[Question #1986] HSV Transmission

48 months ago

Ten years ago I believe I contracted HSV-1 from a partner – she had herpes, but I don’t know whether it was HSV-1 or 2 – subsequently I had two outbreaks of what felt and looked like herpes as I’ve read about it, though the lesions were not tested.

 Since then, HSV-1 antibodies show up in my blood tests.  I have not had any outbreaks since the second one, which was milder than the first, and which occurred within a few months of the first outbreak. On both outbreaks, lesions appeared on the head of my penis (only).

 I’ve had half a dozen sexual relationships over the past ten years, including one of five years duration. With only one or two exceptions, I have NOT used a condom during those relationships, and, to the best of my knowledge, no-one has caught it.

 I’m starting up a new relationship and my partner is concerned – I would say perhaps overly concerned -- about catching herpes. She is concerned about viral shedding and wants me to wear boxer shorts during our lovemaking, in addition to using a condom.

 The condom I understand, but the boxer shorts seem extreme to me, and my question is, what is the level of risk of using a condom if used always and correctly – but without the boxer shorts? Are boxer shorts really necessary to prevent transmission? She has expressed concerns about “skin-to-skin” transmission. Since the infection was on the head of my penis, since I haven’t had an outbreak in over ten years, and since none of my partners has contracted herpes from me, it seems to me that she would likely be safe with just the condom used during intercourse.

 Can you advise us on this matter, and, if so, what would you say to her to reassure her?

 Also, in the past when I’ve used a condom, I’ve used a polyurethane condom. I can’t feel anything with latex condoms. Are polyurethane condoms sufficient to prevent herpes transmission?

 

Thanks

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
Do I think the boxer shorts are a bit extreme?  Yes, I do think it's a bit over the top.  I think your partner is misinformed about viral shedding.  It sounds like she only has part of the picture about viral shedding - the part that it happens.  The part that she doesn't understand is that viral shedding only happens, in men, from the penis and anus - I'm not aware of data showing shedding  from the scrotum though I can't say it would never happen - it is quite thick, and things like the thighs and belly and buttocks don't shed - the skin it too thick there for virus to be released from there. 

Has she actually been tested to see if she has HSV 1?  If not, she should be.  More than 1/2 the population has HSV 1 but most is undiagnosed.  If she she already has this, it is not an issue at all. 

HSV 1 is shed infrequently from the genital area and condoms reduce transmission by more than 95% when worn regularly - they are very effective in preventing transmission to partners.  Maybe you could negotiate this if she in uninfected - how would you feel about daily antiviral therapy instead of the boxer shorts?

Terri
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