A common partner question re: HSV

[rrr123]

Dear Doctors,

I wanted to ask one more question...which is in turn a question that I get asked very often by new partners after I disclosed my HSV-2 status. Does mutual masturbation pose much risk in the transmission of HSV-2? What I have been telling my partners is that DIRECT genital contact could pose a risk, but indirect exposure (genital to hand to genital, that type of thing) would most likely not. Is this pretty much correct?

The thing that makes this difficult for me is that when I have outbreaks they are TINY, and I don't notice them until the scabs appear. What if my partner was touching my genitals and then proceeded to touch his own genitals with the same hand while I was having an unnoticed outbreak? Would fluid from an unnoticed outbreak pose a threat? Or is herpes the kind of virus that dies very quickly in air or or on hands? There are definitely some websites that state "touching a partner who is having an outbreak and then touching yourself poses an actual risk"....but I know a great deal of info on the web (especially concerning STD's)  is not to be trusted.

Some clarification on this would be greatly appreciated!
Thanks doctors

[Edward W Hook, MD]

The answer to your question is that transmssion from genitals to hand to genitals does not happen, just as persons using a glass after someone with a cold sore drinks from it do not get HSV-1.  The virus is just not that hardy.  In addition, remember that most HSV exposures do not lead to transmission of infection.  Finally, let me also point out that transmission is, in part dependent on the amount of virus one is exposed to and that with each successive transfer (i.e. genital to hand, etc) the amount of virus present falls off markedly.

There is a theoretical exception to this.  In health care workers, there is a well described phenomenon called a herpetic whitlow in which transmission to a persons hand follows direct contact of the hand with a lesion. This tends to occur primarily when the person's hands have open sores or are chaffed and are very, very rare in the course of masturbation/sexual contact.

Thus, while there may be a tiny, tiny risk of transmission occurring in the manner you describe, it simply is not a realistic possibility.  To put it in context, it is far more likely that your partners will contract HSV from contact with partners who are unaware that they are infected with herpes, as is the case for 8 of 10 infected persons, than that they will get herpes from you in the situation you describe.  Hope this helps.  EWH

[Edward W Hook, MD]

Thank you.  Glad we could help.  EWH

[rrr123]

I found it very coincidental that friend of mine was freaking out last night about sharing a glass with someone who he later realized had a cold sore (in brighter lighting). I tried to tell him that a doctor had just informed me glasses and such cannot pass it regardless of outbreaks, but it did not seem to calm him down.

Im not surprised. All of these (non-medical) websites say that glasses, towels, etc, can pass it. I wish this mis-information could be monitored some how! It makes life so much more difficult for people who actually have it. The web is great in many ways but I think it contributes to peoples irrational fears about STDs because there is just SO MUCH wrong (and scary) info out there. Im glad reputable sites like this are around to counter the wrong info on the other ones.

[rrr123]

Thanks again Doctor Hook!