[Question #12893] HSV 1 serodiscordant couple
 |
4 months ago
|
Hello doctor, hope you’re well thank you again for answering my previous question,
I m still with the same partner we did a sti test at the beginning of our relationship, everything came out negative for him exception for HSV 1 ( IgG and IgM) I got tested aswell for both HSV 1 and 2 but only IgG and it came négative which puts us in a position of being a serodiscordant couple. He assumes that he has oral herpès and says he never had a genital outbreak. If I understand correctly having HSV in one location makes acquiring it in another very very unlikely. What worries me the most since i never had it and so I’m more susceptible to it, is having genital hsv and not so much oral as I réalise that most adults have it (60-80% if I’m correct). What would I need to do to avoir contracting my boyfriends oral hsv1 genitally. I réalise that I would be in this situation with most potential partners as it is incredibly common. I’m going to test for Ig M as well to see if I’m not already infected from any previous contact we had
would him being on antiviral medication be useful and if so how much less risky for me would that be.
if his hsv really is really oral would avoiding oral sex protect me completly from acquiring genital hsv ?
What would you suggest I do.
Thank you very much !
 |
Terri Warren, RN, Nurse Practitioner
4 months ago
|
Yes, you are discordant but remember that the IgG test for HSV 1 misses 30% of infections, so not terribly accurate. There is zero point in testing using IgM. It has many false positives and the CDC has for years recommended that people not do it. In some disease states, IgM comes up first as an immune response, but with herpes, IgG and IgM come up about the same time. So I recommend that you not do it.
We don't have data on the impact of taking antivirals on the transmission of HSV 1, but we do know that antivirals work well for HSV 1 and I think it is a very reasonable thing to ask him about doing daily antiviral medicine to reduce the risk of transmission.
If you do not receive oral sex, and if he does have it orally, then that's going to prevent that risk of acquiring it genitally. You could still acquire it orally, right, through kissing?
Terri
--- |
4 months ago
|
I’m mostly worried about getting HSV-1 genitally not oral, since most adults have it orally and there is more of a stigma that way. It feels like avoiding oral hsv1 is not realistic and it would mean giving up any romantic or physical relationship. I don’t know how to handle this, because no matter who I’m with, the risk seems to always be there. It makes me feel like I have to give up all intimacy to stay safe.
Are serodiscordant couples common? If so, what precautions should I take? Is avoiding oral sex during outbreaks enough, or should we avoid it entirely? Is oral-to-genital HSV-1 transmission high? If so, I don’t get why genital HSV-1 isn’t more common.
|
Terri Warren, RN, Nurse Practitioner
4 months ago
|
You are correct - avoiding HSV 1 in your life would mean giving up intimacy in your life - kissing or receiving oral sex. If I were you, I would try evaluating exactly why this is such a big issue for you. Is it worth giving up what you would need to give up to be 100% safe? Are you good with never receiving oral sex from your HSV1 positive partner to avoid getting something that will rarely recur or shed? Or is the relationship so uncertain that you are unwilling to take that risk? Would you partner take daily antiviral meds to help reduce the risk? There are several questions to think about here.
Terri
---