[Question #3077] Don’t want to give genital herpes to my partner

40 months ago

Hi-My question is about preventing my partner from getting genital herpes. 


Here’s my history: 

I had unprotected sex 10 years ago and contracted herpes. I do not know the levels or the test, but the sores were swabbed and came back positive. I also was tested (a blood test) at my PCP a few years later which also came positive. 


I have only had that first outbreak and since have had maybe 1 or 2 more. I used to get flu symptoms that I attributed to a possible outbreak coming, but never got sores.  


I do get sores on the back of my neck (in my hairline) that I’ve read could be herpes. These neck sores have occurred over the past 5-7 years and I get them about 2-3 times a year.


I have abstained from sex for about 8 years. I’m in a new relationship and want to have sex and protect my partner. I asked my PCP for Valtrex 500mg 2x daily and she said I should only be taking it if I have more than 5 outbreaks a year, which I do not have. Is there a risk to taking Valtrex if I’ve only had 2 outbreaks in 10 years? 


I plan on taking this dose and using condoms unless there is any in taking Valtrex. Anything else you recommend to protect my partner? (He’s male, I’m female btw) Also, is there anyway to know if I’m “shedding,” are there symptoms I should be aware of? 


Does risk of transmitting herpes decrease after so many years? Do people have less outbreaks over time? 


Thanks! 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
40 months ago
The risk of transmitting herpes does decrease over the years for most people.
It would be important to know which type of herpes you have (HSV 1 or HSV 2 or both).  It could be genital HSV 1 since you have so few recurrences.  And if that is the case, your partner could also be infected.  I would strongly encourage you to get an IgG antibody test and see which type of herpes you have and I would also suggest that your partner be tested to see if you are the same or different. 

Your PCP is unfamiliar with the most recent research showing that dosing of Valtrex is not dependent upon the frequency of outbreaks but rather the thing to pay attention to is our understanding of viral shedding.  We know that people shed virus between outbreaks and that most transmission is due to viral shedding without symptoms.  The appropriate dose is 500 mg of Valtrex once daily.  Shedding can happen with or without symptoms - it is simply giving off the virus from the body. 

Please consider getting the tests I recommended for you and your partner to further clarify your situation.

Terri
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40 months ago
I will ask for the antibody test. I kind of want to say it’s HSV 2.  

Regardless, the person I want to have sex with is not the guy who infected him. The new guy does not have herpes or anything, and I do not want to infect him.  

I plan on taking Valtrex and using condoms.  Is there anything else I can do to protect him?

What are shedding  symptoms?  (I understand I may not have any.)

Is HSV1 or HSV2 more contagious? Is Valtrex effective for both? 

Thank you!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
40 months ago
You cannot know for certain if the new guy has HSV or not without testing - 80% of those infected with HSV 2, as identified by antibody test, would say that they are not infected.  An antibody IgG test would help clarify that situation.
Asymptomatic shedding has no symptoms. 
Genitally, HSV 2 is far more contagious.  Valtrex is effective for both.  Condoms and Valtrex daily will greatly reduce the risk of transmission

Terri
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