[Question #1787] Herpes

44 months ago
I started dating someone a few months ago who has genital herpes but doesn't know if it's 1 or 2. She hasn't had an outbreak in many many years.  We've only had protected sex but I've tested positive for HSV1 this week. I have read extensively through this site and just about every other about herpes but still have questions that I'm not clear about. I'm really concerned about my young daughter now. Is it possible that I have infected her by drinking from the same straws, cups or bottles? Is it possible to contract HSV2 if I have HSV1? Can someone infected with oral HSV1 get genital HSV1 and vice versa? Is there any benefit to taking valtrex if both of us are infected? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
Welcome to our forum. 
Let me ask you - have you ever in your life had a cold sore on your lip or in your nose or on your chin?  If yes then that's where the HSV 1 antibody is coming from.  More than half the US population betwe4en 14 and 49 have HSV 1 infection, probably most in the form of oral infection.  You may have had this since childhood.  I'm thinking that you got tested for herpes to know if you might already be infected, either prior to this partner or from this partner, is that right?  This positive HSV 1 may well be something you've had for a long time but just discovered through testing.  You won't transmit this to your daughter through straws cups or bottles, shared with you, no.  It is certainly possible to acquire HSV 2 after having HSV 1, yes, the reverse is extremely unlikely.  Someone infected with oral HSV 1 is also extremely unlikely to get HSV 1 in a new place on their body, like the genital area  In this situation, it is important to know if she has HSV 1, HSV 2 or both.  An IgG antibody test will tell her that.  If she has HSV 2, then yes, it would be beneficial for HER to take antivirals (like Valtrex) to reduce the risk of infecting you.  However, if she doesn't have HSV 2 and has only HSV 1, like you, then it would not be necessary or beneficial for anyone to take antiviral therapy.  Please feel free to ask other questions that you might have.

Terri
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44 months ago
Yes i got tested as part of a physical and asked specifically for STD testing just to see. I actually looked at her test results last night with her and it does say 9.? for HSV2 and negative for HSV1.  Unfortunately ( or fortunately ) we have amazing sexual chemistry but i have been struggling with the risk. I have never had cold sores that i'm aware of. I realize that only abstinence can prevent me from being infected from her but the numbers that i have found for couples using condoms and valtrex ( i think she takes it twice daily) are all over the place. Anywhere to 70-99% reduction in being infected. In your expert opinion, is it inevitable to be infected if we continue an active sex life? Well, as active as 2 single parents who only see each other a handful of times each month can be.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
And you are certain it doesn't say .9 for HSV 2, rather 9.  Why the question mark?  It looks, from your post, that she is infected with HSV 2.
Studies indicate that for female to male transmission of HSV 2, having sex about twice a week, with condoms and her taking medicine, about 2 men our of 100 while get HSV 2 in a year.  To be fair, these studies are done in couples who have been together for a while (long enough to do a study together, anyway).  But as you can see, the risk is quite low if all precautions are taken.  It is definitely not inevitable that you will become infected. 
But only you can determine how much risk you are willing to take in this situation.  I will say, in my personal experience, it is challenging to find an agreeable and loving partner.  Dealing this very manageable  skin infection is much easier.  Just my opinion.  I  can't tell from your post if this is the case with you or if this is strictly a sexual thing. 
Terri
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43 months ago
Sorry i thought i remembered the HSV2 number being 9 point something but may be wrong. It was bold and the others weren't. The relationship is definitely not only sexual but it is certainly challenging to put the risk out of my mind not knowing what the future holds. Can you clarify about HSV1? I'm am understanding correctly that kissing is a risk of transmitting oral HSV1 but not drinking from the cups, straws etc.? With half of the population being infected, I'm trying to figure out if the conversation about having HSV1 should happen before ever having the first kiss with a potential new love interest. Seems very very unlikely for anyone to do that and probably an instant (perceived) red flag that won't get you a second date. Lol  Thanks for the help
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
If the number is 9.something, then she is most certainly infected with HSV2.  But if she takes daily antiviral therapy and you use condoms, the risk of transmission is low indeed.  Only you can decide if you want to take any risk at all. Perhaps you should wait and see how the emotional side of the relationship develops before making the decision?

If you have HSV 1 orally, then kissing is a small risk for transmission, yes, more so when there is a cold sore present but at other times as well.  Experts do not believe that sharing cups,etc is a risk.  The issues of when or even if  to disclose one's HSV 1 status is  subject of much debate, even among experts. In my opinion, it should at least be disclosed before giving someone oral sex. I am firmer on that opinion since Dr. Wald's study showing that HSV 1 orally is shed on about 1/4 of days tested.

Terri
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