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Herpes Infecting Others
About a week and a half ago, my girlfriend was giving me oral sex when she discovered a small bump on the bottom of my penis. I had no idea what is was and it had been 15 years since I had my last episode of herpes 2 so I just assumed it was something else(we have been monogamous for 5 years). Sure enough, a few days later, I developed some small lesions. I have two questions. Maybe this is obvious, but what is the chance of my girlfriend getting infected from this oral sex?(she was not beforehand)? I went to my doctor and am now on Valacyclovir 500mg from my doctor which he prescribed 2 per day for 5 days as an initial treatment and 1 per day going forward(forever?) as a suppressant. I also found this blog which has convinced me that L-Lysine is also a good way to inhibit Herpes outbreaks so I am now taking that as well with the other prescription. I took 1500mg today and will do so for the next few days and then cut back to 1000mg daily as an added suppressant. My 2nd question is if you're on a daily suppressant regimen of taking Valtrex(Valacyclovir-500mg) and L-Lysine-1000mg, what is the risk of possibly spreading infection of herpes 2 when having unprotected oral sex given to you by a non-infected person and also having intercourse with a non-herpes person if you are not showing or feeling symptoms? In the past I would have a tingling warning me of a coming outbreak, but this time the first I realized something was going on was just the small bump on the bottom of my penis and no tingling. How do you know when you're contagious if you're not feeling any physical warning signs? Thank you.
MEDICAL PROFESSIONAL
Welcome to our Forum. I'll try to help. Your questions are good ones and there are good data on the situation. Over the past 8-10 years we have learned a lot about herpes which help us to understand the disease and how it is transmitted. I'll provide some information, some of which your GF may not like to hear which I hope will be helpful.
Years ago there was a belief that herpes was a disease which was episodic and was only transmitted when people had active recurrences. This is no longer the case. We now know that the virus can be present on normal appearing skin as much as 10% of the time and that these asymptomatic occurrences account for most transmission of infection. We also know from the same studies that most exposures to infected partners, EVEN if they do have lesions present, do not lead to transmission of infection. We also know what can be done to prevent transmission of infection - these include telling your partner of your infection, avoiding sex during outbreaks, using condoms and taking antiviral therapy to suppress the asymptomatic shedding I mentioned above., In doing this, the transmission of infection, which typically occurs at about a rate of about 7-8% per year to about 3% per year or less. In addition, there is a tendency for transmission to occur less often when you have been infected for longer periods of time, something that is also in your favor.
In your specific case I have several suggestions:
1. Your partner should have a blood test for HSV. She may be infected and not know it (and if she is, it does not mean she got it from you). Over 80% of persons who have HSV-2 in the U.S. do not know they are infected. If she is already infected, there is no need for further precautions, she cannot get the infection again.
2. You should take the valaciclovir daily. Typically there is very little difference in cost between the 500 mg dose and the 1000 mg dose and, at least theoretically (it has not been studied) the 1000 mg dose should be more effective than the 500 mg dose for prevention of transmission of infection.
3. She should not be too worried about her recent exposure. Transmission of genital herpes due to HSV-2 to the mouth during oral sex is quite uncommon. If she does not develop an outbreak within 2 weeks of exposure, she can be confident she was not infected.
I hope these comments are helpful to you. EWH
Years ago there was a belief that herpes was a disease which was episodic and was only transmitted when people had active recurrences. This is no longer the case. We now know that the virus can be present on normal appearing skin as much as 10% of the time and that these asymptomatic occurrences account for most transmission of infection. We also know from the same studies that most exposures to infected partners, EVEN if they do have lesions present, do not lead to transmission of infection. We also know what can be done to prevent transmission of infection - these include telling your partner of your infection, avoiding sex during outbreaks, using condoms and taking antiviral therapy to suppress the asymptomatic shedding I mentioned above., In doing this, the transmission of infection, which typically occurs at about a rate of about 7-8% per year to about 3% per year or less. In addition, there is a tendency for transmission to occur less often when you have been infected for longer periods of time, something that is also in your favor.
In your specific case I have several suggestions:
1. Your partner should have a blood test for HSV. She may be infected and not know it (and if she is, it does not mean she got it from you). Over 80% of persons who have HSV-2 in the U.S. do not know they are infected. If she is already infected, there is no need for further precautions, she cannot get the infection again.
2. You should take the valaciclovir daily. Typically there is very little difference in cost between the 500 mg dose and the 1000 mg dose and, at least theoretically (it has not been studied) the 1000 mg dose should be more effective than the 500 mg dose for prevention of transmission of infection.
3. She should not be too worried about her recent exposure. Transmission of genital herpes due to HSV-2 to the mouth during oral sex is quite uncommon. If she does not develop an outbreak within 2 weeks of exposure, she can be confident she was not infected.
I hope these comments are helpful to you. EWH
MEDICAL PROFESSIONAL
Glad to help. EWH
Thank you for your response
MEDICAL PROFESSIONAL
Totally safe, no. the risk if more than half what it would be if you were not taking the suppessing drug but the risk does not fall to zero. EWH
Thanks for your answers. Just to be clear, if I am not showing any herpes symptoms either physical or tingling or body aches and I am on a suppresent daily drug like valtrex, is it totally safe for my girlfriend to preform fellatio on me or do we still need to use condoms?
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
