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Grace: Herpes transmission question
Hi,
I am currently dating someone who was diagnosed with HSV2. He has never had an apparent outbreak and never knew he had it until I made him get a blood test. I am negative. At first I had so much anxiety that I decided that we could not continue intimately, but after doing my homework so to speak, I feel that if we take precaution, the risk of me contracting it is low. I am not really willing to risk it, so I'd like to know the transmission probablity.
We have discussed that he goes on Valtrex, but right now he does not have insurance and we haven't been using it. We have had intercourse three times and used a condom. To further cover skin, he also kept his boxer shorts on. I know, I know, a little extreme. I've read that condoms aren't all that effective because some area is exposed--- the base of the penis is never fully covered. What is the risk of passing the virus through that small exposed area? How effective are condoms against preventing the spread of asymptomatic shedding? I know Valtrex is the way to go, but since he doesn't have it yet, I'm wondering if we should abstain depending on how safe condoms are.
Advice? Thank you so much!
I am currently dating someone who was diagnosed with HSV2. He has never had an apparent outbreak and never knew he had it until I made him get a blood test. I am negative. At first I had so much anxiety that I decided that we could not continue intimately, but after doing my homework so to speak, I feel that if we take precaution, the risk of me contracting it is low. I am not really willing to risk it, so I'd like to know the transmission probablity.
We have discussed that he goes on Valtrex, but right now he does not have insurance and we haven't been using it. We have had intercourse three times and used a condom. To further cover skin, he also kept his boxer shorts on. I know, I know, a little extreme. I've read that condoms aren't all that effective because some area is exposed--- the base of the penis is never fully covered. What is the risk of passing the virus through that small exposed area? How effective are condoms against preventing the spread of asymptomatic shedding? I know Valtrex is the way to go, but since he doesn't have it yet, I'm wondering if we should abstain depending on how safe condoms are.
Advice? Thank you so much!
Have you ever had him get a copy of his blood test results and post them anywhere for help with them to make sure he doesn't need additional testing? I'll gladly look at them here if you can post the numeric results - ie hsv1 igg 6.4 and hsv2 igg 4.6 or whatever they are.
If your man doesn't have insurance but you both feel that suppressive therapy is in your best interest - then look into acyclovir. It reduces shedding as well as valtrex and famvir does - you just have to take it more often than valtrex. It's available as a generic and is much cheaper.
If you two do nothing but avoid sex anytime he has any itching/pain/obvious lesions in the anogenital area you have about a 10% risk each year of contracting hsv2 from him. Suppressive therapy cuts that in half. Condoms on top of all that and you are about 97-98% likely each year NOT to contract hsv2 from him. Condoms provide about a 40% reduction in risk of contracting hsv2 if you are just using them.
Him knowing that he has hsv2 actually reduces your risk compared to if you were dating someone who had it and didn't know they had it!! It's completely up to the 2 of you if you think it's worthwhile to completely abstain from sex at this time. The pleasure and intimacy you get from sex together is an important part of a relationship and letting something as common as genital herpes get in the way of that - just doesn't seem worth it to me. Many discordant couples stay that way a very long time with just minimal precautions. They really aren't all out there covered in latex and popping pills all the time to stay that way :)
If your man doesn't have insurance but you both feel that suppressive therapy is in your best interest - then look into acyclovir. It reduces shedding as well as valtrex and famvir does - you just have to take it more often than valtrex. It's available as a generic and is much cheaper.
If you two do nothing but avoid sex anytime he has any itching/pain/obvious lesions in the anogenital area you have about a 10% risk each year of contracting hsv2 from him. Suppressive therapy cuts that in half. Condoms on top of all that and you are about 97-98% likely each year NOT to contract hsv2 from him. Condoms provide about a 40% reduction in risk of contracting hsv2 if you are just using them.
Him knowing that he has hsv2 actually reduces your risk compared to if you were dating someone who had it and didn't know they had it!! It's completely up to the 2 of you if you think it's worthwhile to completely abstain from sex at this time. The pleasure and intimacy you get from sex together is an important part of a relationship and letting something as common as genital herpes get in the way of that - just doesn't seem worth it to me. Many discordant couples stay that way a very long time with just minimal precautions. They really aren't all out there covered in latex and popping pills all the time to stay that way :)
That's pretty much the nature of herpes, you can't predict what will happen with it. There are too many considerations that are impossible to tell; his viral load, your body's resistance etc.
IgG of 1.1 is within the false positive range, but because HSV1 affects 60-80% of the adult population it's likely that it's an actual positive. Most people contract HSV1 as a child.
IgG of 4.2 is outside the false positive range. Yes they do happen for HSV2 but usually those are numbers smaller than 3. This result should be treated as a positive.
IgG of 1.1 is within the false positive range, but because HSV1 affects 60-80% of the adult population it's likely that it's an actual positive. Most people contract HSV1 as a child.
IgG of 4.2 is outside the false positive range. Yes they do happen for HSV2 but usually those are numbers smaller than 3. This result should be treated as a positive.
His hsv2 result is above the false positive cut off rate and he had a genital lesion to boot so no I don't think there's any reason for him to get retested. His hsv1 is technically + - it's right at the cut off rate.
This will probably come to a surprise to you but MOST couples who one partner has hsv2 and the other one doesn't - probably aren't doing anything other than avoiding sex during symptoms and/or condom use. Most of the discordant couples I know in day to day life aren't using suppressive therapy ( most are too lazy to take a pill everyday to be honest ). Look at it this way - if the weatherman said there was a 10% chance of rain today - would you take your umbrella to work? Your man really isn't a walking biohazzard and anything you do above just avoiding sex during genital symptoms just puts the odds more and more in your favor.
Don't keep driving yourself crazy by getting a new herpes test everytime you two have sex!!! Unless you have obvious symptoms - either just get tested at your yearly gyn appointment for curiosities sake, if you get pregnant or 3 months after this relationship ends. No reason to keep paying for blood tests everytime you two are intimate!!! It sounds like overall you are happy with him so far ( it's all pretty new yet I know ) but that it's just the fear of herpes holding you back. Either decide that you two are doing all you can do to reduce your risk and you accept whatever hand fate gives you or move on. Just remember that it's easy to find someone with herpes simplex - not so easy to find someone who you are attracted to and who you want to pursue a relationship with.
grace
This will probably come to a surprise to you but MOST couples who one partner has hsv2 and the other one doesn't - probably aren't doing anything other than avoiding sex during symptoms and/or condom use. Most of the discordant couples I know in day to day life aren't using suppressive therapy ( most are too lazy to take a pill everyday to be honest ). Look at it this way - if the weatherman said there was a 10% chance of rain today - would you take your umbrella to work? Your man really isn't a walking biohazzard and anything you do above just avoiding sex during genital symptoms just puts the odds more and more in your favor.
Don't keep driving yourself crazy by getting a new herpes test everytime you two have sex!!! Unless you have obvious symptoms - either just get tested at your yearly gyn appointment for curiosities sake, if you get pregnant or 3 months after this relationship ends. No reason to keep paying for blood tests everytime you two are intimate!!! It sounds like overall you are happy with him so far ( it's all pretty new yet I know ) but that it's just the fear of herpes holding you back. Either decide that you two are doing all you can do to reduce your risk and you accept whatever hand fate gives you or move on. Just remember that it's easy to find someone with herpes simplex - not so easy to find someone who you are attracted to and who you want to pursue a relationship with.
grace
Hi Grace,
Thank you so much for the prompt response. He got tested only one time and the doc said his numbers read as HSV1 1.1 IGG and HSV2 4.5. The doc told him he was negative for HSV 1, but that appears to be positive. I'm wondering if it could be a false positive since the number is low? Before he got tested, we had had intercourse twice. I just got a second place test and I'm still negative. However, we recently slept together three other times, so I won't know if I contracted HSV from those exposures for at least another month. I don't want to have to feel like everytime we have sex, I have to get tested a month later! I know that it should not get in the way of an intimate reltionship, but since we have only been dating 3 months and I'm not sure if "he is the one," I do not feel it is worth contracting herpes over. If i knew that he was the last person I'd be with (which is hard to know even for married couples sometimes), then I'd riks it more. So basically, its hard to resist and not sleep together, but at hte same time, I really don't want ot contract the virus. With that said, we are being careful with condoms, but based on what you have said, it seems like suppresive therapy is the way to go.
I am suprpised to hear that people can have ungoing unprotected sex and not necessarily contract the virus. You hear of people having sex once and getting it. It is a frustrating thing because it seems that many people don't get symptoms and thus never know when they are shedding it! I'm hoping that the last three encounters with a condom were safe.
Do you think he should get retested since he only get tested once? Are they ever any HSV 2 false positives? Thank you for listening! I will stop rambling now:)
Thank you so much for the prompt response. He got tested only one time and the doc said his numbers read as HSV1 1.1 IGG and HSV2 4.5. The doc told him he was negative for HSV 1, but that appears to be positive. I'm wondering if it could be a false positive since the number is low? Before he got tested, we had had intercourse twice. I just got a second place test and I'm still negative. However, we recently slept together three other times, so I won't know if I contracted HSV from those exposures for at least another month. I don't want to have to feel like everytime we have sex, I have to get tested a month later! I know that it should not get in the way of an intimate reltionship, but since we have only been dating 3 months and I'm not sure if "he is the one," I do not feel it is worth contracting herpes over. If i knew that he was the last person I'd be with (which is hard to know even for married couples sometimes), then I'd riks it more. So basically, its hard to resist and not sleep together, but at hte same time, I really don't want ot contract the virus. With that said, we are being careful with condoms, but based on what you have said, it seems like suppresive therapy is the way to go.
I am suprpised to hear that people can have ungoing unprotected sex and not necessarily contract the virus. You hear of people having sex once and getting it. It is a frustrating thing because it seems that many people don't get symptoms and thus never know when they are shedding it! I'm hoping that the last three encounters with a condom were safe.
Do you think he should get retested since he only get tested once? Are they ever any HSV 2 false positives? Thank you for listening! I will stop rambling now:)
Didn't you post on the doctor side of the forum? It sounds like you are really ambivalent about this relationship in general. If a senior research physician at the top of his game can't reassure you, I say you probably have no hope of moving forward with this guy. Your next step is probably therapy, since you seem overly anxious about your partner's herpes. If you can't move past it, have enough respect for your partner to let him go and find a woman who will treat him better.
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STDs can't be transmitted by casual contact, like hugging or touching.
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