I am a male positive for HSV-2 IGG type specific AB greater than 6.  I am currently taking Valacyclovir HCL 500 mg twice per day.  My question is how safe is it for me to perform oral sex on a woman unprotected and have intercourse with condom protection?

If you only have HSV 2 genitally, then you can perform oral sex on people without a concern of transmission, yes.  The vast majority of HSV 2 is at least genital and sometimes oral, but the oral from rarely recurs and rarely sheds virus.  Condoms reduce the risk of transmission by 30-50%, depending upon the study that you read

Terri
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Thank you Terri, do you have any statistics on the transmission of HSV-2 while using  of Valacyclovir and  condoms  together during vaginal intercourse?

Yes, I do.  Without any interventions, the transmission rate from male to female, having sex on average twice per week, no sex with symptoms, is about 10% per year (10 women out of 100 will become infected). This is with the female knowing the male is infected.  If you add daily antiviral therapy, it drops to about 5%, add condoms it drops to about 2-3 women in a year will become infected in a year.

Terri
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Thank you Terri, one last question, which antiviral therapy do you recommend?  Your answers have helped me very much, so thank you very kindly for your help.

I recommend either acyclovir OR valacyclovir, both work equally well when taken as directed.  You can take valacyclovir once per day where you need to take acyclovir twice per day (if taken daily).  Acyclovir is way cheaper and works as well, just have that additional dosing per day.

Terri
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