HIV Risk with Herpes

[Frederique]

Hi Doctor,

Do the chances of HIV contraction significantly increase when you have herpes?  I've read that the odds of contracting HIV from vaginal sex with an infected partner are approx 1 in several hundred.  Does this number significantly increase if you have herpes?

Thanks

[Edward W Hook, MD]

The quoted risk of getting HIV from heterosexual sex is the probability is less than 1 in 1000.  Persons with genital herpes, if exposed to an infected partner are thought to be about 3 times more likely to become infected.  Thus, the chances of a person with herpes contracting HIV if exposed are still less than 1 in 300, all other things being equal.  EWH

[Frederique]

Thanks Doctor,

Does an un-circumsized penis further increase the odds?

[Frederique]

Sorry, also one last question, if you weren't experiencing an outbreak of herpes, does that change anything?

[Edward W Hook, MD]

An uncircumcised penis also adds to the risk somewhat.  The effect of herpes appears to be operative even in the absence of an outbreak.  It has been proposed that the reason for this is that the lymphocytes which respond to herpetic outbreaks remain in the area where prior outbreaks have occurred, acting as a "target' to facilitate acquisition of infection.   EWH

[Frederique]

I read it with approx 4 times more likely to contract HIV if you are uncircumsized, is that accurate?

Thanks

[Edward W Hook, MD]

Somewhere in that neighborhood.  Of course condoms are highly effective in reducing that risk, as are other measures to avoid high risk settings.  EWH