1. Given she has never had any cold sores/oral outbreaks, I’m not sure what to do with this information. She already takes Valtrex prophylactically once per day. Do I now have to assume there will always be a risk of me getting HSV-1 if I kiss her or receive oral sex? I really enjoy the oral sex, especially since we always have to use condoms for vaginal sex.

Let's say you can't handle that she's positive for HSV 1 as well and you move on to another partner.  There is a 50-50 chance that they too will have HSV-1 and likely won't know it, as about 70% of those infected with HSV-1 don't know they have it.

If you really love this partner, I would encourage you to accept this new diagnosis, making a conscious decision to take a small risk, as you have already been doing, and move on with kissing and receiving oral sex from her.  Good partners are challenging to find and in the big picture, herpes will take it's place as a minor inconvenience.  At least that's my take on your situation.

Terri

1. Do you think it is unusual that she only had the swab test when diagnosed for HSV-2 or is it typically standard to get a blood test for both HSV-1 and HSV-2 at the time of an outbreak?

2. I can’t help but have a minor concern of when she may have picked up HSV-1 or that it could be a result of infidelity. Given how easily HSV-1 can spread from sharing food utensils and kissing, do you think it’s a waste of mental energy wondering how or when she may have got it? Would it be worthwhile to see if she was previously tested to see if it really is a new diagnosis?

I know some these questions sound silly but my mental health therapist encourages me to get these thoughts out of my head to make them easier to deal with.

1. Do you think it is unusual that she only had the swab test when diagnosed for HSV-2 or is it typically standard to get a blood test for both HSV-1 and HSV-2 at the time of an outbreak?

It is more typical if there is a lesion to test, to swab the lesion only although some providers also do a blood test.

2. I can’t help but have a minor concern of when she may have picked up HSV-1 or that it could be a result of infidelity. Given how easily HSV-1 can spread from sharing food utensils and kissing, do you think it’s a waste of mental energy wondering how or when she may have got it? Would it be worthwhile to see if she was previously tested to see if it really is a new diagnosis?

Many people acquire HSV 1 in childhood from adult kissing them with a cold sore.  And once you have HSV 2, you don't later acquire HSV 1 later though the opposite is true - if you have HSV 1 you can acquire HSV 2 subsequently.  So HSV 2 protects against HSV 1 but the opposite is not true.  I think this concept is important for you to know given you concern about possible infidelity.

Worry about infidelity is an entirely different concern.  Had she had a blood test when you had the swab test, and the blood antibody test was negative, that would have indicated a new infection - virus present on the skin but not enough time had gone by for antibody to be developed yet.  But that time has passed now and she already told you that she was positive for HSV 2 previously, right?  Did you have concerns about infidelity prior to her testing positive for HSV 1 and 2?  

HSV 1 is rarely transmitted via food or utensils but often through kissing, just so you know.  

It is really OK to ask these questions and get clearer on some facts about herpes.

Terri