[Question #8386] Risk of HSV-2 Transmission (female to female)
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45 months ago
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I was diagnosed with HSV-2 in May of this year and tested negative for HSV-1. I had the obvious signs in my lady parts and got the diagnosis from having them swabbed/tested. I have the following questions:
1) What is the risk/rate of transmitting HSV-2 to a female partner performing oral sex on me if I'm taking 1000 mg daily of an antiviral, *not* wearing a dental dam, and *not* in the midst of an outbreak? What is that same risk if I'm wearing a dental dam? I've read in both cases that it is low but I'm a statistics person and haven't been able to find a numerical value, just the word "low". I want to have the most factual and specific information possible before I disclose my status/we have sex. I guess I just want to know what is meant by "low" and how different the rates are for wearing protection vs. not wearing protection.
2) What is the risk/rate of transmitting HSV-2 to her if we're rubbing our genitals together (assuming the same information above - a daily antiviral but no physical protection and no current outbreak)?
1) What is the risk/rate of transmitting HSV-2 to a female partner performing oral sex on me if I'm taking 1000 mg daily of an antiviral, *not* wearing a dental dam, and *not* in the midst of an outbreak? What is that same risk if I'm wearing a dental dam? I've read in both cases that it is low but I'm a statistics person and haven't been able to find a numerical value, just the word "low". I want to have the most factual and specific information possible before I disclose my status/we have sex. I guess I just want to know what is meant by "low" and how different the rates are for wearing protection vs. not wearing protection.
2) What is the risk/rate of transmitting HSV-2 to her if we're rubbing our genitals together (assuming the same information above - a daily antiviral but no physical protection and no current outbreak)?
3) I've also read that the risk of spreading it to another female being a female myself is lower than for gay male couples and heterosexual couples. Is this true? If this is true, would this be because there's nothing penetrating the vagina?
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Terri Warren, RN, Nurse Practitioner
45 months ago
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I understand that you would like specific risk numbers but unfortunately, we don't have that data. We woefully have no data on the transmission of HSV 2 between same-sex couples and we also have no data on transmission via oral sex only.
I would agree that the risk of transmission of HSV 2 between two female partners is low because there is nothing penetrating the vagina, correct. We do know that taking daily Valtrex reduces both shedding of the virus and subsequent transmission to a sex partner, the transmission risk lowered by almost half.
Anecdotally, I can say that I've not seen a case of oral HSV 2 alone without genital symptoms, though I'm sure others probably have. The cases I've seen of oral HSV 2 have always been accompanied by genital HSV 2.
Sorry I don't have more specific info for you.
Terri
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45 months ago
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Okay, thank you for the information you're able to provide. I guess to just follow-up then, would you agree that the likelihood is probably fairly low to give someone oral HSV-2 via oral sex if they don't get it on their genitalia first, since asymptomatic shedding happens infrequently (especially being on an antiviral)?
In addition, you mention that the transmission risk is lowered by almost half. I think I might have found the study that you're referring to: transmission occurred in 1.9% of couples that were taking daily valacyclovir yet in 3.8% of couples that were taking a placebo. I understand that study involved heterosexual couples but based on reading that the transmission of genital HSV-2 to oral HSV-2 seems to be way less common than spreading genital HSV-2 to genital HSV-2, is it logical to think that the probability when it comes to spreading genital to oral HSV-2 would likely be less than 0.019?
Lastly, there is really no way to know if I have oral HSV-2, correct? I know I have genital HSV-2 based on the location of my sores when getting diagnosed but it's possible it could be in my mouth as well even if symptoms never appeared there?
Thank you very much for you time, that should conclude the remainder of my questions. This forum has been so helpful and I'm very grateful to have found it.
In addition, you mention that the transmission risk is lowered by almost half. I think I might have found the study that you're referring to: transmission occurred in 1.9% of couples that were taking daily valacyclovir yet in 3.8% of couples that were taking a placebo. I understand that study involved heterosexual couples but based on reading that the transmission of genital HSV-2 to oral HSV-2 seems to be way less common than spreading genital HSV-2 to genital HSV-2, is it logical to think that the probability when it comes to spreading genital to oral HSV-2 would likely be less than 0.019?
Lastly, there is really no way to know if I have oral HSV-2, correct? I know I have genital HSV-2 based on the location of my sores when getting diagnosed but it's possible it could be in my mouth as well even if symptoms never appeared there?
Thank you very much for you time, that should conclude the remainder of my questions. This forum has been so helpful and I'm very grateful to have found it.
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Terri Warren, RN, Nurse Practitioner
45 months ago
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Yes, I think giving someone HSV 2 orally via oral sex is rare
I would agree with your statistic that this risk is likely less than 1.9%, correct, quite a bit lower
That's also correct, there is no way in this case to prove a negative.
I'm glad we could be of help.
Terri
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