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Avatar universal

Percentage risk of passing on HSV2


I was diagnosed with HSV2 last week and am really confused. I've been doing research and can't really seem to find an answer to (what seems like) simple questions:

1. If I am taking regular suppression therapy and using condoms (i'm male and gay) what is the likelihood (%) of my passing on HSV2 to my partner?
2. They say that skin to skin contact can transmit during asymptomatic viral shedding periods. Is this any skin in the genital region, or just mucosal skin?
3. If I'm on suppression therapy what is the likelihood of my passing HSV2 to my partner's mouth during oral sex?
4. Does shedding during suppression therapy release a lot less of the virus than non-suppression therapy. Is it possible to have a small amount of virus on the skin and not transmit this to a HSV2-negative partner?
5. I got my very first symptoms ever 20 days after my last sexual encounter (unprotected receptive anal). I never noticed symptoms before so does this point to the fact that this is when I got it? Or could I have had it for quite a while and just had an outbreak over the last week during stress?
7 Responses
Avatar universal
in regards to point 5, the reason that I ask is that I'm 37 and have had sex with over 400 guys (although rarely unprotected receptive anal) and just assumed that I had the HSV2 virus already and was just asymptomatic. Guess not!

In some ways I'm answering my own first question and that is it's not that easy to catch if you're being safe :\

Thanks for your time :)
101028 tn?1419606604
if you've never been tested for herpes before, no way to know if it was a newly acquired infection or not. what testing was done to diagnose you this time?

we don't have stats for transmission for male to male unfortunately.

skin on skin contact means the softer mucosal skin in the genital area - penis and anal contact for the most part in males.

the risk of transmission to the oral area is overall low. if it's not a regular partner, we always recommend protected sexual contact.

having hsv2 increases your risk of contracting hiv. If you have multiple partners instead of just one regular partner, be sure you are always having protected sex!!

Avatar universal
Thanks Grace

A genital swap was taken from the blister and came back as HSV2+. I'm not going to be unsafe again (lesson learned) but I have met someone really special - unfortunately he's freaking about contracting it (even safe) and wants to know what the actual risk is and I can't give him answer :(
101028 tn?1419606604
overall the risk of transmission is low. we just don't have stats for same sex couples.  

has your new partner been tested yet? if not, that's your next step. the rates of herpes infections in gay males are overall very high.
Avatar universal
OK - sorry for the multiple postings, I wasn't watching where I was posting to.

This is relevant to what you said about "rates of herpes infections in gay males are overall very high" ...

I see from the forum that Dr. Handsfield has estimated the percentage of gay men with HSV-2 at around 40-50%. I have to admit see that statistic does make me feel better about my own HSV-2 positive status, but I can't find any studies that can corroborate this statistic.

I did find this one in Sydney (a major gay city) that showed the prevalence not that much different from the general population: around 23%.


It was also interesting to note that HSV-2 acquisition during the course of the study (over ~5 years) was only 2%.

I guess I'm in two minds about this statistic: although it would be some comfort to know that the rate in the gay community was higher and that my chances of finding a partner is greater, on the other hand, this rate of acquisition shows that if I take precautions that my chances of transmitting it aren't that much greater than the general population.

Many thanks
101028 tn?1419606604
many studies on pubmed on rates of hsv2 infections in MSM and I've seen them as high as 60% even.  

correct - we recommend precautions because they work :)
Avatar universal
OK, with respect, I've found the HSV2 rates of most gay men to be just slightly higher than the general population in developed countries.

The exceptions are MSM in developing countries, drug users and HIV+ men where the HSV2 rates can be between 50-60%.

But of course the majority of the gay population in developed countries DOESN'T have hiv, so now it's making sense why most of the figures I'm seeing in PubMed for the general gay population are between 18-27% (just a few are a little higher) which seems to be only just a little higher than heterosexual females.  

Once again, I think this bodes well for "the talk" that I have to give to my future partners. If condoms weren't that effective at protecting against HSV2 then with 1/4 men having HSV2 and this group apparently shedding the virus asymptomatically 10% of the time, via protected sex  (which lowers the risk by just 50%), then this would make the risk:

0.25 x 0.10 x 0.5 = 1.125%. Of course this assumes 100% transmission which is never the case. Other things like lack of abrasion, heat and friction probably make the risk much, much lower than this.  
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