[Question #7313] HSV2 transmission rates

6 months ago

Hi, I would like some factual information regarding transmission from an infected female to an uninfected male. 


  1. What is the transmission rate/risk if we have sex 3 times per week on average With daily valtrex and no condoms 
  2. I have had HSV2 for 2 years now and I have only had 2-3 outbreaks which were very minor. I always read that people have back to back outbreaks but that does not seem to be me. 
  3. Is it possible for my partner to never get HSV from me if on daily meds or is it likely if we remain long term. 
  4. Do you ever think there will be a cure for HSV2 or better medications to reduce risk of transmission? 

I forget I have HSV2 most of the time although I sometimes get anxious thoughts about passing it onto my partner. We have been together for 8 months now and the last thing I want to do is pass this on! 

Your responses on this forum are very to the point. I read a lot of information but no one really gives the fine details and actual facts like you do! You all do an excellent job. 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
6 months ago
First, thank you for your very kind words.  That means a lot to me.
Second, from the name, I am going to assume that you are female (correct me if I'm wrong)
We have data on transmission having sex approximately twice per week, so your risk is very slightly more. 
The AVERAGE risk of people who have been together for a while is about 4% per year - that means about 4 men out of 100 will acquire HSV 2.  Taking daily antiviral medicine reduces the rate to around 2%.  Condoms obviously reduce it more. 
Most people with herpes don't have back to back outbreaks, actually
It is certainly possible for you to be together for a long time and not transmit HSV 2, yes.
I also now think that there will be a functional cure for herpes in the next 10 years or so with gene editing - maybe 15?  Hard to say but I am hopeful for sure.

Terri
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6 months ago
Thanks for your response.  It amazes me that the risk is so so low but people have this huge issue with HSV. The stigma is just so uncalled for.

One more thing - i have noticed purple veins around my vaginal opening sometimes I feel pressure on it. Could this be related to herpes? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
5 months ago
No, I don't believe so

Terri
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5 months ago
Thanks Terri. 
Another thing.. just say I forget to take my valtrex for one or two days will it put my partner at greater risk or is it not a huge issue. I missed two days of taking the tablets once and I've always been very curious. How long does valtrex last in your system? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
5 months ago
I think if you miss medication, it increases the risk slightly, yes.  But it takes 5 days for the medicine to become fully effective and 5 days to completely leave your body.  So missing two days is somewhere in the middle, right?  I think to best protect your partner, it would be best to try to keep that consistent schedule as much as possible.  If you miss one day,  you may wish to double up the next day.  The dosing for daily therapy is 500 mg once a day but the treatment for outbreaks is 500 twice a day so it's safe to double up the next day if you forget a day.

Terri
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