Advice needed...

[txone]

I am a female that has been in a solid relationship for over a year. Mid March, he had back surgery for a herniated disc.  About 6 days later, he had an outbreak around the incision with about 4 patches of blisters.  Not knowing what they were, but once he thought about it, it told me what it could be.  He told me that about 25 years ago, he had two small bumps on his penis, but they went away in a couple of days and he told me he had never had any signs of the virus again until now. I decided after my research, that we should both be tested, which we did. My IGG test came back with an .091 and his came back with a 5.41.  Since the outbreak and the test result confirmed our fear, he has almost completely withdrawn himself from me.  After the initial shock wore off, I have been or tried to be, very supportive, but to no avail.  I have told him that it really doesn't matter, he is the same person that I knew before and that I had no plans as to "move on" like he suggested.  The doctor has prescribed the medication for him, he took it for a few days, then stopped.  He also gets irritated at me for constantly bringing up the subject, wanting to discuss it.  He told me after our last arugement that until we find out "exactly" what we can and cannot do, there will be no contact.
One more thing....the outbreak after surgery went away in about a week.  He had another cluster appear last night.

What is hard for me to understand is...how did we go a year almost without me becoming infected?

Questions:

1. Is the virus transmitted by only broken-out skin to uninfected skin contact?  Does the semen carry the virus?  Saliva?  I have read so many different variations of opinions on this.

2. From what I have read, infected M to F oral sex is very minimal risk...true?

3. If the infected person is on steady, daily medication routine....what is the risk factor of unprotected vaginal sex?

Any help would be greatly appreciated...
Thanks...

[Terri Warren, RN, Adult Nurse Practitioner]

I'm assuming that we are dealing with HSV 2, right?  The tests reflect HSV 2 antibody?  Transmission between two people (one infected and the other not) who are sexual doesn't always happen, as you have witnessed personally.  If he's on daily therapy, there's only about a 5% chance that you will get infected in a year's period if you're having sex twice a week.  
He's adjusting to this diagnosis, and not doing so well right now.  I'm sure this has impacted his self esteem and the way he perceives himself as a sexual being.  I would recommend that you give him lots of time and space and be patient if this relationship is important to you.  Be around him, but don't bring up the herpes for a while.  Be affectionate.  If he wants to give you oral sex, let him.  This will allow him to feel like he's pleasing you without putting you at risk, and if he is only infected genitally, there is no risk at all to you (to answer you question above).  Mutual masturbation is also no risk and will be a first step towards re-establishing your sexual relationship.

It is important that he be on daily suppression if you two want to restart your sexual relationship.  This will offer you considerable protection, though not perfect protection.   Condoms will also offer you consider protection.  

You may want to pick up my book on Amazon "the Good News about the Bad News" for both of you to read - I think you will find relevant chapters to your situation.

Hope this is helpful.

Terri

[txone]

Hi Terri...

Have another question for you...they pop into my head!  

Since his outbreaks are only on his back, no signs of anywhere other than there and this virus is transmitted by affected skin to skin contact....can he still transmit it during unprotected vaginal intercourse?

Is "shedding" only in a certain area or can it be anywhere...ie,  the groin area and/or anal area, thigh, just contact with his back?  I don't understand how this occurs and where it occurs.  Does shedding occur before a breakout, during (and/or both)?

Thanks...

[txone]

"Somethings' up there".....I know...I have insurance and I can't get a prescription for it...just doesn't seem fair.  We went thru the biggest hassle trying to get him into surgery without insurance....it was a nightmare!  Finally found a great doctor that found a surgicial center and negotiated the price for us and did his surgery for almost nothing!  Great guy!

I will get the book and read.  Thanks again for all your help!  If I think of other questions, I will post them for you.

[Terri Warren, RN, Adult Nurse Practitioner]

I'm wondering what the doctor wrote for, how many and for what dose.  If he wrote for 90  pills at 1 gram each, maybe that's correct. But otherwise, I cannot imagine one month of 500 mg once day being that much.  Somethings' up there.  Glad the acyclovir was much cheaper for you.

Terri

[txone]

I went to pick up the prescription at CVS and she told me it would be $965.  I just about had a heart attack.  I called the doctor to see if this was right, even had the pharmacist check again and sure enough that is what they charged for it.  I didn't check anywhere else to do a price comparison.  The doctor changed the med to the acyclovir which was $17 for 180 pills.  I am going to check online to see what I can find.

I am glad I found you, too!!  Many thanks for what you do!  God bless you!

[txone]

Yes, we are fine as a couple.  We just have to get over this hurdle in our life together.  We will make it, I think we are determined to do that...I know I am for sure.  From what you have told me, what I have read on this forum and another one I found....I have to give him space and time.  I guess patience is not one of my greatest attributes!  I want to know and do "now".  Get it resolved and get on with whatever the next day brings.

[Terri Warren, RN, Adult Nurse Practitioner]

I'm glad you found this board.  My best to you and your partner.

Terri

[txone]

And yes....this is HSV2 he has, I have HSV1.  My IGG on the HSV1 was 3.26.  I knew I had that for many years, since I was a child.  My mother and father both have HSV1, most of my siblings have it.  What is so strange is, it is not a big deal, acceptable to most everyone about having HSV1, just a fever blister, cold sore!  But gential herpes is like a death sentence to some/most....just a cold sore in a different location of the body!  It is a shame!  Having dealt with HVS1 all my life, it is not that bad.  A few times in my life it was bad, but not so bad that it affected my life in a very negative way...an outcast from society.  I never thought I had to tell anyone I ever dated that I had HSV1, which I didn't know the medical term for it years ago.  I just didn't kiss anyone until it was healed, it hurt to much to do much kissing anyway!!

Thanks for letting me "vent" here.  I don't have anyone to talk to about this, other than the man in my life.  That doctor that did our tests seems to be more on the "negative" side of this than the positive, helpful side.  She tells me, just go get material and read...hasn't taken the time to actually talk to me about it.  She is young, fairly new at her profession.

[Terri Warren, RN, Adult Nurse Practitioner]

There's something not correct about the $950 price.  500 mg of Valtrex once daily should cost about $150 per month without insurance, but if he is able to remember to take medication twice daily, then acyclovir 400 mg twice a day should be fine also.  Valtrex is my preference simply because it is easier to remember to take something once a day than twice a day so people comply better, but that's very individual.

I'm glad he's doing better and it sounds like the two of you are doing better as a couple, yes?

Terri

[txone]

Thank you, Terri for your response.  I will get the book and we will read it.

I think you are right, I need to give him space and not push him, let him set the pace so to speak.  He has alot to deal with right now, recovering from surgery and now this news, along with outbreaks.

He did go back on his medication yesterday.  Another question, please...is acyclovir just as affective as Valtrex as a suppressive? Is there a significant difference between the two drugs? He was prescribed acyclovir because of the cost of Valtrex, he doesn't have insurance. We found out that Valtrex costed a $950. for a month's supply.

Thanks again...