[Question #6510] HSV1 g

14 months ago
Some background: I've been blood testing positive for HSV1 since I first became sexually active around the age of 18. I've never had a cold sore. Between the ages of 18-25, I believe that I had many HSV1 genital outbreaks but have only i.d.'d them as such in retrospect.  At 25 when I did some research and realized that I could have contracted HSV1 g through oral sex from my first bf who regularly had cold sores, I went to the doctor during what I thought was an outbreak and was given visual confirmation of herpes lesions, though no swab test was conducted on them. Fast forward to age 28, and I'm still having fairly regular outbreaks (about 6 times per year), which I understand is abnormal for HSV1. I get the tingly feeling and then it usually appears as 2-3 papercuts on my labia. Due to the frequency of outbreaks, my doctor and I became concerned that I also had HSV2, but I've had very few partners and get tested every 6 months. It always comes back HSV1 + and HSV2-. I did suppressive Valtrex therapy for a couple of years and even had a couple of outbreaks during that time. 

Question 1) Why the heck am I still having fairly regular outbreaks when I've had HSV1 for at least the past 10 years? 
Question 2) I've read conflicting things about whether sexual partners can ping-pong HSV1 infections between each other. Am I in the clear to have sexual contact with people who have a history of cold sores/are HSV1 positive, or is it possible that I could give the HSV1G even though they already have it orally? 
Question 3) Disclosure: Up until now, I've always fully disclosed before intimacy and it's gone well. However, I recently had my first experience where the person acted hurtfully after I disclosed, which threw me off of my stride. I've recently started having sex with a new partner who I really like, but I didn't fully disclose. I told him that I'm HSV1 positive but did not provide any specifics. We've had intercourse with condoms and now I feel awful. Ethically speaking, w
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
14 months ago
Question 1) Why the heck am I still having fairly regular outbreaks when I've had HSV1 for at least the past 10 years?

I would strongly suggest that you have these papercuts on the labia swab tested for herpes the next time they arise.  Women get labial papercuts for any number of reason and before you decide that a positive HSV 1 antibody test came about as a result of HSV 1 genital infection, you should most certainly confirm.  Also, this is way more often than other people we see who have HSV 1 genital infection, though people will say that they have lots of outbreaks.  Until they are proven so by swab test, I am skeptical.

Question 2) I've read conflicting things about whether sexual partners can ping-pong HSV1 infections between each other. Am I in the clear to have sexual contact with people who have a history of cold sores/are HSV1 positive, or is it possible that I could give the HSV1G even though they already have it orally?

If you are having sex with someone who also has HSV 1, regardless of it's location, it is extremely unlikely that either of you will get HSV 1 at a new location on your bodies, correct.

Question 3) Disclosure: Up until now, I've always fully disclosed before intimacy and it's gone well. However, I recently had my first experience where the person acted hurtfully after I disclosed, which threw me off of my stride. I've recently started having sex with a new partner who I really like, but I didn't fully disclose. I told him that I'm HSV1 positive but did not provide any specifics. We've had intercourse with condoms and now I feel awful. Ethically speaking,

I personally don't think you have anything to be sorry about here.  Although you seem to be quite sure you have genital HSV 1 in the form of papercuts that are frequently recurring, I am far less certain that you.  If you get a positive swab test from a genital lesion that is HSV 1, that would be another story.  IF your infection is genital, then condoms are going a long ways to reducing any transmission risk.  The thing is, at some point, if you do get a positive swab test from the cuts, then I do think you need to let him know, since you are describing frequent outbreaks.  but find out first if this truly is genital HSV 1.

Terri
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14 months ago
Thank you for your reply. In re: ping ponging, is the exception if someone recently acquired an infection in one site and then acquires in another site shortly thereafter? And do you think I should suggest my current partner be tested for HSV1 so I know if we are discordant? He denies cold sore history.  I'm experiencing the paper cuts now and went to a new doctor today. She swabbed the lesions but said that she didn't think it was herpes, though a past doctor did identify the paper cuts as herpes. She said the area was very dry and redder than normal color. I read on your site that if it's a recurrence & a small lesion, there is a high chance of a false negative. Also, I noticed the onset Sunday night, so I realize it's a bit outside the ideal window since I got it swabbed this afternoon. If it's negative, I planned to tell partners that I'm HSV1+ through bloodwork and had a negative swab test, though those are not 100% accurate. Then if it happens again, get it swabbed at onset. Does that sound ethical to you? (Sorry, I'm an anxious attorney lol)
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
14 months ago
The only way for anyone to know if something is herpes or not is to swab test it.  A visual inspection alone cannot tell you if a lesion is herpes or not.  If I saw a woman with skin splits or paper cut type lesions, I would NEVER say they are herpes without a positive swab test.  I've seen way too many be negative by PCR to make that assumption. If this swab test is also negative, I think your disclosure plan is adequate  - not only that, it's accurate.

Terri
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