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Likelihood of transmission from protected anal sex with condoms?

I just tried posting this but i don't think it went through:  
had receptive anal sex with a partner at the end of June (condom protected). He then had his first HSV 2 outbreak back in mid July on his penis shaft; I got tested shortly after and that test came up negative, so i'm reasonably sure he didn't get it from me. His last recent partner also went and get tested and came back negative, so unless the tests were false negatives (or someone is lying), we're reasonably sure the infection has to be at least a year old.

I really care for this person and would like to have sex again, but since I've been confirmed HSV2 negative, I also don't want to put myself at unnecessary risk. He doesn't want to use antivirals unless he has another outbreak, which i understand, so the only precautions we would use are condoms. What is the likelihood of me contracting it given this situation or is that impossible to estimate?
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207091 tn?1337709493
COMMUNITY LEADER
Hi :)

Unfortunately, we don't have same sex transmission stats. We know, generally speaking, that men who have sex with men, have higher rates of STD transmission than any other group, but exactly how much higher the transmission is for herpes, we don't know.

Assuming you're using lube and condoms, it's probably not that much higher than male-to-female transmission, which we do know.

The transmission rates for hsv2, male to female, over the course of a year, assuming sex 2-3 times a week:

Only avoiding sex during an outbreak - 8-10%

Adding condoms OR daily suppression - 4-5%

Adding condoms AND daily suppression - 2-3%

Is there a specific reason he doesn't want to take antivirals? Anything I can help with there?

I'm glad you've found someone you really like. :)
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4 Comments
Well doesn't think they're necessary since he's only had one outbreak in the however many years he's had it, so we assume that means he's less contagious than someone who has multiple outbreaks a year. I'd feel more comfortable with suppressive therapy obviously, but there's a big difference between cutting the risk in half from 8-10% and cutting the risk in half from 4-5% or something smaller. So I don't know how to approach that conversation.
He wants to determine how many outbreaks a year he has since getting the first one before jumping on suppressive therapy
It doesn't mean he is shedding less. People with fewer outbreaks shed the same as those with more outbreaks.

You're in a tough spot, I know. I know you don't want to make him feel like a big walking, talking contagion, but on the flip side, does he know about asymptomatic shedding? It also doesn't matter how many outbreaks he has, at least as far as suppression goes. There aren't any guidelines for it pertaining to frequency of outbreaks, and simply wanting to go on it should be enough for doctors, especially if you're in a discordant relationship.

You're allowed to have questions and concerns, and allowed to discuss those with him. He's also allowed to share his. Maybe set some time aside just to talk about that, so it's not lingering? This is all very new for you both, and there are bound to be questions and concerns.
Oh and I can't remember if I've ever given you this link, so I'm sorry for it if I have, but maybe you can both read this -

https://westoverheights.com/herpes/the-updated-herpes-handbook/

That's the Herpes Handbook written by Terri Warren, one of the leading experts on herpes. It's free. :)

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