[Question #129] Herpes

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108 months ago
Hello I have had herpes for 24 yrs I'm now 43 yrs old.I was married for 15 yrs.I recently started Dating someone New. we were using condoms but my new Boy friend decided not to.Last week I had an outbreak on my sacral area and we had unprotected sex. I had a dose of Vatrex one gram the night before. the morning of I had 2 grams valtrex. is the incidence of transmission less if it's in the Butt area.Please advise I'm really worried.I don't want to pass it on.My genital area had no outbreaks just a small patch 3 red bumps on the butt area.Please let me know
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Terri Warren, RN, Nurse Practitioner
108 months ago
When herpes is active on the buttocks, about 1/4 of the time it is also active at the genital site.  It is possible that you transmitted the virus to your new partner but there is no way to know for certain except to observe carefully for symptoms and have them swab tested if they appear.  Also, do you now if he has actually been tested for herpes before to know that he is not already infected and doesn't know it?  Have you discussed the herpes issue with him?  The antiviral therapy will reduce the risk but in order to maximize that reduction, it should be taken every single day.  Just so you know for the future, you should never had sex when you have an outbreak in the entire area between waist and mid thigh.

Terri
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108 months ago
Hi Teri thanks for responding.I have discussed the issue with him.He stated that he has dated a girl with herpes before but used condoms. He is 44 yrs old so may have some virus in his system he has dated a lot and is an ex marine.U stated that one quarter of the time it will be on the genitals.I did not feel any itching or lesions on my Vaginal area.I have read that some sites some people spouses never get sacral herpes.I m really anxious and will not have sex again without protection. Do u think that the Valtrex that I took may have decreased any viral shedding in that Area.how long does it take for the valtrex to decrease shedding.I had one gram the night before sex and 2 grams the day ofPlease give me some hope .I have also read some persons at not show symtoms.The area was really small 3 bumps on my right buttock
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108 months ago
I have tried taking valtrex daily and I notice that I get a rash after a week.What do I do to decrease this?
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Terri Warren, RN, Nurse Practitioner
108 months ago
The medicine needs to be in your system for five days to be fully effective but 1 gram will certainly help with shedding. 
In general, it is certainly possible to shed virus with no genital symptoms at all.  But the odds that you will transmit the virus to someone else through a single encounter is statistically  really small.  Let's say you were having sex twice per week with no medicine and no condoms.  The rate of transmission in that situation, in a year, is about 4% - 4 men out of 100 would get infected.  You can do the math here - it is really a small risk - it isn't zero but it is really low.  You might try acyclovir and start at a low dose like 200 mg twice a day and see if you still get the rash and if not ease up the dose.  This would certainly not be true if you have any difficulty breathing or rash on her face, Sarah.  This is also something you really want to run by your doc for suggestions.

Terri
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