I was recently diagnosed with Type 1 genital herpes after full-on outbreak.

I am in a new relationship. My boyfriend got tested, and he came back negative for both type 1 and 2, which means he was not the source. I assume from my reading that I probably got it from the only other person I've had unprotected sex with, and the only man to have performed oral sex on me - an 8-yr relationship which ended 9 years ago. I contacted that man, and he said that he just found out a few years ago that he is positive for type 1. I've never had symptoms before, so it was a great surprise to have a primary outbreak so many years after when I imagine I was infected.

Now I am in a wonderful new relationship with a totally clean guy (not even type 1 oral!). I don't want to pass this on to him. My questions are:

1) What is his risk of genital-to-genital transmission if we use condoms? Without condoms? Is it worth my taking Valtrex to decrease the risk if we don't want to use condoms? (He's had a vasectomy, and we are both STD clean otherwise.)

2) What is the risk of my having type 1 oral as well? I've never had any cold sores or visible symptoms, but neither did my former partner. Is it likely that I have oral as well, or is the fact that I have genital mean I possibly don't have oral? If the risk is high, should we be using condoms if I want to perform oral sex on him?

3) I've read that HSV contagiousness reduces over the years. I got this many years ago, but just had the primary outbreak now. Should I still consider myself less contagious, or does this recent outbreak mean I am probably shedding more often?

Thanks for any advice you can give. I am super lucky to have such a supportive, wonderful partner (especially since I originally blamed him!).

Many thanks,
k

welcome to the board

this wouldn't actually be a primary ob if indeed you contracted it 9+ years ago - it would just be your first obvious recurrence. how did they diagnose you as having hsv1 genitally? odds are actually that you contracted it from your current partner if you had a classic ob with multiple lesions. even the best blood tests for herpes we have still miss 1 out of every 10 hsv1 infections. it's just a lot harder to detect hsv1 on the blood tests we currently have than it is hsv2.

1) What is his risk of genital-to-genital transmission if we use condoms? Without condoms? Is it worth my taking Valtrex to decrease the risk if we don't want to use condoms? (He's had a vasectomy, and we are both STD clean otherwise.)

very low risk of transmission in general. usually just avoiding sex anytime you have anything going on genitally is all it takes

2) What is the risk of my having type 1 oral as well? I've never had any cold sores or visible symptoms, but neither did my former partner. Is it likely that I have oral as well, or is the fact that I have genital mean I possibly don't have oral? If the risk is high, should we be using condoms if I want to perform oral sex on him?

most people who contract hsv1 orally don't get obvious symptoms. no easy way to know if you have it orally or not. since odds are you did get it from this partner, really not an issue anyways

3) I've read that HSV contagiousness reduces over the years. I got this many years ago, but just had the primary outbreak now. Should I still consider myself less contagious, or does this recent outbreak mean I am probably shedding more often?

contagiousness doesn't really change after the first year

betsy

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Thanks for the response, Betsy.

I had a bad outbreak - multiple lesions and pain for about 10 days (no fever or any other symptoms, however). I had a culture done immediately, which came back positive for HSV-1, as well as a blood test, which also showed positive for HSV-1, negative for HSV-2.

My partner immediately went to be tested, and his blood test came back negative for everything. Even though there's a 10% chance this is wrong, he never performed oral sex on me, which is how I understand most transmissions occur. He also has never had any symptoms (this doesn't prove anything, but does back up his not actually having it). GIven the fact that my previous partner told me that he tested positive for HSV-1, and that he and I had unprotected monogamous sex for 8 years, I still assume it came from him.

I have read that HSV-1 genital can go a lifetime undetected, but may pop up due to a trauma to the region. My current partner and I were engaging in some rough sex, so I wonder if that could be the cause, 9+ years after the fact?

In any event, since I am the one who had the outbreak, and he has tested negative, we have to assume that he really is negative and try and take precautions. I suppose we just need to decide whether he is at much higher risk without condoms than with. I'm also worried that it's more likely that I will infect him by performing oral sex on him since asymptomatic shedding is so much more common that way (assuming I have it there, too), but he seems less concerned about that.

Even though you think he might actually be HSV-1 positive, if you were to assess risk for a negative man contracting HSV1 genitally from a woman, is the risk that much greater without a condom? Or is the risk low in either case and we can just go about enjoying our sex life again...?! (Like I said before, my current partner has been hugely supportive, and if anything, I'm more concerned than he is and am wracked with guilt.)

Thanks again, Betsy. The information on these boards has been extremely helpful!

just make sure it was igg testing that was + for hsv1 and not igm.

did they also test you for any vaginal infections at that time like bv?

betsy

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ASHA Moderator

My results were:

HSV I/II IgG, 50.8
HSV 1 IgG, Type Spec 3.55
HSV 2 IgG Type Spec <.91

I had tests for gonorrhea and chlamydia at the same time, both were negative.

I'm not sure what my partner's specific blood test typing was, but I can find out. It was done at a pphood clinic, so I'm confident they knew what they were testing (but who knows). Is the IgG test more conclusive?

Igm testing isn't accurate which is why I asked you to check. thank you for getting those numbers for me.

evidently this is a recurrence but usually when they are that extensive, it's because something else is going on - usually bv. if you get another recurrence within the next month or so, be sure to be seen again and get properly tested for bv just to err on the side of caution.

you can transmit hsv1 from genitals to genitals but usually the risk is very , very low. Hsv1 genitally doesn't shed a whole heck of a lot so usually just avoiding sex whenever anything is going on genitally is all it takes to protect a negative partner.

as for oral sex, no easy way to know if you also have hsv1 orally or not. totally up to you and your partner if you think it's worth switching to you only performing protected oral on him or not.

keep asking questions

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Thanks again for the response, Betsy.

Sorry to be ill-informed, but what is bv? And how worried should I be about it?

bv is bacterial vaginosis. it's a bacterial infection of the vagina in us gals. it's known to trigger herpes and make it more active in the genital area.

betsy

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