I’m a man and I’ve just learned that a partner of mine has genital herpes (we're non-monogamous and have sex with other people). She found out by having a painful outbreak and is currently on acyclovir to treat it. I've never had an outbreak myself and have never been tested for it. What I'm trying to understand is to what extent I should change my sexual behavior with her. I want to change my practices as little as possible, as we have a good relationship and I don't want to stigmatize her. But at the same time, I want to prevent contracting HSV2 if I don't already have it.

 

She and I always use condoms when having vaginal and anal sex, and I give her oral sex without using any barriers. I know that there is a heightened risk of contracting genital herpes if she's having an active outbreak, but what I'm wondering is -- Even with a condom, there's some skin-on-skin contact, of course, so to what extent am I at risk by having sex with her (with a condom) if she's not having an active outbreak?

 

Also, after an active outbreak subsides, how long should I wait before having sex with her again?  A day after the scabs fall off? A week?

 

I'm also wondering how safe it is to continue giving her oral sex without using a barrier, like a dental dam. Could you give me an idea of the risk I face of contracting HSV2 if I give her unprotected oral sex when she's not having an outbreak?

 

She said she's going to by taking acyclovir daily even after her current outbreak subsides. To what extent does that prevent outbreaks and transmission?

Thanks.

First,  you need an IgG test to see if you are the same or different in terms of your herpes status, from your partner.  If you are the same, no worries about doing anything.  Both HSV 1 and 2 cause genital herpes - which does she have?
The transmission rate from females to male, with you knowing she is infected, having sex about twice per week, avoiding sex with outbreaks, daily antiviral therapy, you using condoms with every intercourse, is about 1-2% per year, meaning about 1-2 men out of 100 will acquire herpes in a year, given these circumstances.
We have no data on genital to mouth transmission but we do know it is not common

Terri
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Thanks, Terri. I’m not sure whether she has HSV1 or 2, but I expect to find out within the next week. If possible, I’d like to keep the thread open until then and mention that in my second follow up. 

I think my biggest remaining question is how to how to make sure she and I aren’t having sex around the time of an active outbreak. Are there warning signs that appear just before an active outbreak starts during which time she is more contagious? And after an outbreak subsides, how long should we abstain? A few days after the blisters fall off? A week?

Also, we occasionally have threesomes with other women. Any advice on preventing the spread of genital herpes to any of the other women who haven’t previously been infected?

about half of asymptomatic viral shedding occurs before or after an outbreak so avoiding sex for perhaps a week after an outbreak resolves can be helpful but doesn't completely cover the problem.  And half is completely random.  Her taking daily antiviral therapy reduces transmission by half so that would be useful in terms of other partners.
So you need testing, not just her.  I'll keep this thread open for sure.

Terri
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