Risk assessment that I transmitted HSV-2 to my partner

[Justin Z]

Hello,

Thanks in advance for responding to my question.  My girlfriend and I got especially intimate for the first time yesterday.  It was largely unplanned.  She is aware of my genital HSV-2 infection.

I have not had symptoms for at least a week, probably closer to ten days.  In the course of the day, she performed oral sex for a brief time (perhaps five minutes).  We had unprotected vaginal intercourse for approximately five seconds (ultimately thinking better of it).  We also engaged in mutual masturbation, which I believe to be the greatest source of her personal concern.

She is worried sick and so I am worried for her.  Obviously, I can relate to how she feels.  I have told her what I have read regarding transmission and gave her my honest assessment that the risk of transmission was very low.  But, I am sure that she would feel more comfortable to have a doctor's assessment as well.

Thanks very much for your help, it is very much appreciated.

~Justin

[H. Hunter Handsfield, M.D.]

I'll try to help.  There probably isn't much cause for worry about HSV transmission.  Hand-to-genital transmission just doesn't occur; the mutual masturbation isn't an issue.  Also, oral infection with HSV-2 is uncommon (or if it occurs, it usually doesn't cause symptoms).  So despite the brevity of the exposure, the greatest risk might have come from vaginal sex.

But if you clearly had a fairly recent outbreak that had definitely healed, you might have been in a relatively safe period without asymptomatic shedding of the virus.  There is no way to be sure, but most people have outbreaks of either overt herpes of asymptomatic shedding an average of 3-6 times per year, that is every 2-4 months.  Also, among monogamous couples in whom one person has genital HSV-2 infection, and who have sex 2-3 times per week, and who avoid sex when symptoms are present, transmission occurs in only about 5% of couples  per year.  So the risk for each episode of sex is low.

So most likely your girlfriend escaped infection this time.  But take it as a warning:  start keeping condoms handy (temptation being what it is, be realistic even if you don't plan on having sex again in the near future); and consider starting on suppressive antiviral therapy to reduce the risk of asymptomatic viral shedding and transmission.

Good luck--  HHH, MD

[Justin Z]

Thanks for your help and quick response.  Based on what I've read here, it seems like even if I HAD been in a period of shedding, the chance of transmission would still be vanishingly low because of the short duration of what occurred.  It's also good to know the manual activity really equated to zero risk whatsoever.

Cheers.

~Justin

[clinique_diva]

i'm not a dr. but if you had a condom on there would be like almost zero chance of infection.

[clinique_diva]

the above post was directed to you

[gracefromHHP]

Justin...if you haven't already you and your gf should take the time to read thru the herpes handbook at www.westoverheights.com. It's free and full of terrific information - there is a whole section on reducing transmission to a partner too.

Have you thought about daily suppressive therapy for yourself? In studies daily suppressive therapy with valtrex reduced transmission to a partner by 50%. For male to female transmission it's a significant reduction in transmission and well worth considering utilizing if your partner is hsv2- . Along with consistant condom use you can reduce her risk of transmission down to 2-3% a year.

Has your gf had a herpes test herself to know her status? If not getting  a baseline test now will be useful in seeing if transmission is even an issue ( most folks who have hsv2 have no idea they have it ) and will also give you something to compare future results too.

grace

[gracefromHHP]

Kilo... 5 weeks was probably too early to test but it is a good sign.  Did you have herpes blood tests or just general std tests? If you aren't sure ask for a copy of all the testing you had done so you know for sure what you were and were not tested for. What was your hsv1 result on the blood test? Knowing that is helpful in determining how much possible exposure your oral sex encounter was.

If you are using IV drugs it's a good idea to get tested for hepatitis and hiv on a regular basis.

grace