Aa
Aa
A
A
A
Close
Avatar universal

spread of HSV-1 on the genitials

I have a close friend who is positive for HSV-1 genitially. We are very close and im trying to help her through her issue because it is very hard for her. We were sexually active before she got it and i am not positive for it as recently as last week. I have no had intercourse since then of any kind. She has not either since she found out about it.

My questions would have to be.

1) How likely would it be for her to spread HSV-1 during intercourse
2) how likely would it be to spread it through oral sex as well.
3) what precautions could we/she take to help prevent the spread of HSV-1
4) how likely is spreading of genital HSV1 during oral sex or intercourse with out a condom if she is taking the suppressant Acyclovir/Zovirax 400mg daily?

I am aware that both HSV 1 and 2 are both contagious but i also read that is less likely to spread HSV-1 genitial then HSV-2


5 Responses
Sort by: Helpful Oldest Newest
239123 tn?1267647614
MEDICAL PROFESSIONAL
There are no such tests either OTC or by prescription.  HSV PCR tests can be done on vaginal swabs, but viral shedding is intermittent and probalby averages less 1% of the time for HSV-1.  Even if you tested 100 separate specimens, zero to 3 of them might be positive, and because of statistical variability you still would not know whether your partner sheds virus more or less frequently than 1% of the time.  And each test costs $50-100.

For the same reasons as discussed both here and in the other thread, my advice is that you should not let fear of herpes interfere with this relationship, assuming you consider it a potentially committed long term one.  Even with a lifetime of unprotected sex, you might never catch it; if you do, it might be asymptomatic and you would never know; and if you have symptoms, they can be promptly treated and recurrent outbreaks are not likely to be a problem.  If I were in your situation, I would be happy if my partner stopped suppressive therapy and would continue unprotected sex without fear or concern.  And even if she contiues suppressive therapy, you could still catch the virus; suppression reduces transmission by about 50% for HSV-2 and is probably less effective against HSV-1.  If you just can't deal with the possibility of catching your partner's infection, you'll have to choose between continuing the relationship (with or without 100% condom use) or accepting the risk of catching HSV.
Helpful - 0
Avatar universal
Are there any OTC or prescription tests that she could purchase in order to tell if she was asymptomatic or shedding so the risk of transmission could be known?
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Thanks for the comprehensive update; excellent information. In these circumstances, you indeed should assume you are susceptible to your partner's HSV-1.

Your partner may have had a recurrent rather than new HSV-1 genital infection.  If her yeast symptoms were typical, that might be what it was -- with coincidental recurrent genital herpes due to HSV-1, not an initial infection.  Recurrences often have single canker sore-like lesions, whereas most initial herpes presents with many extremely painful lesions all over the genital area, often with fever and inflamed lymph nodes in the groin.  Also, it takes several weeks for the blood test to become positive.  If her blood test was done at the same time as her genital lesion -- or if done sooner than a few weeks after her oral sex exposure -- then most likely it reflects a distant, past infection.

Your partner may not need continuing acyclovir.  As you saw in the other link, recurrent herpes is uncommon for genital HSV-1 and the risk of sexual transmisson relatively low.  Further, the effectiveness of suppressive therapy on genital HSV-1 really isn't known anyway; all research has been for HSV-2, which is more susceptible to acyclovir than HSV-1 is.  My routine advice to people with newly diagnosed genital herpes (with either virus) is to hold off on suppressive treatment for a few months, in order to get a sense of recurrence frequency in the absence of treatment.  If there are frequent outbreaks, or if avoiding transmission to a partner is a high priority, suppressive treatment can then be started.  However, in your circumstance, a decision to do this depends a bit on how much risk of transmission you are willing to take.  But most likely that risk will be fairly low even if she isn't on treatment.  You and she should discuss this carefully, and she can then discuss it with her doctor.
Helpful - 0
Avatar universal
Yes she was made aware of her hsv-1 on 3/27/2011. I know I am not the one who gave her the virus because she recieved oral sex from someone who had a herpes sore on his lip. Her and I have not been sexually active for about 3 months. When i found out that she had it i got myself immediate tested (PCR ) even though we havnt been sexual active with each other.

she had the following tests done
-H viral culture
-H virus antigen detction test
-blood test
all confirmed genitial HSV-1

symptoms
- origanlly went to her OBG for a yeast infection
- dr noticed one bump on the outside of her labia minora. it started as a bump, but after 2 days or so it turned white exactly like a canker sore
- slight discomfort

the doctor started her on acylovir 400mg 3 a day for 10 days on thursday 3/31/2011
now she is taking the same med once daily for 6 months in tablet form, same dosage.

if you need to know anything else please ask and thank you for your help
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.  Thanks for this question.  And congratulations on a responsible, non-panicked perspective on this, and for the support and care you show for your partner.  For a lot of men, if a partner turned out to have herpes it would be "Sayonara, Baby".

These are typical questions in settings of new genital herpes due to HSV-1.  My replies will be brief, but more detail is available at the following link.  

http://www.medhelp.org/posts/STDs/Recently-diagnosed-with-Genital-Herpes-HSV1/show/969931

Give me a bit more information about the circumstances.  Presumably her infection is newly diagnosed, correct?  Say more about her symptoms and when they started, and whether (to your knowledge) she had sex with anyone aside from you in the 2-3 weeks before onset.  Also, let me know exactly what tests she had to confirm her diagnosis and the virus type, i.e. HSV-1 versus HSV-2.  If not, it is likely you are the source of her infection, despite having a negative blood test.  Up to 15% of people infected with HSV-1, maybe even 20%, have negative blood tests results.

1,4) Genital HSV-1 is less frequently transmitted sexually than genital herpes due to HSV-2.  She may have few or no future outbreaks or viral shedding.  Further,if you were the source of her infection, you are not susceptible and won't catch it again.  Even if you are not infected and therefore susceptible, the chance of transmission is very low while she is taking acyclovir plus using condoms.

2) If she had oral sores along with her initial genital symptoms, then she may develop recurrent oral herpes due to HSV-1.  If there were no oral symptoms, probably this isn't an issue.

3) See the linked thread.  We can also discuss this better once I have the information about her symptoms, diagnosis, etc.

Bottom line:  Nobody wants genital herpes, but if it happens, HSV-1 is the preferred type.  In the long run, it's generally not a big deal at all.  Take a look at the other thread, then come back with the additional information, and I'll fine-tune this advice if necessary.

Regards--  HHH, MD
Helpful - 0

You are reading content posted in the STDs Forum

Popular Resources
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.