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Ghsv1 transmission rates

I’ve read on many experts forums that it’s hard to transmit ghsv1 due to its low shedding rate . I’ve read on westoverheights.com that new studies states that an established ghsv1 infection 2+ years out sheds 1.3% of days which comes out to 4 days a year ? Is that correct ? Why is it so hard to transmit ghsv1? What’s the likeliness of spreading it after 7 years ?
2 Responses
207091 tn?1337709493
COMMUNITY LEADER
Where did you see that study? Can you link it for me? I haven't seen it, and can't find it.

I found this one, but it doesn't give the figures you have - https://sti.bmj.com/content/93/Suppl_2/A24.3

In any case, even without that new study, we know shedding rates are these:

HSV 2 genital 15-30% of days evaluated

HSV 1 genital 3-5% of days evaluated
  
HSV 1 oral 25% of days evaluated

HSV 2 oral 1% of days evaluated

It's hard to transmit ghsv1 because it doesn't often recur - many people with ghsv1 only get the initial outbreak and no recurrences - and it sheds so infrequently compared to other hsv infections/locations.

Also, about half the adult population has hsv1 already, usually orally, and once you have hsv1 you can't get it again. If your partner already has hsv1, you can't transmit it to them.

It doesn't mean ghsv1 isn't infectious. It is. It's just really, really unlikely. If one person in the relationship has ghsv1, and the other partner doesn't have hsv1 already, you really just need to avoid sex during outbreaks.

Do you have ghsv1? If you do, you are worrying far too much about it. Ask your partner to test, or if they've ever had a cold sore. If they haven't, or can't remember, they can get a type specific IgG blood test. 90% of those with oral hsv1 will never get symptoms, so you can have it and not know.



11 Comments
https://westoverheights.com/forum/search/Ghsv1/
Here is the link .. in terri’s Reply is we’re he stated the new ghsv1 shedding stats
& he has said he had a cold sore before but it was inside of his mouth so I thought he could’ve mistaken it for a cold sore .. we’ve been together 4 years and have been having unprotected sex the whole time .. every thing I see regarding ghsv1 says it’s no big deal but anticipation of transmission worries me the most
https://westoverheights.com/forum/question/transmission-question-10/
Here’s another response drone Terri saying shedding is 4 days at 2+ years out
Ahh I found it. :)

Terri is amazing and you can trust what she says.

This is the question from the member, with Terri's response:

2. I know you mentioned new research that says shedding is way less after two years, but I am GHSV1 positive for a year and 3 months. What does that mean in terms of shedding? Also, can you link the research so I can read it?

The research came out at an International STD meeting in Vancouver BC and I don’t think it has yet been published. Shedding at 3 months out is 7% and at 2 years 1.3% so somewhere in between those two.

The direct link to the whole exchange is here - https://westoverheights.com/forum/question/ghsv1-and-panicked/

Even without this new data, which is pretty cool and thank you for bringing it to my attention, I would have told you that you have nothing to worry about. In all my years of doing this, and working in an STD clinic, I can't say that I've heard of one case of genital to genital hsv1 transmission. Terri has said that she may have heard of "one, maybe", and she's been doing this for 35 years, longer than I have.

7 years in? I have no idea. I don't know if it drops more, or stays the same, but even at 4 days a year? No big deal.

Shedding doesn't mean transmission is automatic. A lot goes into transmission - how much virus is present, how much friction is involved, etc. We don't know how much virus it takes to transmit, and it's probably different for everyone. We do know that viral levels are highest with an outbreak, which is why we know to avoid sex then.

I'm assuming your partner knows you have ghsv1, and doesn't care? He's a grown man who can make decisions regarding his body. Trust him on that.

Worst case scenario - he gets it. So what? You've been together for 4 years, and that seems like you're in it for the long haul. No one wants to transmit anything, and no one wants herpes, but if it happened, it would change nothing for either of you, really. Ghsv1 recurs infrequently, sheds infrequently, and would be a very small blip in your relationship. You all would probably fight about money or something more than you'd have to deal with herpes.

That's how it should be now, too. Please don't let this take any enjoyment out of your sex life. So much can already do that - stress, relationship issues, kids, health issues, etc., etc. Don't add herpes to that list. You're worrying for nothing.
So considering it’s 4 days out of the year for me and if we avoid sex during an outbreak what do you suppose the likeliness of transmission ?
I've already said that it's very, very unlikely to ever happen, even before we knew about the new study. If it were me, I wouldn't give it another thought, unless I had an outbreak.

I specifically said, "You're worrying for nothing."

If you can't let this go, I'd suggest counseling. I don't mean that harshly. You deserve to find peace with this.
You do sound a little harsh but it’s ok . Thanks for your help
I'm sorry - I didn't mean to sound harsh at all. That's a drawback of reading someone's words - they sound one way in my head, and don't always come across that way.

I just really hope you find peace with this. You deserve to enjoy your sex life. :)
If someone has recurrent OB’s often does that mean they will asymptomatic she’s more ?
We don't have this answer with ghsv1. We know with ghsv2, the number of recurrences doesn't influence shedding, but we don't know about ghsv1.

If you're getting frequent OBs, you might consider going on suppressive meds, like acyclovir or Valtrex. This can help you be more comfortable physically, and can help reduce shedding, too.
Will it reduce viral shedding or asymptomatic shedding or is that the same thing ? Even though it’s 4 days out of the year can it reduce it less than that ? Or will it reduce the amount of virus your shedding ?
207091 tn?1337709493
COMMUNITY LEADER
Those are the same thing.

We don't have studies for suppression and ghsv1 to know how much it reduces shedding, and the 4 days a year thing is really new, so I can't really answer that.

If you're having frequent OBs, we know that suppression can help with that. We know that suppression reduces shedding by about 50% in ghsv2, but don't know if it's less or more with ghsv1, which already sheds a lot less than ghsv2. If it works the same, you'd be down to 2 days a year.

We know that while using daily suppression with ghsv2, the transmission rates from female to male are about 2-3% a year (while also avoiding sex during OBs). Taking into account that ghsv1 sheds a lot less (HSV 2 genital 15-30% of days evaluated compared to HSV 1 genital 3-5% of days evaluated), using suppression for ghsv1 could reduce the already very low transmission rates even more.

17 Comments
I’ve never been on suppressive medication well ONCE when I was pregnant but that’s the only time . . And during pregnancy was the only time I had OB’s .  I have a good immune system does that play apart ? What about herbal remedies ?
So you aren't having frequent OBs now?

If you are, and this is suddenly new for you, you should get checked by your doctor for things like yeast and bacterial vaginosis. Secondary infections like that can trigger OBs.

I wouldn't waste money on herbal stuff, unless it makes you feel better to use them. There haven't been any studies on them for ghsv1, but the studies on most of them for ghsv2 don't show a lot of benefit.

Your immune system can play a role, to a point, but there are people who never get sick and are otherwise really healthy but get frequent OBs (usually with ghsv2, as ghsv1 doesn't usually result in frequent OBs).

As far as shedding, it's just part of the infection, and the immune system doesn't play a role in that.

I'm not on here during the weekends, but if you are having OBs, see if you can get checked for yeast or BV this weekend, either at your doctor or an urgent care or something.

Have a good weekend. :)
Just saw this ,  anywho hope you had a good weekend & no I am not currently  having  recurrences currently haven’t since my pregnancy .

Over seven years I only had the primary then 5 years later during my pregnancy I had OB’s ( well idk if they were even out breaks sometimes had severe itchiness-redness and some bumps that never turned into ulcers and went away after 2 days ) but that’s it . So would u still recommend  meds for suppression since it’s been so long ? & considering the shedding rates are already so low (which results in low transmission ) do u recommend I take meds for that ?
No, I wouldn't. You may be shedding 4 days a year, and I don't think you need it.

I would be really surprised if you ever transmitted it.

Hope you had a good weekend too. :)
“I may be shedding 4 days a year “so that means I could be shedding more than that :( ?
And why would u be surprised if I ever transmitted it ? (I’m happy to hear that but just curious )
Honestly, I don't know how often you are shedding. Since the study hasn't been published yet, I haven't read it. I said may because maybe you are shedding less. I don't know the sample size, if 4 days is an average or a mean, or if 4 days was found among everyone. My guess is that it's pretty standard for 4 days, or Terri would state it differently, but I don't know how to interpret it yet.

Even before knowing the 4 days a year new study, I'd have been surprised if you ever transmitted it.

It sheds so infrequently, even at the original 3-5% of days found in previous studies, and recurs so infrequently, that it means the chances of transmitting it are really low. Even taking those numbers, and comparing it with hsv2 genitally, which has a 4-5% transmission rate per year (female to male) if all you do is avoid sex during outbreaks while shedding 15-30% days/year, ghsv1 transmission rates are much lower.

Add in that over half of the adult population has oral hsv1, and 90% of them don't know they have it, chances are decent that your partner already has it (is he your source, or did you have it before you were with him?). If he already has it, he can't get it again.

I mean, he hasn't gotten it yet, right? :)
No not to my knowledge .
What are the places outbreaks can pop up on a male and what does it appear as on a male so I can know for future reference?
If a man gets either hsv1 or hsv2 genitally, it will look like blisters, probably. Some say theirs look like paper cuts, but the norm is blisters. You can look up herpes outbreaks online, but be aware that most are worst case scenario.

Just like in a woman, herpes infects nerve groups. Genital herpes infects the sacral ganglia, which affects the boxer short area, meaning anyone with genital herpes of either type can get outbreaks in the area that boxer shorts cover.

Most commonly, outbreaks occur in the place where you were infected, but that's not always true. It's also most common to get outbreaks on the mucous skin - the labia, vagina, anus, penis, etc. Some people get outbreaks in their pubic hair area, or pubic mons (the triangular area just above your genitals).

Don't spent a lot of time looking. Chances of you ever transmitting this are so, so low that you should spend your naked time having fun, not worrying about this. :)
What about the groin ?
Are you asking about the scrotum, perineum, etc? A man can get outbreaks there, but the penis, usually the shaft, is more common.

You can get outbreaks on the insides of your thighs, but it's not that common.

You are only infectious from mucous membrane skin. Since your female, it's the vagina, vulva, the labia, the anus - the thinner, moister areas.
Sorry I should’ve specified can a male get a primary OB in the groin ?
Yes, they can get a primary outbreak anywhere in the boxer shorts area, but it will most likely be in the site of infection.

For example if you had a sore on your left side, and you had intercourse and he got infected, he would probably get a sore on the right side of his penis. If you had a sore on your pubic mons, he might get one on his, if your skin was rubbing on his.

That's not a hard and fast rule, but it's most typical.

Does that help?
Does that include the crease between the thigh and groin ?
That's thicker skin so it probably wouldn't be a point of infection if the skin is intact, but outbreaks can happen there.

Since it's thicker skin, any kind of sores or rash there would be more likely to be a fungal infection like jock itch or yeast than herpes. A lot of sweat can collect there, too, so it could be irritation, or even eczema, dermatitis, chafing from underwear, etc.

Do you accept private messages ?
Yes :)
I messaged you . Thank you
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