herpes, mucous membranes and skin

[GregParis]

I read that genital herpes is spread only by means of a mucous membrane (genitals or mouth) or active sore being in touch with a partner's mucous membrane (genitals or mouth) or a break in the skin--is this true? Or does simpy skin to skin contact spread the virus? When someone has no symptoms, I understand that s/he may be "shedding" the virus--is this on the surface of the skin, or is it by means of mucous membranes? I am assessing my own risk. I am a man. My female partner has genital herpes, however, she takes antiviral medication and has not had an outbreak for decades. I do understand that she may be occasionally shedding the virus. I have been using condoms from start to finish with her and I understand that even all of these precautions do not provide absolute protection because condoms do not cover every body part which might have contact with a shedding area. However, would this shedding area be at a mucous membrane or would it be the on the skin? I guess I am asking if my mucous membranes do not have contact with her's and if I don't have a break in the skin which contacts a mucous membrane, is it still possible for me to contact herpes? I understand that the risk is pretty minimal with the precautions we are taking--I have been told around 1% over the course of a year--but is there more that I can do to minimize the risk such as washing thoroughly with antibacterial soap afterward? Thanks so much for your help!! --Greg

[auntiejessi]

Does she know what type she has?  Have you been tested?  You both should get type specific IgG blood tests to find out.

If she has type 2 (you can have genital type 1, but its not as infectious as type 2), and all you did was avoid sex during an outbreak, there is about a 4% chance per year that you'd get herpes from her.

If she took daily suppression OR you use condoms, its 2% per year.

If she took suppression AND you use condoms, its 1%.  

(Its a bit higher for positive men who have negative female partners.)

So overall, that's a 96-99% chance that you won't get it.  That's better than or equal to getting pregnant on the pill or when using condoms.  

There is no guarantee that you won't get it - no zero risk.  If you don't think you can handle that, do her a favor and let her find someone who can.  You don't need wash after, etc.  That won't make a bit of difference.

And how will you avoid mucous membrane contact with her when you have sex?  I can't even imagine that, but I think if you try to do some sort of funky position, and get up after to wash, all you are going to do is make her feel bad.  I have herpes, and if some guy tried that with me, he wouldn't get another chance, ya know?

I'm sure I sound harsh, but these are questions you need to ask yourself to find out if you really can handle it.  If you aren't willing to take a 1% risk, then maybe you can't.  

Aj

[GregParis]

Thanks so much for your answer and help on this.
Greg

[GregParis]

To answer some of your questions--my female partner has type 2 genital herpes, I have never been tested for herpes as far as I know but have never had any symptoms (although I understand that I might have something anyway). We have had intercourse maybe six times--always protected (condoms from start to finish). As I say, she hasn't had an outbreak for many years and faithfully takes antiviral medication. Actually, I don't understand this business about mucous membranes. I understand she has one in her vagina and I have one in my urethra, but if I am wearing a condom, then my urethra is covered so I don't see how we could have mucous membrane to mucous membrane contact. So how would I get infected, even if she is shedding the virus? Sorry to be so dumb about this. Thanks, Greg

[auntiejessi]

Mucous membranes are thinner tissue.  Her vagina is a mucous membrane, as is her labia, vulva, perineum, anus, and all the "pink" skin.

Your penis is a mucous membrane, as is your perineum (the little area between your testicles and anus), and anus.

Your mouth, eyes, and inside your nose are too.  

Don't let this freak you out.  If you had a 99% chance of winning the lottery, you'd play, right?  You have a 99% chance of not getting herpes if you use condoms and she is on meds.  Even if you decided to ditch the condoms (assuming you both are otherwise std-free), its a 98% chance.  Statistically, that's not a significant difference.

AJ

[GregParis]

Thanks once again. I really appreciate the time you are taking to answer my questions. It is GREATLY appreciated!! Greg