[Question #6791] HSV2 Transmission Rate w/Razor Cut

11 months ago
Hello, 

I'm a 32 yr old male, confirmed with HSV2 positive (with three  independent AB testing results showing all positive  this includes western blot). I'm currently on Valtrex 500 mg daily and me and my wife practice safe sex using condoms every time. She is a 31yr female who tested negative for both HSV1/HSV2 through a AB blood test.  She recently cut herself with a very "minuscule nick" on her vulva (medial, upper labia majora)  before we've had sex for the first time since getting married. We're concerned about the rate of transmission increasing by having vaginal sex while she still has recent/fresh razor cuts. My question is that does the rate of transmission increase (and to what %) if my wife and I having sex 1-2 times daily on average if she has these recent/fresh razor cuts? 

Also, what is the rate of transmission of my wife acquiring HSV2, if we have sex 1-2 times daily on average [while I'm on 500 mg valtrex daily every day (planning to stay indefinitely), while also using condoms] with and without recent razor cut(s)? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
11 months ago
I would suggest that your wife try trimming her pubic hair rather than shaving.  Shaving really does open both obvious (sometimes) and minuscule breaks in the genital skin, allowing the virus to enter more easily.  However, with you using condoms, the transmission risk is reduced by 96% compared to no condoms, so the risk is already pretty small if she really wants to shave.  The condom and the Valtrex together reduce the risk to a very low number.  Our studies are based on people having sex an average of 2X per week, but you guys are having way more sex than that, so the risk is higher, but how much higher, we really don't know.  With no condoms and no antiviral medicine, the risk is about 10% per year transmission.  Now to be clear, we are always looking at "survivors" in our studies - people who have already been together having sex for a while before they enter a trial.  But that's the only number we really have so if we apply the 96% reduction to that number, then another 50% reduction with antiviral therapy (which may not fully apply given the already significant condom reduction), we are at very low numbers of transmission.  But then with your frequent intercourse, the number goes up some.  Having you been having sex right along or have you only started having sex since getting married?

Terri
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