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STDs (Expert Forum)
Having sex after outbreak of Herpes on buttock
Answered by
Edward W Hook, MD - HIV Prevention, stds
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.
Having sex after outbreak of Herpes on buttock
by saf77740, Jan 10, 2009 09:16AM
I have a new partner of 3 months.
I caught genital herpes about 18 years ago, and after a long course of antivirals, I only have an outbreak once or twice a year, if that. I dont remember the last time I had blistors on my genitals, possibly about 4-5 year ago, but sometimes I still get a couple of blistors in my buttock, near to the top, in the crack and this never lasts long, so I havent thought about it for a long while. I keep the blistors dry, they itch for a day and then disappear.
This week I have had unfotunately had 2 very small blistors at the top of my buttock and I am due to go on holiday with my new partner tomorrow.
I am at day 6 of healing and have not had any sexual contact for 10 days. The skin area is now quite smooth, but there is a small flat red patch where the blisters came up. There is no itching.
Can you tell me what my options are for my holiday, given that I havent spoken to my partner about this, and I dont feel that I can.
- is it likely I am still shedding the virus?
- can we have sex with a condom?
- if I took an antiviral, would this be useful?
- is it OK as long as there is no contact with the outbreak?
- I have put a small cold sore patch on the buttock (compeed), this covers it and is comfortable. Is this useful?
Could you please tell me in detail what the risks are and what kind of safe sex we can have.
Many thanks
I caught genital herpes about 18 years ago, and after a long course of antivirals, I only have an outbreak once or twice a year, if that. I dont remember the last time I had blistors on my genitals, possibly about 4-5 year ago, but sometimes I still get a couple of blistors in my buttock, near to the top, in the crack and this never lasts long, so I havent thought about it for a long while. I keep the blistors dry, they itch for a day and then disappear.
This week I have had unfotunately had 2 very small blistors at the top of my buttock and I am due to go on holiday with my new partner tomorrow.
I am at day 6 of healing and have not had any sexual contact for 10 days. The skin area is now quite smooth, but there is a small flat red patch where the blisters came up. There is no itching.
Can you tell me what my options are for my holiday, given that I havent spoken to my partner about this, and I dont feel that I can.
- is it likely I am still shedding the virus?
- can we have sex with a condom?
- if I took an antiviral, would this be useful?
- is it OK as long as there is no contact with the outbreak?
- I have put a small cold sore patch on the buttock (compeed), this covers it and is comfortable. Is this useful?
Could you please tell me in detail what the risks are and what kind of safe sex we can have.
Many thanks
Doctor's Answer
by Edward W Hook, MD, Jan 10, 2009 09:40AM
, Jan 10, 2009 09:40AM
I will answer your questions is just a moment but before I do I need to make a comment which is important. It appears that you know you have genital herpes and think that you have herpes on your buttocks as well. I suspect that one of the things you identify as herpes is not. It really is very unusual for persons to have herpes at to separate parts of their bodies which have difference recurrent patterns. I suppose it is possible but I have never seen such an instance. In addition, I would point out that there are many other skin conditions, some of which involve the genitals, which can come and go and can be mistaken for HSV. A relatively recent study showed that about 1 in four clinical diagnoses of herpes (i.e. those that were not confirmed with a culture or PCR test) made by experts were incorrect. Thus, for starters, I am not sure what we are talking about here is herpes. Having said that, I also think that the best thing to do is to assume that you do have herpes (somewhere) and thus my advice will be from that perspective (i.e. that you have HSV at both sites). After all it is best to be cautious. Now on to your questions>
1. Yes. We know that even persons who have had herpes continue to have asymptomatic shedding of the virus and that this continues irrespective of outbreak frequency or duration of infection.
2. Yes. Condoms are an important part of prevention of herpes transmission prevention and they work. Use condoms.
3. Yes, taking a regular suppressive dose of an antiviral such as valacyclovir or acyclovir will reduce asymptomatic shedding, reduce the likelihood of recurrence and has been proven to reduce transmission to uninfected partners. The benefits of condoms and antiviral suppressive therapy are additive.
4. Not sure by what you mean by "no contact with the outbreak". HSV is symptomatically shed from normal appearing skin in the absence of lesions so transmission is, essentially, always possible.
5. There is no evidence that covering an outbreak area with anything other than a condom will prevent transmission. What you suggest might help and certainly won't hurt but its benefit, unlike the benefit of condoms and medications, is unproven.
Finally, one further comment. Please realize that there is a fair chance that your partner has HSV but either has not mentioned it or, even more unlikely, does not know that they do. If this relationship is going to go forth, I would encourage you to discuss things and to have him/her go get tested with a good type specific blood test.
Hope this helps. EWH
1. Yes. We know that even persons who have had herpes continue to have asymptomatic shedding of the virus and that this continues irrespective of outbreak frequency or duration of infection.
2. Yes. Condoms are an important part of prevention of herpes transmission prevention and they work. Use condoms.
3. Yes, taking a regular suppressive dose of an antiviral such as valacyclovir or acyclovir will reduce asymptomatic shedding, reduce the likelihood of recurrence and has been proven to reduce transmission to uninfected partners. The benefits of condoms and antiviral suppressive therapy are additive.
4. Not sure by what you mean by "no contact with the outbreak". HSV is symptomatically shed from normal appearing skin in the absence of lesions so transmission is, essentially, always possible.
5. There is no evidence that covering an outbreak area with anything other than a condom will prevent transmission. What you suggest might help and certainly won't hurt but its benefit, unlike the benefit of condoms and medications, is unproven.
Finally, one further comment. Please realize that there is a fair chance that your partner has HSV but either has not mentioned it or, even more unlikely, does not know that they do. If this relationship is going to go forth, I would encourage you to discuss things and to have him/her go get tested with a good type specific blood test.
Hope this helps. EWH
