Herpes HSV2 Transmission Statistics

[utboi23]

Hello,

I am a gay male that was diagnosed with HSV 2 in 2004 or 2005.  I made the mistake of having unprotected sex with a man who I believe did not tell me he had herpes.  I also made the mistake of not washing my penis after having sex and I'm uncircumsized--all things which probably led to my transmission.  I'm thankful not to have contracted HIV.

Since then, my recurrence rate when not medicated is pretty frequent.  Unmedicated, I probably have an outbreak about once a month or so.  Instead of episodic therapy, I take Valtrex daily as suppressive therapy and it works.  I do not have any outbreaks, so long as I don't forget to take it.  If I miss 2 or 3 days in a row, I get the "symptoms" that tend to lead to an outbreak, and then, when I take it again, the symptoms tend to go away or I get a very small outbreak.

This has severely affected my sex life (in a positive way, really).  I do not have one night stands like I used to, but I also fear dating.  My question is in regards to transmission to an uninfected partner.  What is the data on transmission when I am on Valtrex, we have anal sex (let's say he's receptive) with a condom, and we don't have sex when I have an outbreak?  

Also, my biggest fears are:

-him contracting it during foreplay when we're not using condoms and our penises touch
-him contracting it during sex somehow that I don't know (my sores have only been on the head and very upper shaft, so the condom covers those areas)
-him getting oral hsv2 (which I understand is so rare, that it hasn't been documented)

I think that hits all areas I should be concerned with, right?  I used to be fearful of telling my partner, but at this point, I'm prepared (once I get THIS information).

Your comments and information would be greatly appreciated.

[troy935]

Hi, please tell me: is it possible to do a test for hsv2, if there is no any outbreak and nothing is showing up, if hsv2 is ''hidden''? thanks, Troy.

[gracefromHHP]

Unfortunately we do not have stats on gay couples and transmission.  In heterosexual couples, the rate of infection to a male is about 4% /year on average if all you do is avoid sex during obvious genital symptoms.  Daily suppressive therapy reduces it by half and along with condoms takes the risk down to 1%/year.  At this point we don't have studies in gay couples to see how they compare.  

Since you get recurrences so often, I recommend taking either valtrex 500mg 2x/day or 1gm daily as your suppressive therapy.  You should get better relief on those doses.

washing up after sex just makes you smell better. It doesn't reduce your std risk.  

when you have an ob - you are shedding the virus from the area of the lesion as well as from the anogenital aera. Avoid sex completely when you have an ob. Same as when you are asymptomatically shedding the virus in between obvious lesions, you periodically shed from the anogenital area - not just where you usually get lesions or just the penis.

Your partners can contract hsv2 orally.  It happens but just not as often as it does genitally. if your partner performs oral sex on you with a condom, the risk is also lowered.

having hsv2 increases your risk of acquiring hiv. Be sure to talk to partners about their status and when they were last tested.  Also they should be tested for herpes too - about 60% of gay males is hsv2+ so why take the blame for transmitting to a partner if they already had it and never knew it.

keep asking questions as you think of them - just add them to this same post :)

grace