[Question #6069] Protection successes

17 months ago
 I am in a monogamous relationship. We found out several months ago that I have herpes 2
I immediately began the antiviral drug, valtrex, daily.  I have never had an outbreak or any kind of reaction to the virus but believe my former husband has the virus as well . 
My new partner of two years is freaked out big time. We were using the antiviral and condoms for a while but then he had an outbreak related to something else and really began to freak out.
We have consulted with my physician his physician and we both went to a mutual medical doctor to get advice regarding protection. In all cases they assure him the chances of the virus spreading to him are very minimal especially since we’ve been to get her  two years, I’ve never had an outbreakAnd I am now taking the antiviral medication as a back up.
 I guess his comfort would be in talking with couples, discordant couples, about their successes and their advice. I am wondering if he will be able to get over this and also if there is some psychiatrist or support group we can talk to so that he can become reassured that he will probably never be affected by the Herpes,  as I am not.
 Although I believe he dearly loves me I think this has become a real problem in his head so I want the best and most help possible .

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
17 months ago
Before I answer your question, let me ask how you were diagnosed with HSV 2. If by blood antibody test, what was the index value associated with the positive result?  Then I will answer

Terri
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17 months ago
3.1    Index score
Blood test
Not sure the second reading/second test but in same range
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
16 months ago
So the thing is, your index value is in what we call the low positive range.  The CDC recommends that everyone who obtains a test result in the range of 1.1 to 3.5 obtain a confirmatory test because there are false positives (50%) in this range.  The closer one gets to 3.5, the more likely the positive is to confirm, however.  Please do this to be certain you are dealing with a real issue rather than a lab error. 

Second, if it is real, and you take daily antiviral medicine and he uses condoms, the risk of transmission to him having sex about twice a week for a year is about 1-2%.  Very low.  And then my question is, has he been tested to know if he is possibly infected already or not?  If not, he should be.

Terri
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16 months ago
Thanks for your quick response. Yes my scores were both low, 3.1 and 2.8
 And yes he was tested and confirmed not positive , even after he had some sort of rash and outbreak himself which created all kinds of anxiety. .
 Again he is still very cautious and does not want to contract any virus.   When he initially found out about my situation , we both found out in March,  he dealt with it pretty well but wanted to use condoms,  which is what we did until he got the rash. My OB/GYN told me that many of her clients only use the antivirus and have used it successfully for years. For me since I’ve never had an outbreak and have never had any kind of issue over the past two years ( and he has been witness to that )with my monogamous partner, my preference is to use only the antiviral, But at this point we are not having intercourse even with the antivirus and condoms.
 This has been going on for several months.   We talked to my doctor,  he talk to his doctor and we went to a doctor in Toledo at the University Hospital where they deal with this quite often. The doctor himself told my partner that if it were his wife he would Probably only use the antiviral and was pretty certain he would not get the virus. My partner thought if maybe he talked to some couples that have been through this for several years he would feel better about having intercourse again but so far we have not found anybody and he is not feeling comfortable. So now I guess it’s time to find specialistsOr some resources that can help us cope with the problem at hand.  Even though it mentions groups in some of the CDC and Asha articles we have been on able to locate any groups or any knowledge of groups. 
 I would also like recommendations for a psychiatrist so that we can  consult with somebody that deals with this as well 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
16 months ago
So you definitely need a herpes western blot to determine whether or not you are truly infected.  Both of your index values are below 3.5, which is the CDC cutoff for those who need to get a confirmatory test. I think you are ahead of yourself in trying to sort out what to do until you find out if you are actually infected or not.  I hope you take my advice very quickly about this as it seems that things are rolling ahead without this important information.

Terri
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16 months ago
I will get the test you are suggesting of course, but if positive,  can you answer my original questions and since it would mean I have had this for years with no outbreaks, would you think the shedding would be minimal by now? 
Sorry. Each question creates more questions.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
16 months ago
Yes, we know that people who have been infected longer have less shedding, on average.  There is a decrease at 6 months and another at 2 years and certainly decreases after that.  If you take daily antiviral medicine and your partner uses condoms, there is probably a 1-2% chance of transmission, having sex twice a week on average. 
I would be happy to have a video conference with you and your partner about the transmission concerns, if you wish.  You can set that up at westoverheights.com.  I think I can provide him a lot of good information about couples who are discordant (one infected, the other not), not transmitting over time.  So I would ask how do you know that the rash is related to something different than herpes and has he been tested to know that he is negative well after the rash appeared?  The test he took looks for antibody, not virus, and if taken too soon, it is not accurate.  Anyone with a truly new infection will not have antibody so if the test was done within a few weeks of having the rash, that may well not be correct.
I am going to leave this post open for now so you can answer my questions, OK?

Terri
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16 months ago
Yes. He waited a good six or eight weeks. But I will check the results for his type of testing. I will also get the other test for myself. 
I will most definitely set up a video conference -all of that discussion regarding  lengthy successful relationships without infection   It’s just what he’s asking for and needs to hear...  apparently over and over and over again.  He has turned this thing into a huge bundle of nerves, and it just keeps getting worse. Last week we spurged and did some heavy petting... he told me today he was sick to his stomach and had an itchy crotch for two days afterwards. Hence, no more touching I’m sure.
When I get results back I will teleconference but it will be important to stay focused on other successes and low risk... he will always want to talk about worst case senerios and the one percent chance...
We  also have scheduled several counseling sessions in the next month with a really good therapist so I’m hopeful about that .
Thank you thank you thank you
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
16 months ago
You are most welcome.   Petting is not a method of transmission, BTW
glad to hear you are doing counseling. 
The western blot is done only at the University of Washington - you can send for the kit at 206-685-6066 so you can work with your provider to get this done.

Terri
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