How to protect a partner from herpes

[Havquestions]

A little background: I have recently been diagnosed with HSV2 and have a few questions on how to protect a partner that seems uninfected. I say seems because the person in mind tried to be tested but his doctor said he would not test without symptoms of HSV- he did test for HIV, Hep, etc. They were very nonchalant about the whole thing. I know that this man loves me (we have history) but we are both conflicted about putting him at risk- what happens if it does not work out and then he has herpes to? Either way I need to know the answers for the future. So, here are my questions:

1. Kissing- I have HSV2 and have never had any oral symptoms. Can he contract it by kissing me? What about if I perform oral sex on him? When dating someone, do I need to tell them before we kiss?

2. Touching- Can he catch it by touching or fingering (sorry to be so graphic) me?

3. I am on daily valtrex. How great is the risk of sex to him when using a condom?

4. Are there any long term health concerns with herpes that we should both be aware of?

Any other advice or insight on this topic? It seems odd to me that so many people are infected and do not know it and that people (including me) are so ignorant about the topic.

[psle1000]

A related discussion, How to protect a partner from herpes was started.

[H. Hunter Handsfield, M.D.]

Among the best websites for genital herpes information are my former health department (www.metrokc.gov/health/apu/std) (I wrote most of that article myself); CDC (www.cdc.gov/std); the American Social Health Association (www.ashastd.org); and the Westover Heights Clinic of Portland, Oregon (www.westoverheights.com). ASHA can also provide in-person, highly expert telephone counseling, if your partner wants to call for that service; and can help identify herpes-knowledgeable health care providers in your area.

[Havquestions]

One more question- is there a reliable website with valid information that won't scare the life out of a potential partner? Thank you so much for your help.

[gracefromHHP]

The herpes handbook and patient counseling video at www.westoverheights.com

Also www.ashastd.org has a terrific herpes section.

grace

[H. Hunter Handsfield, M.D.]

First and most important, I strongly disagree with what your partner was told (or understood) from his health care provider.  You are correct in your apparent understanding that if he is already positive for HSV-2, he is not susceptible to reinfection; in that case you would need to take no precautions against transmission.  Therefore, your situation is exactly one of the primary indications for HSV serological testing--in fact, maybe one of the most important.  I recommend that he return to his provider with this reply in hand; or find another provider.

But the remainder of my replies assume he is indeed susceptible, or that you don't know and want to assume it and prevent infection.

1) Kissing isn't a risk. Few people with genital HSV-2 also have ongoing oral infection.

2) Virtually all genital herpes transmission is by intercourse.  Fingering is not known to be a risk.

3) The risk of transmission is markedly reduced when the infected person is taking Valtrex.  If in addition to Valtrex you are careful to not have sex when you are having symptoms of an outbreak, the odds are strong you could have regular sex for 10 years without transmission ever occurring.

4)  The main serious risk of herpes is transmission to a newborn during delivery; neonatal herpes is a devastating, often fatal disease.  However, transmission is rare from chronically infected women to their babies; the main risk occur when a woman first acquires genital HSV during the last few weeks of pregnancy.  If/when you conceive someday, make sure your ObG knows about your HSV-2 infection; s/he will know what to do to further reduce the low risk of transmission to the baby.

Good luck--  HHH, MD