[Question #2118] Man has genital HSV1, Woman has HSV2... How to proceed with relationship

48 months ago
I am in a new relationship.  We are both in our 50s.  We have not had sexual relations as of yet.  He had a recent outbreak of HSV1 on his genitals and says it is his first outbreak, before which he was completely unaware of his status.  His lesion was cultured.   I told him he needs to have an HSV2 blood test as well as getting tested for other things like HIV, Hepatitis, etc just as I recently have done.  
I am HSV2 positive but have never had an outbreak that I am aware of.   I had an IgG result of 8.47.  The doctor told me my HSV2 is probably not recent within the last 3-6 months because my IgM was 0.  
So, we want to embark on a relationship with each other but are unsure of how to do so.  Can he acquire HSV2 genitally if he already has HSV1 genitally?  Can he have an oral outbreak of HSV1 if he has already had it in his genital area or will it only resurface where it has already been?  Is it true that we might both have more immunity to the other virus since we each have the opposite one?  Do I need to go on anti-viral meds if I am not having any issues as a result of having HSV2?   I would do so if it meant protecting his health and if it meant protecting my health from a possible future outbreak.  Thank you!  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
Hello, and thanks for visiting our forum for answers to your herpes questions.  He does need to be tested for HSV 2, yes, and if he infected, you have no worries about transmission.  but if he is negative, he is vulnerable to your HSV 2 and daily therapy would reduce your risk of transmitting to him as you shed virus from time to time even if you have no symptoms.  And yes, he could still acquire HSV 2 genitally even though he has HSV 1 genitally, though some researcher believe that the risk is lowered because of his prior HSV 1 infection genitally.  I don't think we have enough data to be certain, however.  His HSV 1 will only recur genitally if that is his only location of infection. If he acquires HSV-2 genitally, his prior infection with HSV one Will likely keep a new HSV-2 infection well under control and he may not even notice it.

Your index value of 8.7 does indicate an older infection rather than the new one.

I agree the testing for all sexually transmitted infections is a good idea prior to having sex.

It is extremely unlikely that you will acquire HSV one subsequent to having HSV-2. Please let me know what other questions you might have.

Terri
---
48 months ago
Thank you so much for the fast and comprehensive response.  In this last year, I got divorced, so this HSV2 was a shock.  But, having done so much research in the last week, I realize how many people in my age group must have herpes in one form or another but just don't know it and, since they are asymptomatic, they don't go and get tested.  I was that same person just a week ago.  This has all been a real eye-opener... Thank you again!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
You are most welcome, Susan

Terri
---