Does viral shedding occur on the skin surface or from the mucal membranes of the vaginal canal?  I am confused as to the types of contact that can cause transmission as it can be transmitted during oral sex Can it be transmitted to other body parts such as hands or legs during stimulation or skin to skin contact when cuddling?

First, viral shedding does not occur from thick skin like legs, thighs, belly or buttocks if there are no lesions present.  It is "shed" from mucous membranes or very thin skin like the vagina, labia or anus.  For example, if the labia rubs up against someone's intact thigh skin, and it is shedding virus at that time, transmission does not occur because the skin of the thigh is too thick for virus to enter.  If that same labia with viral shedding rubs up against a penis, transmission could occur (note that I said "could", not "will").  There are many factors involved in transmission including amount of virus, immune factors in the host and uninfected partner, type of contact - aggressive rubbing vs. a slight contact.  I think you get the picture more clearly, but if you have more questions or want to ask about a particular incident, please feel free to ask!

Terri
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Thank you for the clarification.  I know condoms protect the shaft of the penis but as the testicles and the area around it are not covered can it still be transmitted or is that skin too thick to be receptive?

That's a great question.  We know that condoms are more protective for women having sex with an infected male than the other way around.  The skin at the base of the penis is thicker as is the scrotum and I have seen men contract herpes while using a condom, but it is not common.  A condom combined with antiviral therapy is quite protective for men having sex with women who have genital herpes.

terri
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