Aa
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.
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.
Re 6) I am not discussing my "selfishness" or my choice of disclosure anymore, I think we are closer on this topic than you might think and I am genuinely trying to gather an understanding and information.
Statistics may not be of consequence when it comes to the decision of disclosure, but surely they are of consequence in general?
I understand what you are saying about how the shedding works and how unpredictable/random it is.
How do the shedding rates relate to transmission rates. It seems these numbers are being used but not distinguished by a lot of people. The 4% indicates to be a transmission rate, not a shedding rate. Also the 15 days of shedding - does this include pre and post outbreak shedding or is it only asymptomatic shedding?
I can not reconcile what Dr. Hook said, what this "random blog" said with what you are saying. Am I missing something or is somebody wrong?
Dr. Hook:
"4. With or without lesions, the risk of getting herpes from a direct exposure to an infected person is less than 1% and many would say less than 1 in 1000. We presume that direct lesion contact is somewhat more infectious but as noted above, because so many people with HSV do not know they are infected, most HSV is transmitted by persons who are asymptomatic and without lesions. "
I am not a medical professional and English is not my first language, but I am an academic and my real world math tells me that a 1% chance, if this number is correct, reduced by a further 30% with a condom, reduced by a further 50% (?) with antivirals ... makes for a number that is exceedingly small. And this is not even using the 1 in 1000 suggestion, which would be even more exceedingly small.
Regardless of what consequences one might draw from the above math, is the math correct?
Statistics may not be of consequence when it comes to the decision of disclosure, but surely they are of consequence in general?
I understand what you are saying about how the shedding works and how unpredictable/random it is.
How do the shedding rates relate to transmission rates. It seems these numbers are being used but not distinguished by a lot of people. The 4% indicates to be a transmission rate, not a shedding rate. Also the 15 days of shedding - does this include pre and post outbreak shedding or is it only asymptomatic shedding?
I can not reconcile what Dr. Hook said, what this "random blog" said with what you are saying. Am I missing something or is somebody wrong?
Dr. Hook:
"4. With or without lesions, the risk of getting herpes from a direct exposure to an infected person is less than 1% and many would say less than 1 in 1000. We presume that direct lesion contact is somewhat more infectious but as noted above, because so many people with HSV do not know they are infected, most HSV is transmitted by persons who are asymptomatic and without lesions. "
I am not a medical professional and English is not my first language, but I am an academic and my real world math tells me that a 1% chance, if this number is correct, reduced by a further 30% with a condom, reduced by a further 50% (?) with antivirals ... makes for a number that is exceedingly small. And this is not even using the 1 in 1000 suggestion, which would be even more exceedingly small.
Regardless of what consequences one might draw from the above math, is the math correct?
1) No – I am not saying their information is correct, only that there is no way to guarantee that it is. You are only guaranteed to get accurate information from credentialed sources of information. In the United States, this would mean the NIH, the CDC, ASHA, or Westover Heights clinic, as well as the peer-reviewed medical journals and the research arms of the Tier 1 research universities such as the University of Washington.
2) The important aspect of the risks surrounding pregnancy and taking birth control pills is that we get to choose whether to take those risks. We do not have those risks thrust upon us without our consent.
3) First, we tell all of our support group members that one should always disclose that they have oral HSV before kissing. Kissing spreads the virus easily, when one is shedding, which can happen even without symptoms. Second, the two types behave differently, depending on their site of infection. Their protective antibodies also differ behaviorally. Finally, oral herpes is much more prevalent, which may be a factor in why it carries less of a stigma than genital herpes. HSV-2 genitally also sheds more and tends to be much more invasive. It is often more debilitating and painful. Its symptoms can last longer. I do not know whether your first infection was mild, but be assured that many people's first episodes can be extremely severe.
4) My answer is unchanged – they may see it as a non-issue, but they would be wrong. Yes, we are at higher risk for HIV regardless of symptoms, due to a rise in T cell concentrations. When lesions are present, and for a period of time after they have healed, the risk increases up to 37 times, according to official studies.
5) What my comment meant was that you can transmit your HSV-2 to someone who already has HSV-1. In fact, genital HSV-2 is the type/site combination that sheds most.
6) Once again, the statistics are of no consequence. You are correct – the blog you linked is another example of a random website interpreting the research in faulty ways. We shed an average of 10 to 15 days out of the year. And this does not necessarily mean continuous shedding. We could be shedding one hour on one day then eight hours on a different day. In fact one recent study found that in spite of being on suppressive (daily) therapy, our bodies often shed in short bursts, sometimes for as short a span as a half hour. Remember that condoms only provide protection about 30% of the time. Compounding this is the fact that we can shed in areas outside the condom. What all this means is that when you don't disclose before sexual contact, you are gambling with your non-H partners' sexual health.
I urge you to come out of denial and choose to be unselfish. Ask yourself if you want to be "that guy," or whether, because you are exactly that person who is "safer to be with" for knowing your HSV status, the most significant component of this "safety" is an acceptance of the responsibility to help protect a non-H partner, by not taking away their right to control their sexual health.
2) The important aspect of the risks surrounding pregnancy and taking birth control pills is that we get to choose whether to take those risks. We do not have those risks thrust upon us without our consent.
3) First, we tell all of our support group members that one should always disclose that they have oral HSV before kissing. Kissing spreads the virus easily, when one is shedding, which can happen even without symptoms. Second, the two types behave differently, depending on their site of infection. Their protective antibodies also differ behaviorally. Finally, oral herpes is much more prevalent, which may be a factor in why it carries less of a stigma than genital herpes. HSV-2 genitally also sheds more and tends to be much more invasive. It is often more debilitating and painful. Its symptoms can last longer. I do not know whether your first infection was mild, but be assured that many people's first episodes can be extremely severe.
4) My answer is unchanged – they may see it as a non-issue, but they would be wrong. Yes, we are at higher risk for HIV regardless of symptoms, due to a rise in T cell concentrations. When lesions are present, and for a period of time after they have healed, the risk increases up to 37 times, according to official studies.
5) What my comment meant was that you can transmit your HSV-2 to someone who already has HSV-1. In fact, genital HSV-2 is the type/site combination that sheds most.
6) Once again, the statistics are of no consequence. You are correct – the blog you linked is another example of a random website interpreting the research in faulty ways. We shed an average of 10 to 15 days out of the year. And this does not necessarily mean continuous shedding. We could be shedding one hour on one day then eight hours on a different day. In fact one recent study found that in spite of being on suppressive (daily) therapy, our bodies often shed in short bursts, sometimes for as short a span as a half hour. Remember that condoms only provide protection about 30% of the time. Compounding this is the fact that we can shed in areas outside the condom. What all this means is that when you don't disclose before sexual contact, you are gambling with your non-H partners' sexual health.
I urge you to come out of denial and choose to be unselfish. Ask yourself if you want to be "that guy," or whether, because you are exactly that person who is "safer to be with" for knowing your HSV status, the most significant component of this "safety" is an acceptance of the responsibility to help protect a non-H partner, by not taking away their right to control their sexual health.
To me this seems like flawed math. If you shed 4% of days a year, it would be much more. Does 4% mean 4% chance of transmission over a year if you have regular sex, or 4% of days with 100% transmission.
Because one would mean 0.04/365 which is extremely low and matches the blog.
The other would mean about 15 days a year.
I want to understand the facts in context so I will be able to provide answers when I speak to somebody about it.
Because one would mean 0.04/365 which is extremely low and matches the blog.
The other would mean about 15 days a year.
I want to understand the facts in context so I will be able to provide answers when I speak to somebody about it.
Do you think this source is irresponsible - it is extremely confusing to assess what is objective and what isnt. And I am not asking this in relation to disclosure, just in relation to actual real life chances:
www.hsvblog.org/herpes-simplex-virus-hsv-101/
"Transmission
To give you with a realistic idea that demonstrates exactly how much safer sex with an HSV+ partner is, take a look at the numbers provided by scientific studies.
By avoiding sex during an active outbreak, chances of virus transmission are 4% a year (Terri Warren, RN, NP – WebMD, 2005). Yes, per year, not sexual session. Dividing this figure by 365 days (or nights), this makes the possibility of spreading the virus on any given day/night .0001%, or 1/10,000 (.04 / 365 = 0.000109589041).
If also using condoms or anti-viral drugs, it cuts those already-staggering odds in half to 2% a year. The possibility of spreading HSV on any given night would then become 1/20,000. To put this in perspective, you have a better chance of literally dying in a car accident tomorrow on your way to school or work (1/18,585), although, surely this “risk” won’t stop you from driving. 1 in 18,000… driving seems pretty safe, doesn’t it? The fact that you will still drive your car (or ride in cars) after reading this article is proof that you agree.
It’s cool, though, because you’d be right. Driving is pretty safe. Just remember: having a knowledgeable HSV+ partner is safer. If you’re not scared to drive, you are agreeing to this by default.
With the use of both simultaneously [condoms and anti-viral drugs], it cuts the number in half once again: a mere 1% chance of transmitting the virus per annual basis. On any given night, we’re now entertaining a “risk” of 1/40,000. You now have better odds of becoming a pro athlete (1/22,000). Do you plan on signing that million-dollar contract anytime soon?"
www.hsvblog.org/herpes-simplex-virus-hsv-101/
"Transmission
To give you with a realistic idea that demonstrates exactly how much safer sex with an HSV+ partner is, take a look at the numbers provided by scientific studies.
By avoiding sex during an active outbreak, chances of virus transmission are 4% a year (Terri Warren, RN, NP – WebMD, 2005). Yes, per year, not sexual session. Dividing this figure by 365 days (or nights), this makes the possibility of spreading the virus on any given day/night .0001%, or 1/10,000 (.04 / 365 = 0.000109589041).
If also using condoms or anti-viral drugs, it cuts those already-staggering odds in half to 2% a year. The possibility of spreading HSV on any given night would then become 1/20,000. To put this in perspective, you have a better chance of literally dying in a car accident tomorrow on your way to school or work (1/18,585), although, surely this “risk” won’t stop you from driving. 1 in 18,000… driving seems pretty safe, doesn’t it? The fact that you will still drive your car (or ride in cars) after reading this article is proof that you agree.
It’s cool, though, because you’d be right. Driving is pretty safe. Just remember: having a knowledgeable HSV+ partner is safer. If you’re not scared to drive, you are agreeing to this by default.
With the use of both simultaneously [condoms and anti-viral drugs], it cuts the number in half once again: a mere 1% chance of transmitting the virus per annual basis. On any given night, we’re now entertaining a “risk” of 1/40,000. You now have better odds of becoming a pro athlete (1/22,000). Do you plan on signing that million-dollar contract anytime soon?"
1) Does that mean their information is wrong? What are you implying with credentialed, especially in regards to non US websites?
2) I find these comments incredibly unhelpful and extreme. Pregnancy can cause death, and all sorts of other illnesses that are considered completely harmless can have very serious outcomes in some people. What you are stating appears out of context and I still don't see how reading the "possible side effects" list in prescription medicine is a good way to judge whether you should take that pill or not. There is no zero risk activity. I do however see your point that there is a difference between being aware of risk, however low it might be, and not being aware. Having said that, life consists of constant activities that include risks we are not aware of.
3) They are the same thing though, I would like you to explain to me how one is different to the other in terms of moral disclosure of the condition. I don't get it.
4) Isn't this another absolute without taking the context into consideration? I might have not explained properly in the previous post, but what seems to prevalent in the gay community is that hsv is not seen as an issue by itself. Of course him and his partners always use condoms for penetrative sex, specifically because HIV is too serious. But otherwise (oral etc) it is simply and widely ignored and seen as a non issue.
Are your chances of aquiring HIV increased if you have HSV but no outbreaks and use a condom? I never read that. And that is what he was referring to.
5) Something positive at last
6) Thank you. We won't agree on all points and I hope it is not simply because you believe that I am either misinformed or amoral. I just don't believe in absolutes and usually find them to be unrealistic.
2) I find these comments incredibly unhelpful and extreme. Pregnancy can cause death, and all sorts of other illnesses that are considered completely harmless can have very serious outcomes in some people. What you are stating appears out of context and I still don't see how reading the "possible side effects" list in prescription medicine is a good way to judge whether you should take that pill or not. There is no zero risk activity. I do however see your point that there is a difference between being aware of risk, however low it might be, and not being aware. Having said that, life consists of constant activities that include risks we are not aware of.
3) They are the same thing though, I would like you to explain to me how one is different to the other in terms of moral disclosure of the condition. I don't get it.
4) Isn't this another absolute without taking the context into consideration? I might have not explained properly in the previous post, but what seems to prevalent in the gay community is that hsv is not seen as an issue by itself. Of course him and his partners always use condoms for penetrative sex, specifically because HIV is too serious. But otherwise (oral etc) it is simply and widely ignored and seen as a non issue.
Are your chances of aquiring HIV increased if you have HSV but no outbreaks and use a condom? I never read that. And that is what he was referring to.
5) Something positive at last
6) Thank you. We won't agree on all points and I hope it is not simply because you believe that I am either misinformed or amoral. I just don't believe in absolutes and usually find them to be unrealistic.
Grindcore:
1) Herpes.org is not a credentialed source of information.
2) Pregnancy is not in the same category as a disease that can cause blindness, death to a newborn, adverse reactions to existing autoimmune conditions, and post-herpetic neuralgia.
3) You do not have cold sores. You have genital herpes.
4) Your gay friend is wrong. HSV makes us more susceptible to acquiring HIV, and this is an even greater risk in the gay community.
5) HSV-2 antibodies do a much better job of protecting against infection with HSV-1. Unfortunately, the reverse is not true. There may be some protection - the old figure was 40%, but some studies have found no protection at all against HSV-2 from HSV-1 antibodies.
6) You are going through the very same feelings that all of those patients that I mentioned went through and are going through. You don't want to knowingly and consciously risk adding more of you and them to the devastated many, without allowing women you meet the choice of taking that risk. You don't want to be that guy.
You must learn to forgive your gifter, forgive the world, and forgive yourself. Let go of the anger. Here in the U.S., about 75% of the population has HSV of 1 or both types. That's hundreds of millions of people. Tens of millions have HSV-2. You're not alone. Be gentle with yourself, and be gentle with others.
I strongly recommend that you seek out the London herpes group. Meeting the H community in person is often what begins our emotional healing. I wish you the best.
1) Herpes.org is not a credentialed source of information.
2) Pregnancy is not in the same category as a disease that can cause blindness, death to a newborn, adverse reactions to existing autoimmune conditions, and post-herpetic neuralgia.
3) You do not have cold sores. You have genital herpes.
4) Your gay friend is wrong. HSV makes us more susceptible to acquiring HIV, and this is an even greater risk in the gay community.
5) HSV-2 antibodies do a much better job of protecting against infection with HSV-1. Unfortunately, the reverse is not true. There may be some protection - the old figure was 40%, but some studies have found no protection at all against HSV-2 from HSV-1 antibodies.
6) You are going through the very same feelings that all of those patients that I mentioned went through and are going through. You don't want to knowingly and consciously risk adding more of you and them to the devastated many, without allowing women you meet the choice of taking that risk. You don't want to be that guy.
You must learn to forgive your gifter, forgive the world, and forgive yourself. Let go of the anger. Here in the U.S., about 75% of the population has HSV of 1 or both types. That's hundreds of millions of people. Tens of millions have HSV-2. You're not alone. Be gentle with yourself, and be gentle with others.
I strongly recommend that you seek out the London herpes group. Meeting the H community in person is often what begins our emotional healing. I wish you the best.
Another actual question, if you don't mind.
The 4 months figure that you gave in your fist reply is something "new" that I have not learned anywhere else. Am I correct in understanding that basically once you have "either" HSV for a while, your system will have enough defense to fight of the majority of potential new infections? So although it is possible to get HSV1 genitally or orally, it is highly unlikely if you have HSV2 already genitally?
Is the vice versa true aswell, if you have HSV1 already oraly (which according to you and other sources is up to 90%?! of the population) you should have some sort of resistance to HSV2 genitally?
I just played through a scenario in my head where I tell a potential partner about my hsv2 down below, they get a blood test and it comes back positive for hsv1 (which is very likely, right?) - would that mean there is even less to worry about that initally thought?
Somebody should make a fact sheet on which infections actually are probable, which ones are academic and never observed (like your colleague stated) ... it can be quite overwhelming, especially when you feel emotionally drained already.
The 4 months figure that you gave in your fist reply is something "new" that I have not learned anywhere else. Am I correct in understanding that basically once you have "either" HSV for a while, your system will have enough defense to fight of the majority of potential new infections? So although it is possible to get HSV1 genitally or orally, it is highly unlikely if you have HSV2 already genitally?
Is the vice versa true aswell, if you have HSV1 already oraly (which according to you and other sources is up to 90%?! of the population) you should have some sort of resistance to HSV2 genitally?
I just played through a scenario in my head where I tell a potential partner about my hsv2 down below, they get a blood test and it comes back positive for hsv1 (which is very likely, right?) - would that mean there is even less to worry about that initally thought?
Somebody should make a fact sheet on which infections actually are probable, which ones are academic and never observed (like your colleague stated) ... it can be quite overwhelming, especially when you feel emotionally drained already.
Thank you for taking the time to reply again. Despite some of the tension I find this conversation helpful.
Let me re-iterate again that I have by no means made up my mind to not tell people about being hsv2 positive. I simply still fail to see that in all circumstances this is reasonable, appropriate behaviour, and I disagree that a blanket disclosure in all circumstances is the only thing to do.
Also, I am very aware, as you are yourself, as to how much of an impact a positive result can have, as I am experiencing these emotions myself. Strongly. It can feel quite devastating.
Because of this I feel it is even more important to separate fact from fiction and apply reason to what is essentially not a medical problem but a moral problem.
I will refrain debating on the numbers/facts of the disease is not an exercise I should undertake with somebody as yourself - you appear to have dedicated your life to researching into the matter so I must concede that your are more informed than I am, obviously. This of course doesn't change the observation I have made though that numbers such as transmission/shedding rates and factors of protection appear to be displayed differently on different websites. There is a discrepancy even between the official US numbers and for example the NHS numbers in the UK. There is a certain bias in how the information is presented - very matter of fact with conservative, out of context statements, or more progressive, helpful yet factual websites. One that I came across that was so much more nuanced and useful than any others - and I am sorry to say - maybe more helpful than your response:
http://www.herpes.org.nz/patient/facts.htm
Now that I have written this I am conceding, again, that I might be overreacting to responses as I am in emotional turmoil about my diagnosis. But I hope you can recognize on some level, even only personally, that this official government information is much more useful to a newly diagnoses person than for example the UK NHS website.
As for the moral discussion, I think a part of me will always disagree with the notion that full disclosure even during protected, first time sex, is the only way to go. I have spoken to a gay friend of mine who turns out also has herpes, although never had symtoms again after an initial episode. He says in the gay community it is not a big deal at all, and he doesnt tell people until they get serious/decide to take off the condom. He saw no moral issue with it as it is more likely that the other person has it than him passing it on, and if it is passed on it is widely considered "no big deal".
I would never have a relationship with somebody without telling them, but I would have sex with somebody with protection without telling them that they could still get pregnant. Also I am sure we all kissed people although they or ourselves once had cold sores, without disclosing such a thing? I mean are we really supposed to live in a world where because I had a cold sore 10 years ago (I didnt, but let's assume) I need to warn everybody before we kiss?
Would we not all be happier, less stigmatized and also less traumatized by a diagnosis if it was more normal to have herpes and not such a big deal was made of it? If we accepted that having sex can result in it, and if we took precautions that are sensible given the odds at stake ... would that not be a better world to live in? Instead of pretending that I am now a danger to any potential partners? They might be, statistically, more of a danger to me (HPV, other std's) than I am to them. Again - the difference, or shall I say the curse, is that I know, as opposed to being blissfully unaware like 80% of people.
I just don't see how your approach is the ONLY helpful one. I don't see that as a carrier it is your sole responsibility to disclose a risk that otherwise is blissfully ignored by people at all times. Especially when I do everything reasonable to actually protect my partner.
Difficult times, difficult decisions. A week ago life was easier.
Let me re-iterate again that I have by no means made up my mind to not tell people about being hsv2 positive. I simply still fail to see that in all circumstances this is reasonable, appropriate behaviour, and I disagree that a blanket disclosure in all circumstances is the only thing to do.
Also, I am very aware, as you are yourself, as to how much of an impact a positive result can have, as I am experiencing these emotions myself. Strongly. It can feel quite devastating.
Because of this I feel it is even more important to separate fact from fiction and apply reason to what is essentially not a medical problem but a moral problem.
I will refrain debating on the numbers/facts of the disease is not an exercise I should undertake with somebody as yourself - you appear to have dedicated your life to researching into the matter so I must concede that your are more informed than I am, obviously. This of course doesn't change the observation I have made though that numbers such as transmission/shedding rates and factors of protection appear to be displayed differently on different websites. There is a discrepancy even between the official US numbers and for example the NHS numbers in the UK. There is a certain bias in how the information is presented - very matter of fact with conservative, out of context statements, or more progressive, helpful yet factual websites. One that I came across that was so much more nuanced and useful than any others - and I am sorry to say - maybe more helpful than your response:
http://www.herpes.org.nz/patient/facts.htm
Now that I have written this I am conceding, again, that I might be overreacting to responses as I am in emotional turmoil about my diagnosis. But I hope you can recognize on some level, even only personally, that this official government information is much more useful to a newly diagnoses person than for example the UK NHS website.
As for the moral discussion, I think a part of me will always disagree with the notion that full disclosure even during protected, first time sex, is the only way to go. I have spoken to a gay friend of mine who turns out also has herpes, although never had symtoms again after an initial episode. He says in the gay community it is not a big deal at all, and he doesnt tell people until they get serious/decide to take off the condom. He saw no moral issue with it as it is more likely that the other person has it than him passing it on, and if it is passed on it is widely considered "no big deal".
I would never have a relationship with somebody without telling them, but I would have sex with somebody with protection without telling them that they could still get pregnant. Also I am sure we all kissed people although they or ourselves once had cold sores, without disclosing such a thing? I mean are we really supposed to live in a world where because I had a cold sore 10 years ago (I didnt, but let's assume) I need to warn everybody before we kiss?
Would we not all be happier, less stigmatized and also less traumatized by a diagnosis if it was more normal to have herpes and not such a big deal was made of it? If we accepted that having sex can result in it, and if we took precautions that are sensible given the odds at stake ... would that not be a better world to live in? Instead of pretending that I am now a danger to any potential partners? They might be, statistically, more of a danger to me (HPV, other std's) than I am to them. Again - the difference, or shall I say the curse, is that I know, as opposed to being blissfully unaware like 80% of people.
I just don't see how your approach is the ONLY helpful one. I don't see that as a carrier it is your sole responsibility to disclose a risk that otherwise is blissfully ignored by people at all times. Especially when I do everything reasonable to actually protect my partner.
Difficult times, difficult decisions. A week ago life was easier.
You would be wrong to believe that I am in the minority in my view that everyone deserves the chance to determine whether they want to take a risk to their sexual health. I am not a health professional - I am a college professor with two decades of research into the virus, as well as a 19-year veteran of HSV with decades of running support groups for people with herpes. I've experienced firsthand the devastation a new diagnosis creates in patients, and for many of them, it's the betrayal of trust that causes a huge chunk of the emotional fallout. I have been told firsthand by newly-diagnosed patients that they want to take their own lives, to end the emotional pain of having herpes, and because they feel they are doomed to a life without love.
An important alert: not all sources of medical information that claim to be reliable are indeed reliable. The fact that a website contains the words "health," "herpes," "STD," or the like has the credentials to be considered reliable, nor do they always give accurate information.
The official statistic for protection from a condom is 30%. Here is Medscape's (WebMD) report from the 2009 NIH/NAIAD studies:
http://www.medscape.com/viewarticle/705724
I'd be happy to have you point out where my information differs from Dr. Hook's and others. Please provide links to reliable sources.
I did not give you any statistics regarding shedding, therefore there are no contradictions on those topics.
Statistics are meaningless. As you've admitted, there is not a zero risk, even after taking all the steps to reduce the risk. There is a possibility you will transmit it, in spite of your caution. That's all that counts. You imply that I should discount the worst case scenario, when doing so constitutes turning a blind eye to the possibility that it will happen to you. This is not scare-mongering, my friend - the worst case scenario exists. It is why we must disclose every time, out of respect to our partners. It is why Dr. Hook told you it was the right thing to do. Not doing so is lying. Insulting me and others who believe in sexual responsibility will not change that.
What you seem to be saying is that in spite of admitting the risk is not zero, you nonetheless want to insist that there is no way you will transmit the virus to a non-H partner if you take all the steps. I urge you to ask yourself what you will do if you do indeed infect someone who you failed to disclose to. If you can live with the possibility, then I have no more to say. Your behavior is your call. My opinion is of no consequence - only your own self-respect matters.
An important alert: not all sources of medical information that claim to be reliable are indeed reliable. The fact that a website contains the words "health," "herpes," "STD," or the like has the credentials to be considered reliable, nor do they always give accurate information.
The official statistic for protection from a condom is 30%. Here is Medscape's (WebMD) report from the 2009 NIH/NAIAD studies:
http://www.medscape.com/viewarticle/705724
I'd be happy to have you point out where my information differs from Dr. Hook's and others. Please provide links to reliable sources.
I did not give you any statistics regarding shedding, therefore there are no contradictions on those topics.
Statistics are meaningless. As you've admitted, there is not a zero risk, even after taking all the steps to reduce the risk. There is a possibility you will transmit it, in spite of your caution. That's all that counts. You imply that I should discount the worst case scenario, when doing so constitutes turning a blind eye to the possibility that it will happen to you. This is not scare-mongering, my friend - the worst case scenario exists. It is why we must disclose every time, out of respect to our partners. It is why Dr. Hook told you it was the right thing to do. Not doing so is lying. Insulting me and others who believe in sexual responsibility will not change that.
What you seem to be saying is that in spite of admitting the risk is not zero, you nonetheless want to insist that there is no way you will transmit the virus to a non-H partner if you take all the steps. I urge you to ask yourself what you will do if you do indeed infect someone who you failed to disclose to. If you can live with the possibility, then I have no more to say. Your behavior is your call. My opinion is of no consequence - only your own self-respect matters.
Lastly, I specifically asked Dr Hook about the shedding and your information contradicts his and many others. Also you claim 30% protection with a condom, others state 50%.my point is not a debate about the numbers, it is that there is a spectrum in which these discussions operate and you apply worst case thinking to all cases. I had one dot st the tip of my Penis for about 5 days. That's it. According to doctors shedding occurs mostly or completely where the outbreak occurs and a condom would cover me. Do you despite lack of practical evidence also suggest to not share towels etc?
It is almost scaremongering. Hsv is being mostly ransferred asymptomatic because people don't have sex when they have an outbreak. The idea that it happens frequently is of little relevance to the dangers involved, it just states when people have sex and when not.
It is almost scaremongering. Hsv is being mostly ransferred asymptomatic because people don't have sex when they have an outbreak. The idea that it happens frequently is of little relevance to the dangers involved, it just states when people have sex and when not.
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.
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.
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.
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.
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
http://www.medhelp.org/posts/STDs/HSV2-positive---need-some-clarification/show/2047755#post_9687516
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.
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.
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.
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.
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.
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.
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
