Female-to-Male Transmission of HSV2

[Readsalot]

I'm a 48-year-old woman who was diagnosed with HSV2 about 5 years ago after contracting it from my then-boyfriend. I've only had one outbreak, as far as I know, and the only symptom that I can recall was an incredibly bad pain in my lower back, which my doctor seemed to think did not suggest herpes. He seemed surprised that the cervical lesion he found was indeed caused by HSV. I went on Valtrex and just stayed on it for a couple of years but finally quit because it was so expensive and I was so rarely sexually active. I used to get cold sores as a child, so I guess I have HSV1 as well. In the past I've had HPV, the less serious type that doesn't cause cervical cancer.

Now it looks like an old love (who does not have H) and I may give things another try, but I did not have H back when we were together, and I want to be able to answer his questions once I tell him my status. Namely:

If I am outbreak-free, which I seem to have been since my initial diagnosis, what are the chances of his catching H from me through vaginal sex, either with or without condoms, and either with or without Valtrex?

Can we safely have oral sex without using dental dams? What would the chances be of his contracting it from me if we do not use them, either with or without my being on Valtrex?

Do you generally consider taking Valtrex prophylactically in the long term a good idea? I never had any side effects from it, but it was extremely expensive when I used it a few years ago.

Thanks!

[Terri Warren, RN, Adult Nurse Practitioner]

First, how were you diagnosed with HSV 2?

Let's assume for a moment that you really do have herpes.
The odds of him getting HSV from you if you don't use condoms and don't take any medicine and have sex an average of about twice a week is 4%.  If you had Valtrex to the mix, it cuts the risk to 2%.  If you add condoms, it cuts it more, but I can't give you a specific number, but it is a considerable amount.  

I do consider taking an antiviral daily to reduce transmission to a partner.  First I think your partner should be tested to see what they have, if anything, in the way of herpes.  However, you can take acyclovir 400 mg twice a day, and get the same result, you just have to take it once more per day than Valtrex.  And it is way way cheaper.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

If he knew definitely that you had HSV 2, he must have done some test to determine that, yes?

He can be the giver of oral sex to you without a dental dam but there is a small risk he could contract HSV 2 from you orally, but it is really small.  it isn't zero, but really small.

A swab test for herpes is only done with an outbreak but a type specific antibody test can determine infection at any time.

Terri

[Readsalot]

Thanks for the response. At the time I was with the HSV2+ guy and developed the strange symptoms, my gynecologist gave me an internal exam and found a lesion. I can't remember whether he did a culture of the lesion or gave me a blood test, but he said I definitely had HSV2.

Would you be able to address my question about having oral sex without dental dams?

I thought the test for HSV2 was only accurate if it's done during an outbreak. If that is not the case, I'll just get retested.

[Terri Warren, RN, Adult Nurse Practitioner]

First, how were you diagnosed with HSV 2?

Let's assume for a moment that you really do have herpes.
The odds of him getting HSV from you if you don't use condoms and don't take any medicine and have sex an average of about twice a week is 4%.  If you had Valtrex to the mix, it cuts the risk to 2%.  If you add condoms, it cuts it more, but I can't give you a specific number, but it is a considerable amount.  

I do consider taking an antiviral daily to reduce transmission to a partner.  First I think your partner should be tested to see what they have, if anything, in the way of herpes.  However, you can take acyclovir 400 mg twice a day, and get the same result, you just have to take it once more per day than Valtrex.  And it is way way cheaper.

Terri