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How to protect against herpes
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The STD Forum 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.

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How to protect against herpes

Hi Dr., I met a girl i like.  she told me she had herpes, but that she had one little spot two years ago off the side of her vagina and that was two years ago, she takes medicine for it, two years ago is the only outbreak she had, she currently is taking medicine.  the little i know of herpes, i was so horny i decided to take a risk, and we had sex with a condom, and afterwards i just kind of pulled out real quick.  just to be a little careful.  
i like her alot, and i think i might want to continue having sex with her because she's cool and nice, and honest.  what do i have to do to protect myself from getting herpes, is there a medicine I can take?  Can you please tell me everything i can do to protect myself.  Like i thought, after sex, not resting with my penis in her vagina-does that make a difference?  Is there any thing else?  What advice can you give me in this situation?  What kind of protocol would be best for me to protect myself, and if I follow that protocol, can you please give me the chances that i could still contact herpes, as a percentage?  Can you tell me what to look for, I'll ask her to notify me if she has any kind of signs at all?  
I know very little about herpes-i'm not even sure who it is communicated from one person to a next?
My questions are
1)how is herpes communicated?
2)if she is not having a break out what are my chances of contacting herpes, if I take every precaution you advise?
3)if she does break out, of course, i will stop the sexual relationship-how long should i wait before the symptoms disappear before sexual relationship is resumed?
4)what are all the precautions i can take?

this is the general spirit of my question, i like the girl, i would like to have a sexual relationship with her, but i wouldn't do so if the chances of me getting herpes were very good, i wouldn't risk my health like that,

i am sorry for the confusion of my question, i hope you understand and that you can advise me on this situation.
thankyou, c
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Congratulations on your approach to this relationship.  There is no reason that you cannot not have a good, fulfilling sexual relationship with this person despite the fact that she has herpes.  She is to be congratulated as well for letting you know that she has herpes, which is the first step in a safe, fulfilling relationship.   Let me also point out that herpes is not hugely contagious and that most people exposed to herpes do not get it.  When this fact is considered, along with several proven means for preventing spread listed below, you should do well.   There are a number of things that can be done to protect you from getting herpes, if you don't already have it (over 20% of American have it, and of those, between 80 and 90% do not know that they do).  I have outlined them below:

1.  First, find out if you already have it.  As noted, you could and not know it.  The best way to do this is to get a type specific test for HSV such as the HerpeSelect or Biokit assays.  Which test you get makes a difference because many of the available tests have problems with false positive results.
2.  That she is taking what we call suppressive therapy is a good thing. It reduces the chances of her spreading infection to you significantly.
3.  Avoid sex if she should have an outbreak.
4.  Condoms add to the protection offered by taking suppressive therapy.

Finally, let me say that the topic of herpes is a complex one.  The disease is common with HSV-1 being present in over 60% of adults and HSV-2 (the virus which causes most genital herpes) being present in about 1 in 5 Americans.  For both infections, the majority of people who have the infections are not aware that they are infected, either because they either acquired it without knowing in the past or because they misidentified their herpes as something else.   Much very good information about herpes can be obtained by accessing excellent informational web sites such as the one run by the American Social Health Association (disclosure, Dr. Handsfield and I are both on the Board of Directors of ASHA).  


Hope this helps.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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