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Relationship w/ HSV2 Positive Partner
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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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Relationship w/ HSV2 Positive Partner

I recently began dating a girl who I am very interested in. In the midst of informing her of my own social health issue (see earlier posts), she disclosed that she was in fact infected with HSV2 but that she had not had an outbreak in 2 years. With my experience and knowledge that I have acquired through my own experiences, I of course understand that it's not really as big a deal as it's made out to be. I do however want to obtain as much information as possible about preventing transmission of the virus to myself. If we decide to sleep together, while taking all of the available precautions (condoms, antivirals, communication etc) what are the odds that I could become infected? Also, as far as mutual masturbation, oral sex, and kissing, are there risks involved there as well and what can I do to reduce/eliminate them?
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Welcome back to the forum.  Congratulations to both you and your partner for your forthright, common-sense approach to your past warts and her HSV-2 infection.

Among monogamous couples in which one person has HSV-2, who take no measures to prevent transmission except avoiding sex during symptomatic outbreaks, and who have unprotected sex an average of 2-3 times per week, transmission to the uninfected partner occurs in about 5% of couples per year.  That works out to somewhere around once for every 1,000 exposures.  The transmission risk appears to be higher than that for new relationships, perhaps because sexual frequency is higher -- but still the transmission risk for any single exposure is rather low.

You can reduce the risk by consistently using condoms for vaginal or anal sex; and your partner could take suppressive treatment with valacyclovir.  These aren't perfect, i.e. some transmission risk would remain, but it would be very low.  Most couples in this situation would go several years of regular sex without transmission occurring.  Also, once a relationship matures, some such couples decide to stop worrying about it, i.e. drop condoms, suppressive treatment, or both -- knowing that most new HSV-2 infections are mild and effective treatment is available.  By "mature relationship" I mean mutual commitment for the long term, which in turn implies no future risk of transmission to new partners -- which, research shows, is most peoples' single greatest fear in having genital herpes.

There is no measurable risk of HSV-2 transmission by mutual masturbation or kissing.  You would be at small risk of oral infection through cunnilingus (oral-vaginal sex), but it would be quite low.  This too would be reduced if your partner were taking valacyclovir or other suppressive therapy.

The bottom line:  The transmission risks can be managed, and nobody should allow the risk of herpes to seriously interfere with love, romance, and rewarding sex.  

I hope this has helped.  Best wishes--  HHH, MD
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Thank you for your continued guidance, Dr. Handsfield.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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