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STDs  (Expert Forum)
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Female to Male Genital HSV1 Transmission
Answered by
University of Washington Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Female to Male Genital HSV1 Transmission

by crazylarry, Jun 15, 2007 12:00AM
I recently began dating a woman who revealed to me that she has Genital HSV1. Got it approx 13 years ago, had her initial outbreak then nothing till about 3 years ago and she had her second and last outbreak to date. She believes the second outbreak was due to the stress of her divorce. She takes Antiviral Meds. daily. What are my chances of her transmitting this to me either Genitally through unprotected sex or Orally by going down on her? Should I be concerned about her having this? I did have myself tested and it came back that I am negative for both HSV1&2. She's a great girl who I really like, I just can't get the fact that she has HSV1 and that I may be at risk out of my head.

Thanks.

by H. Hunter Handsfield, M.D., Jun 15, 2007 12:00AM
Genital to genital HSV-1 transmission of course can occur, but most likely it is rare.  I have never seen a case of genital HSV-1 that was not acquired by oral sex.  And I have never heard of anyone getting oral herpes by oral sex with someone in this situation.  Not to say it can't occur, but it doesn't seem a realistic concern.  Like your partner's situation, genital recurrences of HSV-1 and asymtpomatic viral shedding are much less common than for HSV-2.  Further, whatever transmission chance exists is further reduced by your partner's antiviral therapy.  

I hope you can get past your inflated concern about the risks.  The odds are you would go through a lifetime of sex with this partner and never get infected.  And if you get it, what's the big deal?  Your partner's history--with rare outbreaks, few symptoms, etc--is typical.  Genital herpes, even with HSV-2 and certainly with HSV-1, simply is not important enough to allow it to interfere with a committed and rewarding sexual relationship.  Anyway, if you're going to eliminate every HSV-1 infected person from consideration, you are cutting your odds of finding a committed life partner by half.  Are you going to ask all future prospective partners to have an HSV-1 test and avoid the positives?  Or commit yourself to never have oral sex with all of them?

Anyway, the choice is yours.  Good luck.

HHH, MD
Member Comments (8)

by crazylarry, Jun 15, 2007 12:00AM
To: HHH
HHH,

Thanks for your reply.

I just want to mke sure I really understand this.

You have never seen a case of Oral Herpes (HSV1)  transferred from a woman to a man where the man performs oral sex on the woman with the woman having genital HSV1.

You have only ever seen Genital HSV 1 aquired through oral sex from a person infected with oral HSV1.  

Can you confirm or deny these for me.

Thanks in advance for your response.

by taysmommy, Jun 15, 2007 12:00AM
To: crazylary
i aquired genital HSV-1 from my husband 6 years ago, we have been having unprotected sex the whole time and hes never got it, just thought id give you some personal experience, and i have only had one outbreak, i agree with the doc, its not a big deal

we even had sex during my intitial (and last) outbreak, in the first few days of the outbreak when its most likely to transfer (not that we planned on having sex with an outbreak, we just didnt know yet) and he still didnt get it

good luck

by H. Hunter Handsfield, M.D., Jun 15, 2007 12:00AM
To: crazylarry
Re-read my original reply.  Why do you need the same answers in different words?

by estrellab, Jun 16, 2007 12:00AM
I have wondered and worried about having HSV 2 for yrs only to be told no, looks ok, culture is neg, etc. and come to find out from the herpes select test I had done twice, I do have HSV 2 and neg for HSV 1. My husband has oral HSV 1 and is neg for HSV 2. It is nuts. We have been together over 14 yrs without any protection obviously as I had no official diagnosis til recently. I find it to be a confusing virus to say the least.
Goodluck, EB

by g10, Jun 18, 2007 12:00AM
well.. i am a 26 year old female. and recently diagnosed with genital HSV1.
BUt i guess i got it since last August (the last time i had intercourse) and no, i didnt have oral sex, just genital.. and got it that way.  
So i guess the person who gave it to me... had gotten if from someone who gave them oral sex.. anyway, i was told obs wouldnt be common.. and i get them all the time!!!! :(

by crazylarry, Jun 18, 2007 12:00AM
To: taysmommy
You stated that you aquired Genital HSV1 from your husband and he's never gotten it from you. If you aquired it from him he already has it. Do you mean someone new has not aquired it from you?

Thanks.

by babe_t, Jun 20, 2007 12:00AM
To: doctor
My last partner is blaming me for herpes infection.  He does not say what type.  I am positive for genital HSV-1, never had an oral outbreak to my knowledge.  So, there must be some level of transmission that can occur with genital to genital HSV-1.
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