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Avatar universal

HSV2 positive - need some clarification

1) I recently have been given a clean bill of health after a full std test, unfortunately in the UK we don't test for hsv by default, why is this?

I slept with a girl that had the same clean bill of health and was on the pill, but I ended up contracting hsv2 from her. She had it for a while (blood test) but never had noticeable symptoms so didn't know. I so far had a minor rash/dot that is now subsiding. So on the physical side things are okay, but I am mentally very stressed and concerned about my future.

2) now that I have genital hsv2 and now that we know she has it too, is there any danger in us having unprotected sex?

3) if we have oral sex and as far as we are aware have no oral infections or hsv1, can we still transfer hsv2 to each others mouth? What is the likelyhood and how does it compare to other likelyhoods of getting stds? In the future, can I still get hsv1 down there or up near my mouth or am I sort of "protected" against new infections? If not, are the chacnes of receiving a new infection actually just academic or have real world relevance?


4) I read that without an outbreak the chances of passing on the virus are quite low, under 10% for men, much less for passing hsv2 on to somebody's mouth. Is this true?

5) Considering that antiviral therapy is harmless and reduces the possibility of passing on the virus by another 50% or so ... and looking at the actual chances of then passing it on either genitally or orally ... aren't the numbers suggesting (2-4% chance per year?) that it would be more likely to get pregnant when having sex with a condom, then to pass on hsv to a partner? I am trying to establish whether the need to tell somebody when using a condom and using antivirals is really just due to stigma, not to practical requirements?

6) My first outbreak was very mild, with just one dot that didn't even really hurt. If it has been somewhere else I would not have noticed even. Can this happen, can it show up somewhere else? Or will it always be in the same place? If that is the case, will it shed from that are aswell, or more widely from the genital area? The reason for this question is because a condom would completely cover the tip of my penis, and if the shedding only occurs where the sore was, I don't see how it can be passed on?!

7) Lastly, I read everywhere that some people only get one outbreak (or none) and that subsequent ones are much less strong. Considering the mild nature of my first outbreak ... can I draw some sort of likelyhood of further outbreaks from it an also their potential intensity? What I of course want to hear is that chances are very good that I won't see it ever again and that if it shows up it will be even more insignificant than before.


Many thanks.
16 Responses
3149845 tn?1506631371
Hi
1. not sure
2. If you both have it then you cant get it again so no danger.
3. highly unlikely to transfer it orally with an established infection.
4. yes
5. with new partners you should tell them as a risk does exist.
6. most recuring outbreaks would be in the same spot and future outbreaks would be less as a general rule but shedding and outbreaks can occur anywhere below the waist.
1998092 tn?1391246445
Grindcore, some clarifications:

1) It's the same in the US. HSV is not on the standard STD testing panel - it has to be asked for specifically.

2) You CAN re-contract the same HSV type in the site you have not yet contracted it (above or below the waist) within the first 4 months following infection. After that time, you are likely to have generated enough protective antibodies to prevent re-infection. The risk will be quite low.

3) You can contract Type 2 orally, but this is hard to do. A percentage of H+ positive folks do have HSV-2, but it's rare. If she's had it for a while, she is not in danger of re-contracting it anywhere else.

After 4 months, our experts posit that you will not contract HSV-1 on top of HSV-2. Anna Wald at the University of Washington confirmed to me a few months ago that she had never seen a proven case of such transmission.

4) Statistical percentages are almost meaningless in the large scheme of things. All it takes is one time for conditions to be right in order for the virus to transmit. Asymptomatic shedding (shedding without symptoms) is how the virus is mostly passed.

However, yes, oral HSV-2 is hard to contract, and almost never recurs, even when contracted.

5) There is never a justification for having sex with an uninfected person without disclosing. Always disclose before sexual contact. There is never a zero percent risk - never. You want to always give your partner the choice of whether or not to take the risk. If anything, failing to disclose, then transmitting, perpetuates the stigma that people with herpes are of questionable morality.

6) Condoms only protect about 30% of the time, against transmission. This is because shedding can occur anywhere that the nerve pathways reach from the nerve bundle. In the case of genital herpes, an outbreak can occur anywhere in the "boxer short" region between belly-button and mid-thigh, and more rarely below, on the legs and feet.
Avatar universal
Thank you both for your replies. I have actually posted this to a doctor aswell and got somewhat different answers, especially about the risk of passing it on in asymptomatic phase with a condom. The numbers really are so low that chances of getting pregnant when using a condom on a casual encounter are equal or higher.

Having said that I have not made up my mind yet as to whether disclosure on casual encounters when there are no symptoms and when a condom is used is really something that is required, morally and practically.

The chances of the other person already having hsv are higher (!) than the chances of me passing it on. In a way the curse here is that I know, not that I have it. My behaviour never was unreasonable or dangerous, and whenever I had sex with anybody I always accepted that there is small chance of something going wrong. I think if you sleep with somebody that you only just met, one night stand or after a few casual dates ... then you have to take responsibility, both. The idea that either side needs full disclosure at all times is a bit strange to me given the context and the numbers. I will do everything that is reasonable to not put anybody at risk, but there is a risk at having sex, and most of the time that risk is unknown. The idea that you have to discolose herpes at all times is like saying that NOW that you know you are more dangerous than before. Well the opposite is actually true, isnt it?

I haven't made up my mind, but I can definitely see the stigma being applied to the "carrier" here and no responsibility being applied to  the person that has sex with a stranger.

I think this thinking needs more space and time, and the conclusions that lead to the idea that disclosure is the only option make not always sense to me. It also makes the whole experience a lot worse and takes away responsibility from people that should carry some themselves.
Avatar universal
I think this is a response based on facts in context, keeping in mind likelyhoods and actual real world outcomes. Not just medical facts and possibilities.

http://www.medhelp.org/posts/STDs/HSV2-positive---need-some-clarification/show/2047755#post_9687516
1998092 tn?1391246445
Dr. Hook's answers are not contradictory to mine. Also, not once does he call the statistical risk in any situation "zero percent." All it takes is one time for the factors to align - for that "less than 1% probability" to be happening at the point of sexual contact - for the virus to transmit.

The condom does not cover every area of possible shedding - we can shed anywhere between the belly-button and the mid-thigh. In fact, I get half my outbreaks near my tailbone. The suppressive meds only reduce the risk about 50%.

Here is something else Dr Hook says in his responses to you: "...when possible and appropriate, disclosure is always the best practice."

Though HSV is a non-fatal, mild skin condition for most, a percentage of HSV+ patients have adverse reactions to the virus. It's not possible to determine who will and won't beforehand. HSV also can cause neonatal herpes, which can be fatal to newborns. Though rare, it happens.

Because all these possibilities exist, everyone has the right to be allowed to make decisions directly related to their own sexual health. I'm at a loss to understand why you think your non-H partners don't deserve that choice. It's their right. Lawsuits have been started and won by newly-diagnosed folks who were purposely not informed about their partner's STD status before sex. This should be a warning to you.

If you're looking for an endorsement to behave irresponsibly and knowingly put someone at risk, I'm afraid you won't get it from me. I hope you make the responsible choice.
Avatar universal
This is a typical and unhelpful response because it is ideological despite the facts. I find it shocking that such rigid views are expressed by health professionals.

At no point was I claiming there is no risk. In fact I specifically said there always is a risk. When two consenting adults have sex they both consent to that risk, and accept that unknowns might occur. Unknowns include the real world fact that one of them might be carrying hpv or herpes and not be aware of it. It includes pregnancy as a possibility. There is reasonable behaviour or as Dr Hook called it 'appropriate'  behaviour to limit the possibility of these outcomes,  such as the use of condoms. There is unreasonable behaviour which is for example to wear a latex suit or never ever have sex.  A balance needs to be found.

The risk of me passing on hsv2 when no symptoms are present and while I wear are condom and possibly even am on antiviral drugs is lower than all potential unknown risks that occur when two people have consentual sex. Yet you state with no flexibility that it is my responsibility to let the other party make an informed choice. Well,  it isn't.
If I was asked I wouldn't lie.  Also in most cases,  if appropriate and possible I would probably state it. But the idea that hsv carriers are bad people unless they tell everybody on their first moment of intimacy seems otherworldly to me and continues the perpetual stigma that this is a terrible,  dangerous,  super contagious disease that can not be controlled.

We are going to have to disagree. I have no issue with that. But I'd appreciate it if you and others if your conviction also took into consideration the context in which these moral questions are asked. I am not amoral,  I just like to think.
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