More information will be required to give clear answers -- you may need to speak more with your son both about his herpes and his sexual lifestyle and practices, perhaps more details than moms want to know (or that kids are comfortable revealing to their parents). How old his he? Does he have sex with men, women, or both? Which of the two HSV types -- herpes simplex virus 1 or 2 -- is the cause of his anal infection? If HSV1, his risk of HIV is no higher than without anal herpes. Most anal herpes is HSV2, and I'll assume that for the rest of this reply.

Among women and heterosexual men, having genital herpes from HSV2 roughly doubles the risk of HIV. There are no data like this for men who have sex with men (MSM), but it's probably about the same. "Double" sounds like a lot, but not necessarily. Say the liklihood of catching HIV for any one exposure is 1 chance in 10,000 (which probably is fairly typical for many rectal sexual exposures). Having HSV2 elevates that risk to 1 chance in 5,000 -- high enough to create a significant chance of infection with many contacts over a few years, but very low chance for any single exposure.

Most important, if your son is careful in his sexuality, especially assuming he has sex with other men, he can easily avoid HIV despite having anal herpes. He should discuss HIV status with his partner(s) before having sex, and ideally avoid going ahead with those who are HIV positive and not on anti-HIV treatment; and otherwise use condoms properly and consistently for anal sex. He also should avoid receptive anal sex whenever he has a recognized herpes outbreak. With these precautions, he'll never catch HIV, regardless of his herpes problem. (Although you don't ask about it, I'll also advise him -- through you -- that if his anal infection is HSV2, he has an obligation to share his herpes status, as well as his negative HIV status, with his sex partners. He can also take anti-herpes treatment, e.g. valacyclovir or acyclovir, to reduce the frequency of HSV2 outbreaks and transmission to his parrners.)

As implied above, I'll be happy to enlarge on these comments if you have the additoinal information implied above. In the meantime, I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

More information will be required to give clear answers -- you may need to speak more with your son both about his herpes and his sexual lifestyle and practices, perhaps more details than moms want to know (or that kids are comfortable revealing to their parents). How old his he? Does he have sex with men, women, or both? Which of the two HSV types -- herpes simplex virus 1 or 2 -- is the cause of his anal infection? If HSV1, his risk of HIV is no higher than without anal herpes. Most anal herpes is HSV2, and I'll assume that for the rest of this reply.

Among women and heterosexual men, having recurrent genital herpes from HSV2 roughly doubles the risk of HIV. There are no data like this for anal infection in particular or for men who have sex with men (MSM), but it's probably about the same. "Double" sounds like a lot, but not necessarily. Say the liklihood of catching HIV for any one exposure is 1 chance in 10,000 (which probably is fairly typical for many rectal sexual exposures). Having HSV2 elevates that risk to 1 chance in 5,000 -- high enough to create a significant chance of infection with many contacts over a few years, but very low chance for any single exposure.

Most important, if your son is careful in his sexuality, especially assuming he has sex with other men, he can easily avoid HIV despite having anal herpes. He should discuss HIV status with his partner(s) before having sex, and ideally avoid going ahead with those who are HIV positive and not on anti-HIV treatment; and otherwise use condoms properly and consistently for anal sex. He also should avoid receptive anal sex whenever he has a recognized herpes outbreak. And if he has sex with more than one mutually monogamous partner, he should consider pre-exposure prophylaxis (PrEP) with anti-HIV drugs, which is nearly 100% assurance against HIV, regardless of HSV2 status. With these precautions, he'll never catch HIV, regardless of his herpes problem.

Although you don't ask about it, I'll also advise him -- through you -- that if his anal infection is HSV2, he has an obligation to share his herpes status, as well as his negative HIV status, with his sex partners. He can also take anti-herpes treatment, e.g. valacyclovir or acyclovir, to reduce the frequency of HSV2 outbreaks and transmission to his parrners.

As implied above, I'll be happy to enlarge on these comments if you have the additoinal information implied above. In the meantime, I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

In our experience on this forum, most people with concerns like your son's have significant emotional or psychological conditions that contribute to their fear of HIV from the environment. Is he germophobic? Or have other evidence of obsessive compulsive disorder? With or without these problems, I would encourage him to seek professional counseling. Fears like this are rare and abnormal.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the disucssion has been helpful.