partner info

[infoquest]

I contracted genital herpes more than 20 years ago, but I never had a blood test to determine the type. From frequent monthly outbreaks, I would say I now have outbreaks one-to-four times a year, although I've gone for years without an outbreak. I recently began seeing someone and am concerned about the possibility of asymptotic transmission to him. I also need to educate him about the risk of transmission so he can make decisions about whether he wants to be intimate with me. When I was not sexually active, I attempted to control outbreaks with home remedies such as L-lysine. But now that I am seeing someone and want to have sex, I took my first dose of Valtrex, which my doctor has prescribed in a 500 milligram daily dose.

I want to take anti-virals to reduce transmission risk, and I will practice safe sex with condom use. Do all anti-virals reduce transmission risk, or is Valtrex the only one as is claimed by the manufacturer? Do I risk damage to my kidneys if I take this drug at a 500 milligram dose daily for long term use and is it effective long term? (I understand the study was for eight months, so there is no information on long-term effect after a year on Valtrex. What about other anti-virals? Since they have more track history, I wonder if I should switch to pill that's been out longer, as long as it also will reduce transmission risk?)

What does the research show on the reduction of asymptotic shedding of the virus with the use of Valtrex. I need this information to provide facts to my partner. I saw something somewhere in my hours of research on the Internet that researchers think 5 percent of time shedding occurs without Valtrex and it is reduced to 2.5 percent, but I don't think those numbers are quite accurate and can't locate that place again. Is there literature that will give me very specific and factoid-heavy information on this subject?

Finally, I would love for my partner to feel he can let himself go with me and love me all over my body. Right now he feels inhibited by fear of contracting herpes. I don't know how he will feel if I'm taking Valtrex because I can never tell him there is absolutely no risk that he would contract the disease despite condom use and my hyper-carefulness any time I feel a twinge, lower back pain, or an overwhelming urge to take a nap combined with the other symptoms that it is coming on.

Supposing he does feel okay about sexual penetration with condom, oral sex and touching my genitals poses an issue for him. I don't think I could bring myself to enjoy oral sex with a dental dam. (I don't get cold sores, so I haven't been concerned about giving him or other men herpes from oral sex, but I plan to get a blood test to better understand the type of herpes I have, etc., which may answer the question from whom I received it and maybe not from the boyfriend I blamed when the outbreaks were so frequent. He said he didn't have it, but I'm not sure there were blood tests back then. I wasn't offered one.) If I take Valtrex in a suppressive daily dose, what are the risks that  my partner will contract oral herpes from performing oral sex on me? Do I need to say, Hey, let's wash our hands! after it's all over if he touches my genitals during sex in order to avoid him transmitting it to himself? If he touches me and then himself, does he risk transmission to his genitals (assuming I'm taking Valtrex in daily dose). Would sex be so complicated that I will have worn myself out worrying about it before we even get there and lose this opportunity for a meaningful intimacy? Will a bottle of antibiotic ointment on the nightstand, one of those new clear jelly sort of kinds, rubbed on hands after sex, kill the stray herpes virus that might have gotten onto our hands during sex? If I touch my genitals, his lips, his penis, and his anus, might I spread my curse all over his precious body? Help!

[infoquest]

And waringblender, I use the word curse because, I don't know about you, but I would rather not have to interrupt getting to know someone and the development of romance to explain that I have genital herpes because things progress to intimacy. I take responsibility for informing a partner so that he can make the decision whether he wants to risk exposure, continue the relationship, or end it. And I know it's not that easy. Current beau says it's okay, but he doesn't know how he'll feel in bed, and in bed he feels freaked. I would rather not have herpes be the deciding factor or even a factor I consider in my romantic life. I was very careful in all sexual encounters -- STD testing, condoms -- but not careful enough. I don't care how informed you are, or how self-accepting, or how under control the herpes is -- and mine is -- it's still a pain in the labia. And I would rather my partner just be focused on the beauty between us rather than the biohazard, but I have to accept the responsibilities that come with sexual freedom and sexual responsibility and with my curse.

[infoquest]

Well, I educated myself as well as I could when I contracted the virus 20 years ago, and I don't believe I've given it to any partners because of my careful monitoring of symptoms and condom use, although I now read current thinking is that you can suffer from shedding and transmission when you don't have symptoms. That may not be news to you, but since I haven't had many sores in recent years, or frankly, many sexually partners, I thought I was covered. I am not saying he will get it on his fingers if he touches me when it is active, though. I'm asking if I touch my genitals or he touches my genitals and then touches his mouth or anus or genitals, is transmission possible? I appreciate your suggestion of blood tests for both of us. As I said in my earlier email, I've scheduled such with my doctor.

[infoquest]

I enjoyed your comparison to the one percent chance of being fired. I'll use that! Thanks for your detailed answer. That was most helpful on all points.
se

[gracefromHHP]

Valtrex is an acyclovir prodrug. Greatly simplified that means that you swallow valtrex and your body turns it into acyclovir.  Because of this unique delivery system you get more active acyclovir into your body with valtrex than you do with regular ole acyclovir ( 55% vs 15% ).  Because it packs a bigger punch at one time - you don't have to take it as often. Otherwise it's the same medication as good ole el cheapo acyclovir.  We have info on acyclovir being taken suppresively non-stop for over 20 years now by folks.  The only reason why it's not available otc is because the medical profession is afraid that folks will mistake syphillis as being herpes and treat it on their own and suffer the effects of untreated syphillus ( herpes can't hold a candle to syphillis that goes untreated ).  You can even successfully argue that acyclovir/valtrex is safer to take than tylenol is.  No worries about taking it long term.  Also you are mistaking the valtrex and transmission study that only went for 8 months as being a study that looked at the safety of taking valtrex long term - that study wasn't looking at that - the safety was already established many years ago.  Wonderful article on the long term safety of herpes antivirals by dr stephen tyring on pubmed if you want more reading.

We have info on valtrex and famvir as far as reducing the risk to a partner. We don't have specific studies on acyclovir because it's off patent so frankly there's absolutely no money to be made doing so.  The only way we'll see that study is if some benevolent institute conducts the study for the purpose of determining it's usefulness in protecting folks in under developed countries ( are you listening bill gates!!! ).  Valtrex shows superiority in protecting a partner over famvir.  We assume the results would be similar to valtrex with acyclovir but as I said that's an assumption. Anything that reduces viral shedding in general helps to reduce transmission to a partner.  

When it comes to sex - as long as you are thinking of yourself ( or your partner is thinking of you ) as a walking biohazzard - how could you enjoy it?  If you and your partner did nothing but avoid sex during obvious symptoms in yourself - he is 96% likely on average each year not to contract hsv2 from you.  Daily suppressive therapy with valtrex cuts that in half. condoms along with all that and it's a 99% chance each year on average that he WON'T contract hsv2 from you.  If a fortune teller told you that there was a 1% risk that if you went to work today you'd be fired - would you call off work and hope to avoid it?  I doubt it - especially if you had to take that day unpaid ;)  Don't let the IDEA of having genital herpes control your life or your sex life.  Use common sense - avoid sex whenever things don't feel right down yonder.  The risk of your man contracting your herpes will always be far, far, FAR lower than the risk of contracting it no matter what sexual contact you are having.

grace

[waringblender]

The first thing that needs to happen is both of you need to get blood tests for both types of herpes. It's possible this guy already has one or both types, and until both of you know which types you have, you can't make any decisions about antiviral therapy or protecting one another. So do that first.

You are asking some very basic questions about herpes and it sounds like you really need to get up to speed on how and when the virus is transmitted with and without medication. You can find tons of information in the Archives of the STD-Expert side of this forum to get your questions answered.

Essentially, taking daily medication will decrease shedding at least 50%, but it probably works even better than this. There are no documented cases of somebody getting herpes on their hands or fingers by touching the genitals of an infected person. With medication, there is zero risk. Oral sex is considered safe sex as long as you don't have a visible outbreak. On medication, again, the risk is too low to even worry about.

Calling your herpes a "curse" is a bit over the top, don't you think?

Start doing some reading about herpes transmission on and off the medication, and both of you get blood tests for both types, and take it from there. I'd start on the doctor side of this forum. There are plenty of threads in the Archives over there to answer all your questions.