[Question #5974] Genital hsv1 questions

19 months ago
I recently started seeing a girl who told me 6 months ago she was diagnosed with GHSV1 .

She told me she had 2/3 red spot like blisters on her inner thigh close to her vaginal area and they swabbed positive for HSV1 (she told me she didn't even take any pan killers and overall it wasn't that uncomfortable for her)

As far as I know I’ve never had a cold sore. Though I guess I’m not sure unless I get tested. Would this offer me any protection if I did carry HSV1 antibodies?
 
I'm having a hard time finding out what my likelihood of getting this is from her. She told me it's very rare to transfer to a partner...is this  true?  How rare is rare? 1 in 1000?  

Does it even transfer genital to genital? 

How concerned should I be?  What if we don't want to use condoms forever?

Should I look at the transmission levels for HSV2 as guidance?  How contagious is HSV1?







Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
19 months ago
If you were also positive for HSV 1, then it would be eXTREMELY unlikely to get her GHSV.  She is correct that it is very very rare to transmit to a partner through intercourse.  We don't have a number, but if someone has had this for at least 2 years, they, on average, give off virus on 4 days a year.  GHSV 1 is far less contagious than GHSV 2.  And since about the half the population has HSV 1, you will most certainly encounter people who have this and not know it and aren't doing anything to try to reduce the risk of transmission.  People with HSV 1 oral infection give off virus on about 25% of days (those with recurrent cold sores).  So you can see that they are a far greater risk of infecting you than this person.  And good for her for telling you about this - because shedding is so infrequent and sexual transmission so rare, many people now are Not disclosing.  Think you might have a gem there ;-)

Terri
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19 months ago
So since she has (most likely) only had the virus for 6 months is she much more contagious at this point? Rather than her being at the 2 year mark? 

How many days do you think she would be shedding? 

If she's shedding and we engage in sex on that particular day will she for sure pass the virus to me? 

If we are using condoms am I protecting myself enough? 

If we decide to stop using condoms should we wait until she's had the virus longer?

She's not taking medication as her doctor said it would be unlikely for her GHSV1 to recur and she told me she wants to see how her own body responds to the virus over a longer period - but will take medication if she ever feels symptoms. 

Do most people with GHSV1 take suppression therapy? Is it recommended?


I very much appreciate your response. Thanks.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
19 months ago
People are more infectious at 6 months out than 2 years out, correct, but even then, it's likely a low shedding rate, perhaps 21 days out of the year?
There is not certainty that even if she is shedding that you will get this.
Condoms reduce transmission from women to men by 65%
You can wait to have unprotected intercourse as long as you like - but she is unlikely to transmit to you even now
Certainly some people who are in discordant relationships where one has HSV 1 and the other does not, take daily medicine, yes.  And will help to reduce the transmission risk
Again, have you tested negative by IgG test for HSV 1?

Terri
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18 months ago
I just got my test back and have tested negative for carrying HSV1. Which actually has me feeling a bit panicked about contracting my girlfriend’s GHSV1 to my genital region. I recently saw you posted that with newer infections people are shedding 13 out of 100 days...that seems like a lot! 
When we did the math she was only diagnosed 4.5 months ago - I'm worried as we had unprotected sex recently - worried that she’s shedding much more than I originally thought. Are we still looking at rare genital to genital transmission with all that shedding? Thnx.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
18 months ago
So if you had the IgG test (never an IgM test but check to be sure which you had) misses 30% of infections so the negative is interesting but cannot be counted upon fully.  If she was tested at 4.5 months out, her shedding had already decreased significantly to around 7%. 
Genital to genital transmission is indeed very rare.  I would encourage you not to worry too terribly much about this.  Since about half the population has HSV 1, you have almost certainly encounter this virus previously and will in the future.

Terri
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