[Question #2366] Risk of Transmission through Asymptotic Shedding

46 months ago

I am a 50 year old woman in menopause. At 18 years old I contracted type 1 herpes (in my genital region) through oral sex. At 38 years old I contracted herpes type 2 (in my genital region) through vaginal sex.

I have not had an outbreak in at least ten years. I have only ever had sex in monogomous relationships. As a result in the span of 32 years I have rarely used condoms and have never transmitted herpes to anyone.

My new boyfriend and I are deciding if we need to use condoms. He is concerned about asymptomatic shedding.

Since it has been 10 years since I have had an outbreak I believe if I had viral shedding over the past decade it would be statistically negligible.

Assuming that I continue not to have outbreaks what would be my boyfriend's percent of risk of contracting herpes (either or both types) from me during unprotected vaginal sex be?

Please be as mathematically specific as possible. I know there are no guarantees but would like to be as precise with him as possible.

Terri Warren, RN, Nurse Practitioner

46 months ago

Even people without outbreaks do shed, and in a study looking at people who have been infected for 10 years or more, we still found shedding, about 13% of days swab tested. Some people in that study did not shed in 2 months of swabbing, one person shed 93% of days. It varies all over the place I'm going to give you transmission rates from an infected female to an uninfected male but first I want to suggest to you that he be tested - 80% of those infected with HSV 2 don't know they are infected. If a woman does nothing, the transmission rate if about 4% per year in couples who have been together for an average of two years. If you take daily antiviral medicine, it cuts the risk in half and if he uses condoms, it cuts it in half again.

Terri
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