Loosening of Herpes Saftey Measures

[B_Baldwin]

My girlfriend has had genital herpes for nearly a decade. She's has had multiple long-term partners since acquiring it, had sex with some of them without ever using barriers (one man for 4 years straight), and never gave herpes to anyone. She only gets one small lesion on her perineum about twice a year and is very sensitive to its onset, predicting it far in advance. She is in exceptionally good health with a strong immune system and always takes an antiviral. Although we always use a condom, we recently went without one in the shower (she has an IUD). We're considering doing this again on occasion, provided she's symptom-free, since it seems incredibly low-risk, especially given her past. But I have a questions:

1) If she were to transmit herpes through asymptomatic shedding, would this be strictly due to my contact with the small spot on her perineum were she consistently feels an onset? If so, would taking special precaution with that particular bodily area (i.e. avoiding it or covering it) help prevent transmission?

2) If the latter is true, would I be able to safely give her oral sex on the upper and mid vulva?

3) Would sex in the shower further help prevent transmission by being able to clean off the mucus membranes quickly?

Thank you.

[B_Baldwin]

Thank you, Grace. But as far as what precisely causes transmission, would friction specifically on the spot in which she has a small outbreak (her perineum) be the only cause of transmission? If so, would some form of barrier on that particular spot help prevent it? And since that's in such a tucked away area, would oral sex be an incredibly low-risk act?

[gracefromHHP]

and no, showering doesn't reduce risk - the virus doesn't just lay on the skin - the heat and friction of the sex act causes it to be shed.

[gracefromHHP]

if you did nothing but avoid sex any time she has anything going on genitally you'd be 96% likely each year not to contract hsv2 from her.  if you use condoms and she takes daily suppressive therapy on top of that, on average you'd be 99% likely each year not to contract hsv2 from her.  totally up to the two of you what precautions you want to take. make sure that you have both also covered other std testing too and discuss if hpv prevention is important to you both or not too.

[B_Baldwin]

Yes, Grace, she has HSV2.  Sorry for not specifying.

[gracefromHHP]

did you ever find out more details about if she has hsv1 or hsv2 and such as I recommended back in the fall when you posted?

grace