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STDs (Expert Forum)
HSVI and risks of oral
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.
HSVI and risks of oral
by jnc31, Aug 08, 2009 10:21AM
I am about to reconnect with a past partner and we plan on having sex with condoms. He is aware of my genital HSVI status, and he is negative on all fronts. I had my first and only outbreak (which was quite severe) five months ago. I was diagnosed visually, with a culture, and by blood work. I have taken valtrex daily, even though I understand that it may not do a lot for us HSVI types.
Question: Regarding oral sex, can you tell me what exactly he is at risk for, and how significant that risk is, if he performs unprotected oral sex on me? I know protection is the safest bet, but considering there are no signs of an outbreak, my daily suppressive therapy, and it’s HSVI, aren’t the risks fairly minimal?
Also, I would like to perform oral on him without a condom. However, I am afraid of passing this on, even though I have no indication at all that I have it orally, other than the naturally inherent risk that I contracted it at the same time as genital HSV. Can you share your opinion on this?
Any clarification and insight would be incredibly appreciated. Thank you.
Question: Regarding oral sex, can you tell me what exactly he is at risk for, and how significant that risk is, if he performs unprotected oral sex on me? I know protection is the safest bet, but considering there are no signs of an outbreak, my daily suppressive therapy, and it’s HSVI, aren’t the risks fairly minimal?
Also, I would like to perform oral on him without a condom. However, I am afraid of passing this on, even though I have no indication at all that I have it orally, other than the naturally inherent risk that I contracted it at the same time as genital HSV. Can you share your opinion on this?
Any clarification and insight would be incredibly appreciated. Thank you.
Doctor's Answer
by H. Hunter Handsfield, M.D., Aug 08, 2009 11:14AM
, Aug 08, 2009 11:14AM
Welcome to the forum. I'll try to help.
Most likely your partner is at little or no risk of catching your genital HSV-1 infection. Genital-to-genital HSV-1 transmission is rare, because both recurrent outbreaks and asymptomatic viral shedding are uncommon (unlike genital HSV-2). Daily Valtrex usually is not recommended for genital HSV-1, and I doubt you need to be taking it -- but in any case, that further reduces the already low potential for transmission. (I'm not sure what you mean about Valtrex and its effectiveness. HSV-1 is somewhat less susceptible to the drug than HSV-2, but treatment still is usually quite effective.)
As for oral sex, in theory there would be a risk of transmission to his mouth through cunnilingus. But the chance is near zero for the same reasons noted above. Further, half of all adults have had HSV-1, so there is a 50% chance your partner is immune to a new HSV-1 infection anywhere on his body. (He could have a blood test to know for certain whether or not he is susceptible.)
In the absence of oral symptoms, it is extremely unlikely you have oral in addition to genital HSV-1. If you do, asymptomatic shedding also is rare and the risk of transmission zero for all practical purposes.
Bottom line: As long as you're not having symptoms of a genital outbreak, for practical purposes there is virtually no chance of transmission. You and your partner have no worries on this score. Best wishes for a rewarding relationship -- don't let herpes stand in the way!
Here is a recent thread that discussed genital HSV-1 in some detail. Please take a look at it: http://www.medhelp.org/posts/STDs/Recently-diagnosed-with-Genital-Herpes-HSV1/show/969931
Regards-- HHH, MD
Most likely your partner is at little or no risk of catching your genital HSV-1 infection. Genital-to-genital HSV-1 transmission is rare, because both recurrent outbreaks and asymptomatic viral shedding are uncommon (unlike genital HSV-2). Daily Valtrex usually is not recommended for genital HSV-1, and I doubt you need to be taking it -- but in any case, that further reduces the already low potential for transmission. (I'm not sure what you mean about Valtrex and its effectiveness. HSV-1 is somewhat less susceptible to the drug than HSV-2, but treatment still is usually quite effective.)
As for oral sex, in theory there would be a risk of transmission to his mouth through cunnilingus. But the chance is near zero for the same reasons noted above. Further, half of all adults have had HSV-1, so there is a 50% chance your partner is immune to a new HSV-1 infection anywhere on his body. (He could have a blood test to know for certain whether or not he is susceptible.)
In the absence of oral symptoms, it is extremely unlikely you have oral in addition to genital HSV-1. If you do, asymptomatic shedding also is rare and the risk of transmission zero for all practical purposes.
Bottom line: As long as you're not having symptoms of a genital outbreak, for practical purposes there is virtually no chance of transmission. You and your partner have no worries on this score. Best wishes for a rewarding relationship -- don't let herpes stand in the way!
Here is a recent thread that discussed genital HSV-1 in some detail. Please take a look at it: http://www.medhelp.org/posts/STDs/Recently-diagnosed-with-Genital-Herpes-HSV1/show/969931
Regards-- HHH, MD
