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Transmission to partner
Hi there, I've recently started dating someone who hasn't dated anyone with herpes nor has knowledge about it or its transmission. We talked on the phone a bit before meeting and shortly after our first date I decided I had a serious interest in him and so divulged to him that I had genital herpes. I haven't really made up my mind as to when it's a good time to say, I've always said it early. unfortunately, honesty sometimes makes a potential partner run the other way.. :( Of course, he was freaked out.
I got this a few years back from a partner who wasn't kind enough to inform me before we were intimate. I've had 4 outbreaks 3 of which weren't too bad... I've never given it to any partners and have always informed those who needed to know PRIOR to intimacy.. I am not taking once-a-day suppressive therapy but during my last serious relationship I did and had no outbreaks. In my last relationship the dr/pharmacist said his risk was dramatically reduced if i went on daily suppressive therapy. Stats we found said risk was 4% per YEAR without daily therapy, and with therapy, it was reduced to less than 1% chance if consistent with medication regime and vigilant with symptoms of outbreak.
From an expert on std's point of view, what is the risk of trans if I do take daily therapy and am vigilant on symptoms, and if i dont take therapy and am vigilant? Also, if we use protected as well on top of either, does this significantly reduce the transmission? And finally, he has asked me if he can develop herpes through kissing me. I've told him no, but I think he's still skeptical. I really like this guy but I can feel he's holding back abit, no doubt in reluctance based on his lack of knowledge on this subject...
Any information you can supply me with as asked above and beyond will enable me to appropriately and confidently answer any questions he might ask me. I would greatly appreciate any information you can give me! : )
Sincerely,
patiently waiting in alberta
I got this a few years back from a partner who wasn't kind enough to inform me before we were intimate. I've had 4 outbreaks 3 of which weren't too bad... I've never given it to any partners and have always informed those who needed to know PRIOR to intimacy.. I am not taking once-a-day suppressive therapy but during my last serious relationship I did and had no outbreaks. In my last relationship the dr/pharmacist said his risk was dramatically reduced if i went on daily suppressive therapy. Stats we found said risk was 4% per YEAR without daily therapy, and with therapy, it was reduced to less than 1% chance if consistent with medication regime and vigilant with symptoms of outbreak.
From an expert on std's point of view, what is the risk of trans if I do take daily therapy and am vigilant on symptoms, and if i dont take therapy and am vigilant? Also, if we use protected as well on top of either, does this significantly reduce the transmission? And finally, he has asked me if he can develop herpes through kissing me. I've told him no, but I think he's still skeptical. I really like this guy but I can feel he's holding back abit, no doubt in reluctance based on his lack of knowledge on this subject...
Any information you can supply me with as asked above and beyond will enable me to appropriately and confidently answer any questions he might ask me. I would greatly appreciate any information you can give me! : )
Sincerely,
patiently waiting in alberta
MEDICAL PROFESSIONAL
Your summary is correct. One thing you might do is ask him to get tested, just to confirm his status. There is about a 50/50 chance he has HSV-1 an does not know it and about a 1 in 5 chance that he could even have HSV-2. (Remember, 90% of persons with HSV do not know they have it). As I said avbove, if he has HSV-1, that also reduces his risk of infection somewhat and if he has HSV-2, he will not get it again from you.
No specific figures on oral sex- likely to be in the same range.
The vaccine is still in clinical trials an no one know how the study will come out. We are all hopefull but will have to wait about a year (at least) before results are available. EWH
No specific figures on oral sex- likely to be in the same range.
The vaccine is still in clinical trials an no one know how the study will come out. We are all hopefull but will have to wait about a year (at least) before results are available. EWH
oops, i also meant to ask: I've been reading about a new vaccine released or soon-to-be released.. any comments on that? ; )
Wow, thank you... that does answer a lot of my questions... By what you're saying, risk of transmission seems a lot lower than i thought. I have had 4 outbreaks, so I guess, just over once a year - during very high stress situations. So, if I do not have an outbreak and absence of any lesions, the risk can be as low as 1 in 10,000 - without taking any steps to prevent transmission, is that right? If I'm taking acyclovir as I did in my previous relationship, the transmission would be half that, and then with protection it would be 2/3s more as well? He's told me he likes kissing and since I've told him he still has kissed me but I can tell he's reluctant... What can I tell him to make him comfortable in kissing me? Also, I imagine he has some concerns with oral sex... What are the risks of transmission for him in a situation where he might oblige me?
Thank you for your prompt response : )
Thank you for your prompt response : )
MEDICAL PROFESSIONAL
Welcome to our site and congratulations to you on your mature and thoughtful approach to dealing with the topic of your HSV. Most of your questions deal with reduction of transmission so let's work through this topic. Before I do however, let me ask, when you are not taking suppressive therapy, how frequently do you have recurrences? Now on to the transmission issues:
For starters, let's consider the issues of transmission. There are certain things known to increase the risk of transmission. These include the presence of lesions and having acquired HSV in the past year (turns out that both recurrence and asymptomatic shedding of the virus from lesion-free skin are more likely during the first year of infection). At the same time, transmission also occurs through the phenomenon of asymptomatic shedding at which time the virus is present on intact, normal appearing skin. In fact, this accounts for most HSV transmission. Transmission risk is actually less if the uninfected partner already has HSV-1 infection (cold sores), presumably due to the immune response to this closely related virus.
So what about transmission. Most of what we know about transmission of HSV-2 comes from the large study in which valacyclovir daily suppressive therapy was evaluated for HSV transmission prevention. In this study all participants we counseling to us condoms regularly, to avoid sex during outbreaks and to take daily medication which could either be placebo or valacyclovir. In the group who were taking the valacyclovir, the risk of transmission was reduced by about half, from about 6%per year to less than 3% per year. How good participants were at using condoms is unknown. Condoms however have been proven to reduce transmission of HSV by about 2/3 as well, independent of whether or not someone is taking daily suppressive therapy. Finally, there is one small study which shows that having told partners about infection also reduces risk of transmission as well.
Bottom line- there are several things that can be done to reduce HSV transmission. Even without taking these steps, the risk of transmission with any single sexual encounter in the absence of lesions is very low- probably as low as 1 in 10,000 and that low risk can be further reduced with the steps outlined above, including suppressive therapy. these are the facts and figures. The risk is low despite the mythology to the contrary. That said, this is a numbers game and it is to you and your partner’s advantage to take reasonable steps towards prevention.
Furthe excellent information for you or your partner is avialable at the American Social Health Association web site (disclosure- both Dr. Handsfield and I are on ASHA's Board of Directors)
Hope this helps. EWH
For starters, let's consider the issues of transmission. There are certain things known to increase the risk of transmission. These include the presence of lesions and having acquired HSV in the past year (turns out that both recurrence and asymptomatic shedding of the virus from lesion-free skin are more likely during the first year of infection). At the same time, transmission also occurs through the phenomenon of asymptomatic shedding at which time the virus is present on intact, normal appearing skin. In fact, this accounts for most HSV transmission. Transmission risk is actually less if the uninfected partner already has HSV-1 infection (cold sores), presumably due to the immune response to this closely related virus.
So what about transmission. Most of what we know about transmission of HSV-2 comes from the large study in which valacyclovir daily suppressive therapy was evaluated for HSV transmission prevention. In this study all participants we counseling to us condoms regularly, to avoid sex during outbreaks and to take daily medication which could either be placebo or valacyclovir. In the group who were taking the valacyclovir, the risk of transmission was reduced by about half, from about 6%per year to less than 3% per year. How good participants were at using condoms is unknown. Condoms however have been proven to reduce transmission of HSV by about 2/3 as well, independent of whether or not someone is taking daily suppressive therapy. Finally, there is one small study which shows that having told partners about infection also reduces risk of transmission as well.
Bottom line- there are several things that can be done to reduce HSV transmission. Even without taking these steps, the risk of transmission with any single sexual encounter in the absence of lesions is very low- probably as low as 1 in 10,000 and that low risk can be further reduced with the steps outlined above, including suppressive therapy. these are the facts and figures. The risk is low despite the mythology to the contrary. That said, this is a numbers game and it is to you and your partner’s advantage to take reasonable steps towards prevention.
Furthe excellent information for you or your partner is avialable at the American Social Health Association web site (disclosure- both Dr. Handsfield and I are on ASHA's Board of Directors)
Hope this helps. EWH
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.
