My partner and I have had oral sex (me to them or them to me) without a condom and vaginal sex with a condom multiple times during our relationship.  I have never engaged in oral sex or vaginal sex when any suspicion of a symptom was present.  But I know it still isn't 100% impossible to transmit HSV-1 asymptomatically.  We obviously kiss, as well, and they have never had any signs or symptoms over the years we've been together either (and they are aware of my status).

Question(s): Given the length of time I've had HSV-1 and the infrequency of obvious/active symptoms, how likely am I to transmit this to my partner or future partners?  How risky is it for my partner to perform oral sex on me, even if I have no active symptoms? 

You are extremely unlikely to transmit this to your partner, either through intercourse or them giving you oral sex.  Has your partner been tested to know that they don't have HSV 1?

Terri

A few follow-up questions:

1.  Since my outbreaks have only been in the genitals, is it safe to assume that my HSV-1 is infected there only and not on/in my mouth since I have never had a cold sore?

2.  Is it safe for me to perform un-protected oral sex?

3.  This seems like a no-brainer but is it recommended that my partner get a blood test for both HSV types?

4.  Regarding pregnancy and HSV-1 in the genitals - I understand that having an active herpes outbreak on the vagina at the time of birth is serious, but do women with "inactive" HSV-1 or no obvious signs/symptoms at the time of birth have anything to be concerned about?

1.  Since my outbreaks have only been in the genitals, is it safe to assume that my HSV-1 is infected there only and not on/in my mouth since I have never had a cold sore?

I think that is a safe assumption, yes

2.  Is it safe for me to perform un-protected oral sex?

yes, if your HSV 1 infection is oral, you can safely perform oral sex

3.  This seems like a no-brainer but is it recommended that my partner get a blood test for both HSV types?

If he did test and was positive for HSV 1 now, then you would be able to relax about him becoming infected from you.  Of course, he if has HSV 2, that's a whole different scenario

4.  Regarding pregnancy and HSV-1 in the genitals - I understand that having an active herpes outbreak on the vagina at the time of birth is serious, but do women with "inactive" HSV-1 or no obvious signs/symptoms at the time of birth have anything to be concerned about?

You would very likely be given daily antiviral medicine from 34-36 weeks on to reduce the risk of having an outbreak at the time of delivery and/or infecting your baby.

Terri

1. Given the estimated frequency of HSV-1 in the population, how many babies are born to women that do not know their status?  Or put another way, statistically it seems like many HSV-1 positive women have children without issue or even knowing, is that true?

2. Regarding disclosure: I knew 10 years ago that I acquired HSV-1 from somewhere (presumably someone with the oral version performing oral sex on me) and have told that to the serious partners I had since that time.  Shamefully, I wasn't so great about telling casual partners.  At this point it seems like a done deal especially since I have no way to contact them, but besides proactively disclosing going forward and seeking some counseling for stress/guilt, is it possible for me to take a little weight of my shoulders thinking that my particular case was/is less likely to transmit, particularly in brief encounters?

3.  Generally how long before/after an actual visible OB is GHSV-1 at its peak contagious stage?  I have tended to err on the side of any time I feel ANY suspicious sensation to avoid contact, and then about 5 days after everything is clear.  With my long-time partner, if everything feels normal and I haven't had any S/S (which is a majority of the time now for years), then we proceed with sex as usual.  Is that a fair policy to have?

Thank you again so much for your help - these are obviously big questions so many of us have but don't know where to turn.  You provide a wonderful service.

Since a positive HSV 1 antibody test does not indicate the location of the infection, I have no idea how to answer #1.

I do think you should take weight off your shoulders!  Not all clinicians even think that disclosure is necessary.  I'm on a little different page but I agree that not telling is an option.

The policy you have about having sex with your regular partner and outbreak that are healed is totally appropriate.

I'm glad you are happy with our service, and thank you for saying so.

Terri