[Question #5828] Hiv Prevention

21 months ago
Hello, I'm a 36 year old male with rectal hsv-1, blood test confirmed with several outbreaks per year.  How do I prevent/avoid HIV the rest of my life? taking into account the fact that I have rectal hsv-1.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
This repeats your question answered by Dr. Hook just two days ago. The answers are the same, except I will add that HSV1 infection does not significantly increase the risk of HIV, even if sexually exposed. Research studies have shown that only HSV2, but not HSV1, is associated win increased HIV risk if exposed. If you had an active HSV1 ulcer of the anal area and received anal sex at that time, I suppose your risk of catching HIV might be elevated. But not by much. It might double the risk -- but if the chance for any particular exposure is, say, 1 in a million, then with an active HSV1 outbreak the risk would be 1 in 500,000, still zero for all practical purposes.

Beyond that, I have nothing to say that was not covered with Dr. Hook. I suggest you re-read that discussion.

HHH, MD
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21 months ago
Thanks for the reply Dr. Handsfield.  Are the below quotes from 2014 accurate today, taking into account I have rectal hsv-1?

"Remember this and believe it:  if you do not have unprotected sex (a penis inside vagina, rectum or mouth) and do not share drug injection equipment with other people, you will never be at risk for HIV."

"All you need to know to avoid HIV your entire life:  choose your sex partners with care, use condoms for intercourse with new or potentially unsafe partners, and do not share drug injection equipment with anyone."

"All you need do to prevent HIV is to not have unprotected sex with partners at risk and not share drug injection equipment.  Nothing else matters."

Given the fact that I have rectal hsv-1, if I follow the above quotes of not having unprotected oral, anal, vaginal sex and not share drug injection equipment, will I avoid/prevent HIV for the rest of my life?

Thanks for all your help.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
Still repeating questions answered by Dr. Hook. The answers are the same. As he said, the quotes from some past answers on this forum remain valid and you will indeed remain free of HIV forever if you follow the guidelines you state. If you do so, your HSV1 makes no difference.

That concludes this thread. Please note the forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions about your HIV risks and your HSV1 infection will receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and is intended to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding. 

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