Greetings all,

I can be somewhat obsessive-compulsive by nature, so in the past few weeks I've probably read about all I could about HSV, transmission likelihood in discordant couples, etc and so forth. This got me pondering a few things which I'd like to pose as questions to the forum:

1) Based I believe on a valtrex study, the numbers being tossed around for HSV-2 seroconversion in discordant couples seems to be about 4%/yr. Maybe down to 2% with 100% condom use, maybe down to 1% with suppressive therapy. In many forums, stories abound of couples who abstain when symptomatic, and choose not to use condoms at other times and successfully avoiding HSV transmission. I'm trying to reconcile these figures with the fact that as many as 25% of adults in the US are HSV-2 positive, and that many infections seem to occur within the first few sexual encounters with someone who appears asymptomatic. On the one hand, I can see a reporting bias where in counseling those dealing with HSV, risk of transmission is minimized, while in the campaign for safer sex, the risks are maximized. Does anyone have any insight to share? Does being proactive knowing you are HSV+ and trying to protect your partner really have that large of an effect on transmission risk?

2) Autoinoculation risk seems to be accepted as low to nonexistant after the first symtomatic episode. HSV-2 severity/recurrence seems to be more limited when the infection is orolabial. As a hypothetical scenario (and no, I'm not going to go do this), it seems one could "vaccinate" oneself by trying to pick up the infection orally, and attempt to benefit from the generally milder effect of that type of infection. Anyone care to comment?

3) Any comments on the uninfected partner taking valtrex, famvir, etc. as an additional method of prophylaxis? Since none of the drugs are approved for that purpose, I imagine it may not be possible to obtain a prescription for such...

Oh yeah, for background - and not to be overly melodramatic - but I think I may recently have met "the one" for me... except for the small issue that she has GH (not sure of the type, but we'll find out). There was probably a time when I would have unconditionally bolted on such news (and to be honest, the news has put quite a damper on my enthusiasm), but I'm finding that I'm rather inclined to stick it out and see what the future holds for us, despite my current anxiety.

I think my anxiety is twofold. 1) While I may ultimately be willing to accept the risk of picking up an HSV infection, I'm not as willing to risk that infection at the relatively early stage of the relationship that I'm in. 2) I don't fear herpes necessarily - I fear the unknown (with a moderate dash of selfishness thrown in). If you told me I'd be asymptomatic after infection, I'd be fine. As unlikely as it may be, I wouldn't want to find myself among the unlucky few with 10+ major episodes a year, etc.

I took a HerpeSelect test to find out where I'm currently at (and in an ironic twist actually hoped I'd test out positive), but alas, I'm negative for both HSV-1 and 2. Which doesn't make me feel any better over my potential reaction to infection.

justaguy... who may have found his girl

justaguy ~

1.) I believe that what is important is to know your status, tell your partner, know your status together as a couple, and decide together how you are going to treat your status. Does it really matter what everybody else is doing when each couple and each situation is different?

2.) Yes, autoinoculation is minimal once your body has had a chance to build up antibodies to the HSV virus. Your self vaccination theory is flawed in my opinion. Once you contract herpes - you keep it for good.

3.) There is no benefit in the uninfected partner taking Valtrex.

Sounds like you've been tested and do not have herpes from what I read that you wrote. That's a good thing, right?

Hang in there,

Angela

_________________
Herpes Help

As a person who has HSV and partnered with someone who does not have it AND as a sexual health educator, I thought I'd throw in my 2 cents.

1) I have also wondered about the seemingly contradictory stats on discordant couple infection and overall herpes infection especially given the common message that most people who get herpes get it from a partner with no symptoms. My theory is that the difference betweeen knowing you have herpes and not knowing plays a significant role. That is, if you know you have it and know what to look for, you know better when to NOT have sex with a partner AND can take Valtrex. Also, studies of discordant couples follow couples who are in at least somewhat serious relationships (I gather since they can be followed for the length of the study) and thus probably more comfortable with each other and communicate much better than casual partners and thus take better precautions against passing H. If a person is not sure if they have H (or even know they have it) and they are hooking up with someone casually, it is probably less likely they'd be extra careful to pay attention to any signs that they have or are getting an outbreak AND less likely that a person will ask if their hook-up has an STD. Thus I think it makes sense that these two stats are so different even if on the surface they seem to be contradictory. (Not to mention that alcohol probably plays a not-so-insignificant role in more casual sex.)

2) Though I see your logic, don't see this theory working. Though I might theorize that while it wouldn't prevent H, it might make a first outbreak less severe if you give your immune system a head start. I don't know, just a thought. Not something I'd ever tell a student.

And just a few more cents thrown in---I am glad to hear you are not running for the hills because your partner has H. Good for you! I was ready for my then-boyfriend (now husband) to run when I told him but would have been heartbroken and devastated if he actually did. I take Valtrex like ever other day and have not had an outbreak in over 3 years and have not infected him. We are very much in love and have a wonderful open and strong relationship. it would have been a real shame if that had been thrown away just because of some skin infection that has come to be SUCH a non-issue. As far as your fear of the unknown--I won't lie, my first outbreak sucked and was painful. But I started on meds right away and basically just stayed in my house with a bag of frozen peas on my crotch (which helped a lot). Of course all this was on top of my emotional devastation of getting H from a partner I was just not that into anyway and the whole fear of no one ever wanting to be with me again etc. etc. But you would not have that element of shock and fear of being alone. Since then the couple outbreaks I have had have been the equivalent of a pimple or two. My point is, don't let fear of the possibility of a few uncomfortable days ruin a great relationship. besides, lots of people get mild first outbreaks anyway. And even if you did leave your partner, odds are your next partner would have herpes or HPV anyway. And maybe this time, they wouldn't know or wouldn't tell you.

Just my thoughts. Take what you will and best of luck to you!! And good for you for educating yourself