[Question #7449] 33 male HSV2 positive dating 27 Female with Type 1 Diabetes (no hsv2)

2 months ago
My girlfriend has had type 1 diabetes since her early 20s.  She has handled it well with consistently healthy glucose levels.
I am currently on suppressive therapy (valacyclovir 1gm daily) for HSV2.    Though my first infection was around the head of my penis, I have had one visible outbreak (pimple looking bump and it appeared on the lower shaft) since being diagnosed about 5 months ago (fully knowing that breakouts aren't always visible thanks to your page).  This breakout did occur while on suppresive therapy.

We are considering having protected sex.  Though I have seen your guy's numbers on protected sex and consistent protected sex among couples, what chances are we looking at for condom use, suppressive therapy, and doing our best to avoid sex during any sign of an outbreak for a woman with type 1 diabetes?

1st follow up: If my gf were to get infected, what could HSV 2 + Type 1 diabetes look like?  Is my infection too dangerous for her to even risk? 
Thank you for your time and expertise!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
2 months ago
I would like you to tell me exactly how you were diagnosed with HSV 2, please.
I think your plan to have sex with the provisions that you list (condoms, suppression) is an excellent one and would reduce the risk of infecting our partner to around 1-2% having sex about twice a week. 
Many people with diabetes have herpes and I think their course of the disease is not unlikely those without diabetes.  If she acquired HSV 2 from you (I am assuming she has tested negative  on the IgG test or western blot (better), she could begin taking medication right away and would likely not have a terrible first infection. 
Thanks for your question

Terri
---
2 months ago
Thank you for the reply.  Please tell your team how much a non-medical professional like me appreciates this service.  Forgive the three day delay, had to go gather specific information to make sure I answer your diagnosis question as accurately as I can. 

Starts with a female I had only know for a couple weeks around May of 2020. I noticed she stopped talking to me and cut off all communication lines within 12 hours of having unprotected sex for the first time.  Three to four days later, I notice a very large red bump on the side of my penis.  First doctor said it was just a genital wart.  I asked him to test for HSV 2, but he sadly didn't include that in the order.  Doctor gave me cream (sadly don't have what it was at this moment) that had no effect.  Nurse called me and said I was clear of everything about 4 or 5 days later.  When I asked about HSV 2, she said I wasn't tested for it.  I scheduled a meeting with another doctor. 

About a week and a half in, a large pimple with a white head showed up under the head of my penis.  Peeing was very painful.  New doctor is an RN and she felt confident it was HSV 2.  We did a HSV Culture Test on the penile lesion.  "HSV 2 Detected."  I took Azithromycin and then Valacyclovir.  Red bump decreased in size.  Pimple with the white head disappeared.   Pain including the (irriated/sun burnt feeling in the thighs and buttocks) went away.  

Over the months to follow, the red bump would get smaller and larger on its own.  I decided to do suppresive therapy since I was actively looking for a girlfriend and also wanted to see the bump get very small.  Since doing 1 gm tablets a day of valacyclovir, the bump became small and remains small.

My doctor friend in Iowa still wonders if there is a small chance I don't have HSV2.  Would love if that was true, but the evidence seems to say I do.

Follow Up Question #2: Is there anything else for me, the male, to wear along with a condom to help make sure no unseen outbreaks potentially around the base of my penis make contact with my girlfriend?  How safe is oral sex with unseen outbreaks ( we most likely will just avoid oral on me altogether)?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
2 months ago
I would disagree with your friend.  If you had a positive culture from the penile lesion, you have HSV 2 infection.  It's so simple, actually, I don't know why that doctor would say what they did.
The other option is the use of a female condom, which tends to cover a bit more area. 
I think the bump could be something entirely different - I would advise you see a dermatologist for a clearer answer.

Terri

---