[Question #5641] HSV-1 Genital Herpes

24 months ago
Why is it unlikely for HSV-1 genital herpes to be transmitted via intercourse, is the source of HSV-1 always through the mouth/orally whether kissing or oral sex?  Is it common to spread HSV-1 genital herpes to oral HSV-1 to a negative partner if they were to perform oral sex on the positive pattern?  Is it common practice for someone to tell a partner that they have HSV-1 with oral or genital?  I have never had a partner tell me whether or not they have been infected with HSV-1 since it seems like oral herpes does not have the social stigma associated with it compared to genital which is usually associated with HSV-2 through sexual intercourse.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
24 months ago
It is unlikely to be spread through intercourse because HSV 1 genital infection is only shed from the genitals, on average, 18 days out of a year.  it isn't impossible - it has been documented in the literature, but it is rare indeed.  It is NOT common to transmit HSV 1 from the genitals to the mouth of an uninfected person but again it is possible. I think it is important to disclose one's HSV 1 status but not everyone agrees with me about this so there are different points of view on this issue.  I think a person who has known cold sores should disclose this prior to giving oral sex to someone else.  The majority of new cases of herpes are now HSV 1, not HSV 2 and the vast majority is due to receiving oral sex.

Terri
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24 months ago
Is someone with prior known cold sores more likely to spread HSV-1 than someone with genital HSV-1?  When I was recently infected the symptoms were only on the shaft of my penis.  Do you think it is fairly safe to say that with correct use of a condom I wouldn't be able to infect a future partner?  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
24 months ago
The person with recurrent cold sores sheds virus on about 25% of days vs. a person with genital HSV 1 sheds on about 55 of days.   A condom reduces the transmission of HSV  by 96% - that is true for HSV 2 but mechanically, I think it would be just the same with HSV 1, yes.

Terri
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24 months ago
I am confused, you mentioned genital HSV-1 sheds 18 days (~5%) in an earlier message but now this says 55 days per year.  Can you please confirm which is correct.

--- "It is unlikely to be spread through intercourse because HSV 1 genital infection is only shed from the genitals, on average, 18 days out of a year.  "
24 months ago
If someone does not have recurrent cold sores how often is the virus shed?  And with genital HSV-1, if one does not have any outbreaks after the initial outbreak what is the shed rate?  Thank you!