If oral HSV1 is so common, then why is GHSV1?

[movingonnnow]

Since discovering I have GHSV1, I have been doing a lot of research on the internet (not sure if that is the right thing lol).

Here is what I seem to have found out.

1. Oral HSV1 is so common, somewhere from 50% up to 90% of the population in positive from what I read. I read that if you have oral, you are very unlikely to get it genitally. But how come GHSV1 is becoming so very apparent, and from what I believe, it is more common than GHSV2?

There seems to be so much confusion about transmission of this disease. There is such a grey area from what I read.

For example, I have spoken to a nurse who hasn't got GHSV2, but her boyfriend of 4 years has. They don't use protection. She has never gotten it, and neither did his ex wife of 25 years. Huh? And i have read that this is the case for many couples...
Yet I found out a good friend of mine has GHSV2. She has only had a few boyfriends and from what she can recall, she can never remember any of them has any sore when they were intimate.

How can this be?

2. Condoms have proven to prevent the transfer of this disease.  When I have had the only 2 OB (from what I recall only 2 in the last 6 years - I am not sure how long I have had it), I don't understand how condoms can protect a man from getting it from me when OB hasn't been internal, but external. One was severe, the other wasn't and I never saw it coming. Had I had a partner, I could've given to him, as I couldn't see any signs.

3. Please do you have any links about the studies that have been done about the transfer of GHSV1. There seems to be so much for GHSV2 but not much for the other.

4. If I was to have a partner in the future, I don't know what to say to him re: transmission. All I can see is that there is a good chance that he will get it, and there is also a good chance that you won't. I can't find any studies or evidence of anything about it.

5. And if the transfer of genital to genital is so very low, like I have seen you reply in a few threads, why is it that I have read on forums that some people only got it via intercourse, as they never had oral sex? I am not questioning your answers, you are a doctor, but how can people be getting it when no oral sex occured?
Is there any proof/evidence that if you are positive to oral, that you are very unlikely to genitally?

6. Both OB, I was on Antibiotics. Does antibiotics make it worse? Funny too that apparently the side effects of antibiotics, is 'thrush'. I wonder if a lot of people are actually getting symptoms of GHSV1...

Sorry for so many questions, but I am trying to come to terms with this so I can move ahead.
I don't want to ignore my questions, and want to be aware of what I have so I can make the right decisions in the future.

Many thanks for your time.

[movingonnnow]

Wow, so really if I have sex with my partner out of the dozen days, (which is once a month, so it does sound a lot!) he will likely get it?

This is SO confusing!

[gracefromHHP]

Actually very little of the areas the virus is shed from is protected by condoms. Condoms offer about a 30-40% reduction in transmission. They help but not 100%.   also it doesn't matter where you get ob's at. You shed the virus from the entire anogenital area when you are shedding it. with hsv1, that happens very infrequently though - less than a dozen days out of the year on average.

You don't know when you are shedding in between obvious lesions. that's why it's called asymptomatic viral shedding - shedding without symptoms.

all really good questions - keep asking as you have them :)

grace

[movingonnnow]

Thanks for your reply.

My questions about condoms - how can they prevent transmission if the area that i get OB is outside the vagina, where condoms won't protect a man.

How will I know when I am shedding? How often does shedding occur with GHSV?  So far I haven't really known if I was, because there has only twice in the last 6 years been a bit of pain down there.

Many thanks again, I appreciate you taking the time to reply

[gracefromHHP]

1 - in the US, we don't reach the 60% infected with hsv1 mark nowadays until we are in our 40's. About 1/3 of us have hsv1 as teens/early 20's so many of the folks we are having oral sex with, don't already have hsv1 orally to protect them at that age.  That's why hsv1 is the cause of 70% of all newly acquired genital herpes cases in that age range.

- most discordant couples stay that way as long as the partner infected is aware of their infection.  Just avoiding sex during obvious ob's, puts the odds way in favor of not contracting it. Not perfect by no means but it really does help to know you are infected and to avoid sex anytime something is going on genitally.   My favorite example of this is auntijessi here on medhelp's std forums.  Her bf had hsv2. Many years into their relationship, he got his penis stuck in his zipper. Knowing it was a zipper accident, they didn't realize that it could trigger herpes to shed so they had sex once he felt less pain.  A week later, she had hsv2 after years of unprotected sex with him and him not being on suppressive therapy.

2- could you please clarify your question for me? I'm really not sure what you are asking.


3 - www.pubmed.gov

4- odds are a partner isn't going to contract hsv1 genitally from you. it doesn't shed very often. if he is also hs1 + himself, he's significantly protected.

5 - prior studies have shown that about 10% of all genital hsv1 infections are from genital sex. it happens but not very often.   If you are having sex when someone is actively shedding the virus, you are at risk.  

6-  sometimes just being ill in general will trigger recurrences. antibiotics themselves are not a trigger.  If you aren't sure if it's yeast or herpes, a quick trip to the clinic can sort that out for you.  They can examine your vaginal secretions under the microscope to look for yeast, do some simple bedside ph testing and a whiff test and/or send off a sample to the lab to look for yeast.