[Question #5623] Question for Terri - RE: [Question #5603] HSV-1 Genital Herpes

21 months ago
From a prior question . Thank you Terri.  You mentioned "Transmission through intercourse of HSV 1 genital infection is quite unlikely - it has been documented in the literature but it is rare."  So genital HSV1 is much less contagious or not contagious via sexual intercourse compared to HSV 2?  And to confirm as I have read mixed opinions, if someone already has HSV1 orally, is it possible for them to get genital HSV1 from me and vice versa?  Thank you!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
Yes, HSV 1 is shed from the genital area on about 5% of days swabbed vs. HSV 2 which sheds on about 14% of days swabbed.  It is highly unlikely that if you have HSV 1 genitally that you will subsequently acquire HSV 1 orally - I have seen this only once in 35 years of practice and even that case, I'm not convinced about. 

Terri
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21 months ago
Thank you Terri.  I am more concerned about me transmitting the virus to a future partner.  So to confirm, if my partner were to have oral HSV-1 it would be highly unlikely or not possible for them to be infected with genital HSV-1 by having intercourse with me?  Also, you mentioned "Transmission through intercourse of HSV 1 genital infection is quite unlikely - it has been documented in the literature but it is rare." is there a reason for this, is genital HSV-1 not spread genital to genital usually?  My doctor mentioned taking Valtrex daily to prevent transmitting the virus to any future partners so I am curious if you think that is necessary or not since it is genital HSV-1 and not HSV-2.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
It would be highly unlikely for your partner who has oral HSV 1 to get genital HSV 1 from you, correct.
And correct HSV 1 is rarely transmitted via intercourse. 
If your partner is truly negative for HSV 1, you may wish to take daily antiviral medicine to help reassure them that you are doing everything you can to reduce transmission to them.  I think many people would find that really helpful even if transmission via intercourse is rare. 

Terri
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21 months ago
Thank you Terri.  Is there any stats/percentages for both scenarios above to give me a better idea of risk to explain to my partner.  Lastly, is it easier for to transmit my genital HSV-1 to my negative partner if they were performing oral sex compared to intercourse?  Thank you for all your help Terri, you have been very helpful in this recent time of distress for me.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
I'm afraid I don't have answers for you on these questions.  HSV 1 has been less studied by far than HSV 2.  I can say that I have only seen once in 35 years of practice someone who reported having had a cold sore in the past come down with genital HSV 1. Once.

terri
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