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HSV-2 Prevention
I have been dating someone who has HSV-2. I am negative. I would prefer that status remain. In that spirit, my partner is taking valcyclovir daily and sex is performed using a condom. I understand that this is useful for prevention, but not of course 100%, because currently condoms do not cover the base of the penis or the scrotum or the upper pubic area (and all of these are places one can get hsv-2?).
Nothing is 100%, but I want to make the odds even better of not contracting hsv-2. Therefore, I have been 1) not shaving my pubic hair, which I presume provides somewhat of a natural barrier to skin contact and absorbs some virus containing moisture (upper pubic area protection). 2) Wearing boxers, as I have come to understand by looking at some forums that hsv-2 can be contracted liberally in the "boxer area" (protection for upper pubic area, base of penis, and scrotum). 3) Showering after sex, as I read in one article that soap disables the hsv-2 virus (and of course, I am washing carefully, not scrubbing hard so as to not make micro-tears). And no sex during an outbreak.
Am I 1)doing everything I can or is there more I could do to prevent transmission? 2) Are any of the above behaviors actually NOT recommended, which is to say do they increase rather than reduce risk? 3) Are any of those methods neutral, do they not reduce or increase risk? 4) What timeframe after an "outbreak" that sex can resume? And when is an "outbreak" over? 5) If washing after sex can reduces risk, what is the best way? 6) Are there certain ways of having sex that can reduce transmission, like going slow or are there certain more or less dangerous positions? I saw previously a comment that the boxer strategy was overkill, but I could never square that with the criticism of condoms that they don't provide enough coverage? I believe in that post it largely rejected as un-fun, but I'm willing to make the sacrafice IF it could reduce transmission. Is there more my partner can do?
Nothing is 100%, but I want to make the odds even better of not contracting hsv-2. Therefore, I have been 1) not shaving my pubic hair, which I presume provides somewhat of a natural barrier to skin contact and absorbs some virus containing moisture (upper pubic area protection). 2) Wearing boxers, as I have come to understand by looking at some forums that hsv-2 can be contracted liberally in the "boxer area" (protection for upper pubic area, base of penis, and scrotum). 3) Showering after sex, as I read in one article that soap disables the hsv-2 virus (and of course, I am washing carefully, not scrubbing hard so as to not make micro-tears). And no sex during an outbreak.
Am I 1)doing everything I can or is there more I could do to prevent transmission? 2) Are any of the above behaviors actually NOT recommended, which is to say do they increase rather than reduce risk? 3) Are any of those methods neutral, do they not reduce or increase risk? 4) What timeframe after an "outbreak" that sex can resume? And when is an "outbreak" over? 5) If washing after sex can reduces risk, what is the best way? 6) Are there certain ways of having sex that can reduce transmission, like going slow or are there certain more or less dangerous positions? I saw previously a comment that the boxer strategy was overkill, but I could never square that with the criticism of condoms that they don't provide enough coverage? I believe in that post it largely rejected as un-fun, but I'm willing to make the sacrafice IF it could reduce transmission. Is there more my partner can do?
MEDICAL PROFESSIONAL
Our space and time for replies are limited. The following brief responses will need to finsih this thread.
Wearing boxers won't hurt. Do I think it will help- no.
Soap DOES deactivate HSV however the scenario described in your what if question about washing deals with something that just has not been studied; I would not worry about "rubbing the virus in" in your sleep.
No one has timed the survival time of HSV on skin. The observation and data from animal models suggests that the virus needs to be worked into the skinto cause infectionand that soon (seconds) after exposure to drying it begins to die, becoming less infectious.
End of thread. EWH
Wearing boxers won't hurt. Do I think it will help- no.
Soap DOES deactivate HSV however the scenario described in your what if question about washing deals with something that just has not been studied; I would not worry about "rubbing the virus in" in your sleep.
No one has timed the survival time of HSV on skin. The observation and data from animal models suggests that the virus needs to be worked into the skinto cause infectionand that soon (seconds) after exposure to drying it begins to die, becoming less infectious.
End of thread. EWH
In addition:
It occurs to me, having posed the above, that perhaps I do not well understand some things about the virus. Maybe it does not live long enough on the skin to be massaged in after sex? How long does the virus last intact on the skin?what is known about the virus? I believe you quoted on another thread that if someone is doing the standard prevention (vacyclovir, condom, avoiding outbreaks) that the odds are about 1/1000? something about how low that figure is suggests to me that it should be easierr to get it even lower, that the virus is fairly weak, or that the trauma to the penis must be substantial. Let me know if I'm barking up the right tree here and again thank you for your patience.
It occurs to me, having posed the above, that perhaps I do not well understand some things about the virus. Maybe it does not live long enough on the skin to be massaged in after sex? How long does the virus last intact on the skin?what is known about the virus? I believe you quoted on another thread that if someone is doing the standard prevention (vacyclovir, condom, avoiding outbreaks) that the odds are about 1/1000? something about how low that figure is suggests to me that it should be easierr to get it even lower, that the virus is fairly weak, or that the trauma to the penis must be substantial. Let me know if I'm barking up the right tree here and again thank you for your patience.
Hi Doc,
Sorry it has taken me so long to reply, I was very bust this weekend. And than you again for your timely, thorough responses!
Okay: "I f you want to wear boxers do it."
So, are you saying that their could be some value? Like I said, I really want to avoid getting hsv-2. I understand that you and Dr. Handsfield believe it isn;t a big deal, and I get that, but unfortunatley a lot of people do not share that enlightened opinion and I don't want to have to go through the emotional rejection for potential future partners. I hope you understand.
On the soap subject. I guess one of my worries about not showering is the possibility of friction happening after sex. For instance, What if I'm laying in bed and roll over to sleep with virii still covering me and accidentally rub it in? Wouldn't it therefore still be good to shower so as to wash, perhaps just by the action of the water and not the soap, the virii away? Or, is that not how it would work? And also, just to clarify, I take it that you don't believe that soap deactivates the virus? Or you do, but you aren't concerned that moving around in bed after the fact could produce the necessarry friction? Thank you for your patience, I just have to know the answers to this. I want to see this girl, but I have to remain hsv-2 free. And any other advice, even if it seems like overkill, that you could add to further reduce my chances of infection would be greatly appreciated.
And what the heck, while I'm at it, I wonder if other readers like my self, would be interested in a few lines about any recent research you might be aware of concerning recent science about the possibility of a cure, or a vaccine, on the horizon. Thank you Doc!
Sorry it has taken me so long to reply, I was very bust this weekend. And than you again for your timely, thorough responses!
Okay: "I f you want to wear boxers do it."
So, are you saying that their could be some value? Like I said, I really want to avoid getting hsv-2. I understand that you and Dr. Handsfield believe it isn;t a big deal, and I get that, but unfortunatley a lot of people do not share that enlightened opinion and I don't want to have to go through the emotional rejection for potential future partners. I hope you understand.
On the soap subject. I guess one of my worries about not showering is the possibility of friction happening after sex. For instance, What if I'm laying in bed and roll over to sleep with virii still covering me and accidentally rub it in? Wouldn't it therefore still be good to shower so as to wash, perhaps just by the action of the water and not the soap, the virii away? Or, is that not how it would work? And also, just to clarify, I take it that you don't believe that soap deactivates the virus? Or you do, but you aren't concerned that moving around in bed after the fact could produce the necessarry friction? Thank you for your patience, I just have to know the answers to this. I want to see this girl, but I have to remain hsv-2 free. And any other advice, even if it seems like overkill, that you could add to further reduce my chances of infection would be greatly appreciated.
And what the heck, while I'm at it, I wonder if other readers like my self, would be interested in a few lines about any recent research you might be aware of concerning recent science about the possibility of a cure, or a vaccine, on the horizon. Thank you Doc!
MEDICAL PROFESSIONAL
The effect of valacyclovir is likely to be fully effective in a day or two after starting it.
The boxer short issue is debatable, except for the data on distribution of lesions and recurrences. I f you want to wear boxers do it.
As for washing soap, again this is someone's guess. I doubt that it has much effect- surface contamination with HSV occurs regularly but does not cause infection- it si the friction that works the virus into the skin to cause infection. That soap kills the virus is irrelevant- if you were exposed and the virus had been worked into your skin to cause infection, soap is not going to undo it.
Try to relax. You're ding things right- keep it up. Don't worry. If you were to get HSV, it is just not that big a deal. EWH
Also, found this article:
http://www.examiner.com/article/anti-bacterial-soaps-don-t-kill-viruses-a-method-that-does-works-well
Nonsense or good practice to kill hsv-2?
http://www.examiner.com/article/anti-bacterial-soaps-don-t-kill-viruses-a-method-that-does-works-well
Nonsense or good practice to kill hsv-2?
Hi Doc,
Thanks for the quick reply. Okay~
I had a blood test about 3 months ago which came back negative. I had been seeing her then for about 6 months.
To answer your second question, she reports that she had mild outbreaks (usually one small lesion) about 3-4 times a year and I believe she was infected about 3 years ago. Apparently her initial outbreak was very bad. On the vacyclovir, I believe she is not having outbreaks at all (though she was briefly off the meds once, and had a recurrence). As an additional question, for purposes of not transmitting hsv-2, how long does one have to take vacyclovir for it to be effective?
So, I am still confused though Doc. I understand what you are saying about recurrence in the boxer area, but is that not where hsv-2 can infect as well? It seemed logical to me (and I take your distinction about logical vs. proven) that if I can get hsv-2 on my scrotum or above my penis or my buttocks, and if hsv-2 is spread by skin to skin contact, then preventing skin to skin contact, say, with boxers can prevent transmission.
On the showering issue, I believe I found the link suggesting it that I had read: http://www.asheris.net/health/FAQ.html
The relevant quote: "Wash thoroughly with soap and water after sex; virii aren't very strong. Soap and hot water kill and/or wash away the herpes virus if it hasn't already made it through a break in your skin."
So, that doesn't square? and showering is neutral you suspect? If there is risk in showering, what form would it take?
Like I said, I'm trying to get my % chance down to almost nothing.
Thank you!
Thanks for the quick reply. Okay~
I had a blood test about 3 months ago which came back negative. I had been seeing her then for about 6 months.
To answer your second question, she reports that she had mild outbreaks (usually one small lesion) about 3-4 times a year and I believe she was infected about 3 years ago. Apparently her initial outbreak was very bad. On the vacyclovir, I believe she is not having outbreaks at all (though she was briefly off the meds once, and had a recurrence). As an additional question, for purposes of not transmitting hsv-2, how long does one have to take vacyclovir for it to be effective?
So, I am still confused though Doc. I understand what you are saying about recurrence in the boxer area, but is that not where hsv-2 can infect as well? It seemed logical to me (and I take your distinction about logical vs. proven) that if I can get hsv-2 on my scrotum or above my penis or my buttocks, and if hsv-2 is spread by skin to skin contact, then preventing skin to skin contact, say, with boxers can prevent transmission.
On the showering issue, I believe I found the link suggesting it that I had read: http://www.asheris.net/health/FAQ.html
The relevant quote: "Wash thoroughly with soap and water after sex; virii aren't very strong. Soap and hot water kill and/or wash away the herpes virus if it hasn't already made it through a break in your skin."
So, that doesn't square? and showering is neutral you suspect? If there is risk in showering, what form would it take?
Like I said, I'm trying to get my % chance down to almost nothing.
Thank you!
MEDICAL PROFESSIONAL
Welcome to the Forum. Let me start by congratulating you on your thoughtful and level-headed approach to HSV-2 prevention. You are doing things right and they will dramatically reduce your risk for infection. Before I address your question, so I can give you as comprehensive a response as possible, can you tell me if you have had a blood test for HSV (since some people have the infection and do not know it. If this were the case, there would be no need for precaution if you were both infected with the same virus types) and, secondly, whether or not your partner had clinically obvious recurrences before he stated taking the valacyclovir.
Also, before I answer your specific questions, let me tell you that while we probably know more about genital HSV transmission than any other STI, there are still gaps. Where this is the case I will try to tell you but would also point out that this is something that Dr. Handsfield and I have discussed thoroughly and our belief is that our guesses are probably better than most. On to your questions:
1)doing everything I can or is there more I could do to prevent transmission?
You are doing great, and perhaps doing more than you need to. I will address this in my answer to 2. below.
2) Are any of the above behaviors actually NOT recommended, which is to say do they increase rather than reduce risk?
There is a difference between "recommended", "proven" and "logical". Condoms, valacyclovir and avoiding sex during recurrences are all of proven value and together reduce the average risk for transmission/acquisition by well over 50% from the about 7% transmission rate that occurs without use of these measures. Not shaving is logical- shaving can inoculate the skin.
Wearing boxers however is not proven. I think you may have misunderstood the knowledge that HSV can recur anywhere in the "boxer short" area once a person is infected. This is a reflection of where the nerves infected preferentially by HSV go. I cannot think of a logical reason why wearing boxers should reduce transmission.
The benefit of showering is unknown.
3) Are any of those methods neutral, do they not reduce or increase risk?
See above. I suspect the showering may be "neutral" (not studied).
4) What timeframe after an "outbreak" that sex can resume? And when is an "outbreak" over?
The virus can be present on the skin at any time during an outbreak. Most experts recommend waiting to resume sex until the lesions of a recurrence are completely healed (your partner should not be having many outbreaks if he is taking the valacyclovir every day).
5) If washing after sex can reduces risk, what is the best way?
See above. Unknown benefit. I certainly would not "scrub" however for the reasons you outline
6) Are there certain ways of having sex that can reduce transmission, like going slow or are there certain more or less dangerous positions?
Just trying to avoid too much trauma which could cause abrasions.
Again, let me congratulate you on what you are doing. I anticipate it will help you to prevent acquiring infection. EWH
Also, before I answer your specific questions, let me tell you that while we probably know more about genital HSV transmission than any other STI, there are still gaps. Where this is the case I will try to tell you but would also point out that this is something that Dr. Handsfield and I have discussed thoroughly and our belief is that our guesses are probably better than most. On to your questions:
1)doing everything I can or is there more I could do to prevent transmission?
You are doing great, and perhaps doing more than you need to. I will address this in my answer to 2. below.
2) Are any of the above behaviors actually NOT recommended, which is to say do they increase rather than reduce risk?
There is a difference between "recommended", "proven" and "logical". Condoms, valacyclovir and avoiding sex during recurrences are all of proven value and together reduce the average risk for transmission/acquisition by well over 50% from the about 7% transmission rate that occurs without use of these measures. Not shaving is logical- shaving can inoculate the skin.
Wearing boxers however is not proven. I think you may have misunderstood the knowledge that HSV can recur anywhere in the "boxer short" area once a person is infected. This is a reflection of where the nerves infected preferentially by HSV go. I cannot think of a logical reason why wearing boxers should reduce transmission.
The benefit of showering is unknown.
3) Are any of those methods neutral, do they not reduce or increase risk?
See above. I suspect the showering may be "neutral" (not studied).
4) What timeframe after an "outbreak" that sex can resume? And when is an "outbreak" over?
The virus can be present on the skin at any time during an outbreak. Most experts recommend waiting to resume sex until the lesions of a recurrence are completely healed (your partner should not be having many outbreaks if he is taking the valacyclovir every day).
5) If washing after sex can reduces risk, what is the best way?
See above. Unknown benefit. I certainly would not "scrub" however for the reasons you outline
6) Are there certain ways of having sex that can reduce transmission, like going slow or are there certain more or less dangerous positions?
Just trying to avoid too much trauma which could cause abrasions.
Again, let me congratulate you on what you are doing. I anticipate it will help you to prevent acquiring infection. EWH
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
