize symptoms in your partner - that's his responsibility. And since he is with a negative partner, he needs to take that responsibility seriously, meaning he needs to start learning to recognize any odd sensations, different sensations or skin changes in his genital area, so that he can inform you and you two can avoid infecting you. Maybe he hasn't been the greatest at "listening" to his body or knowing what's going on, but he will have to start doing that more frequently with negative partners. Just my opinion.

The other thing is that if he is asymptomatic off medication, it's a very high likelihood he'll be asymptomatic on the medication. I'm asymptomatic on medication and my outbreak pattern off meds is 1-2 per year. The medication knocked out my symptoms completely - no prodrome, no visible episodes. They are simply gone during the duration of my using acyclovir.

I can't imagine not using condoms with my partners. Condoms are my birth control method as well, so I always have a reason to use them. It would take a lot for me to ditch the condoms - like dating the same guy monogamously for a couple of years at least, before I lose them.  But I'm a bit of a player :) so I'm not sure that's going to happen any time soon. :)

[gracefromHHP]

If he can get a copy of his herpes blood test results - I'll gladly take a look at them for him to see if he needs additional testing or not.  Not sure how long ago he was tested or anything but with many providers not understanding the tests and the possibility for false positives - it's well worth getting a 2nd opinion on if he never did.  I just need the numeric results - ie hsv1 igg 4.5 and hsv2 igg 1.5 or whatever they were.

Sometimes a pimple really is just a pimple.  

Yes suppressive therapy is probably the best bet in a situation like this along with condoms for at least awhile until you two feel more comfortable.

grace

[helpanswer]

Thank you both for responding. I really appreciate it.

Grace, you made an interesting comment about people knowing what to look for. My partner says he monitors himself on a regular basis and has never seen anything that seems to resemble herpes. I did see two small red pimples on his buttox, but he says he's gotten those before. I get them too from working out. They weren't painful and they didn't look like blisters, but they weren't white heads either. Do you think this could be a minor outbreak? How can you tell the difference between a small red pimple and a minor herpes ob....do they always hurt? If someone is having an outbreak and they aren't aware of it and use a condom, is the person always at high risk of contracting the virus during this time? I read at somewhere they if someone has sex during an outbreak, they have a 75% risk of getting the virus...this is without protection.

Since he doesn't seem to recognize symptoms and probably wont' go to the doc everytime he has a pimple on his behind, it seems that valtrex is really the safest bet for us.

[gracefromHHP]

I totally 2nd waringblender's comments about whatever precautions you take - it's your choice. You don't have to use the whole shebang of precautions every time for the rest of your life together with this fellow ( if things went THAT well ! ). It's up to you and your comfort level.  I certainly recommend starting out using them all but it's not something you have to do for a lifetime.   If you do nothing but avoid sex during his obvious ob's ( which I know is hard when he doesn't think he's having any ) it's a 8-10% risk each year for you.  If the weatherman said it's a 10% risk of rain today - would you pack an umbrella for work?  

I also wanted to point out that just because your man *thinks* he isn't having obvious signs of herpes ob's - doesn't mean that his immune system is "handling the virus well" or however it is you put it.  A lack of obvious ob's is not a reflection as to how often the virus is active in his body.  It just means that he isn't being annoyed by "classic" recurrences of the virus.  He is still actively shedding the virus perodically as waringblender already pointed out. Also one study showed that in folks who tested + for hsv2 on the blood test and swore they had never had any symptoms - once they had education on the virus and what to look for - about 80% of them were able to start recognizing when the virus was active from there on out. So chances are good that he is having symptoms - just not huge, painful blisters that are so obvious for herpes that even a 1st year medical student could recognize them.  

grace

[waringblender]

Using condoms is a choice the two of you make together. Even if you stop using condoms and he continues on medication, your risk of contracting the virus is still very very low. I forgot what the numbers are for man to woman, but it's something like 8-10% per year if you guys do nothing but avoid sex during outbreaks (which he apparently doesn't have). If you add medication or condoms to that, you decrease the risk by half again, so now you're down to 4-5% per year risk of transmission. If you add the other method (meds or condoms) to your above method on top of that, you're halving the risk yet again, so you're down to 2-3% per year risk of transmission using both.

The doctor on the other forum has also commented that the medication is much better than 50% effective in decreasing shedding. It may be as high as 75-90%.

For my latest partner, when I went to get tested at the clinic, the doctor called me with my test results and said my HSV "viral load" was close to "undetectable." I asked him what that meant, and he said "You must be on daily medication." And I said I was. He said that the very low level detected on my blood test (I guess they are testing for antibodies, since the virus itself isn't in the blood) is only seen in folks who are on chronic medication.

That was the first time a clinician has told me this, and I've been tested numerous times over the years while on medication for each new sex partner. It was reassuring to know that there was some solid clinical evidence that the medication was working. Other than that, of course, the strongest evidence is that I've never infected anybody.

If any of my partners wanted to use boxer shorts to bang me, I'd tell them to find another partner. Sorry, but if they're not comfortable enough and trust me enough with the medication, it is probably best that they look for another partner. :(

[waringblender]

Using condoms is a choice the two of you make together. Even if you stop using condoms and he continues on medication, your risk of contracting the virus is still very very low. I forgot what the numbers are for man to woman, but it's something like 8-10% per year if you guys do nothing but avoid sex during outbreaks (which he apparently doesn't have). If you add medication or condoms to that, you decrease the risk by half again, so now you're down to 4-5% per year risk of transmission. If you add the other method (meds or condoms) to your above method on top of that, you're halving the risk yet again, so you're down to 2-3% per year risk of transmission using both.

The doctor on the other forum has also commented that the medication is much better than 50% effective in decreasing shedding. It may be as high as 75-90%.

For my latest partner, when I went to get tested at the clinic, the doctor called me with my test results and said my HSV "viral load" was close to "undetectable." I asked him what that meant, and he said "You must be on daily medication." And I said I was. He said that the very low level detected on my blood test (I guess they are testing for antibodies, since the virus itself isn't in the blood) is only seen in folks who are on chronic medication.

That was the first time a clinician has told me this, and I've been tested numerous times over the years while on medication for each new sex partner. It was reassuring to know that there was some solid clinical evidence that the medication was working. Other than that, of course, the strongest evidence is that I've never infected anybody.

[waringblender]

People don't shed only when they have outbreaks. Average shedding is about 15% of days in a year, you just don't know when it will happen. Even if he's asymptomatic (most HSV+ people are), he is shedding at this rate, even without outbreaks. He's not gonig to feel it or see it.

If he takes the medication for a period of time and then goes off of it, he will generally revert back to his previous level of episodes. In his case, it sounds like that is zero. He shouldn't have any problems in this regard.

Whenever I've gone off acyclovir (because I'm not screwing anybody), I seem to revert back to an even more decreased  pattern of episodes. I have fewer episodes these days off the meds  than I used to have. That could just be coincidental, or it could be that as time goes on, my pattern would have changed anyway.

[helpanswer]

Thank you for your thorough reply. I know you aren't a doctor, but it seems like you've done your research and know what you are talking about.

I've read great things about the use of Valtrex. My partner just thought that if he were to start valtrex, then go off of it, would that make his asymptomatic shedding increase. It seems that isn't the case, but no one really knows the exact amount of shedding that goes on.

Like you said, I've read that the risk is very low if condoms and medication is used. So far we've slept together about 6-7 times and use condoms. I wanted to wait till he went on meds, but since we were careful with the condoms (e.g, made sure they were on right, didnt break) I trusted it. Anyway, sounds like Valtrex is the way to go. Its unfortunate that we can't have unprotected sex. I'm used to being in monogamous relationsihps where we get tested and I use birth control. But, i've decided that this person is worth the compromise.

And yes, we have used boxer shorts! It was a mutual decision thinking that it would cover the groin areas since we don't know where his exposure to the virus was. But, eventually I know that is ridiculous. Glad that Valtrex has worked well for you and you've had a normal sex life. Hopefully there will be more money put towards researching an effective vaccine to prevent this virus.

Thanks again