[Question #9142] Risk of Herpes-2

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35 months ago

I'm wondering about the true risks of getting Herpes from a partner with Herpes-2.  I read about the odds being 4%, is that PER SEXUAL ACT BY DAY?   I am aware I can reduce that risk to 2% with anti-viral medication (and I am a male and my partner who has herpes is a female).  I wonder is this risk compounded such that each sexual encounter has a 2% risk then over 100 sexual encounters the odds become 87% of contracting it (98% chance of not getting herpes to the 100th power=13% of not contracting, so 87% of contracting).  Just to be clear here, as I'm having many difficulties getting this question answers, for example, would the risks be 2% on January 1, then 2% again on January 2, then 2% again on January 3, etc.??  Is this close to correct?  If not, can you help me determine better the risks OVER TIME.



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Terri Warren, RN, Nurse Practitioner
35 months ago
If you have sex about twice per week, with the partner taking antiviral medication but you not using a condom, for a year, about 2 men out of 100 will get herpes in a stable relationship over the year's period.  So I think you are thinking about it correctly, yes.  Adding condoms reduces transmission by 65% from females to males, so that would provide additional protection.

Terri
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35 months ago
1) How about if sex is in a spot from where the herpes is?  E.g the herpes is on the vagina, what about anal sex? (Or is shedding still present in those areas?) 

2) I have read quite a bit about unprotected oral on HSV-2 from you Terri, you have said its "INCREDIBLY" rare.  I don't know if its possible that you have numbers there but that would be appreciated same as you gave more exact numbers in my initial answer.  If not if possible to contextualize it some.  The problem is a lot of these rare events, over time, become even likely! 

3) If I finger her and touch my penis, that is a potential transfer of HSV-2?

These are all related to having sex with HSV-2 female, happy to split them up and re-ask if you can not answer all these!  Thank you Terri.
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Terri Warren, RN, Nurse Practitioner
35 months ago
1.  Anal sex also presents some risk as well.
2.  I have probably seen HSV 2 orally, in my whole career of 40 years, 10 times
3.  I think transfer via hands is also extremely unlikely.  I've never seen it happen

Terri
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35 months ago
Is there offical guidance that the risk of herpes-2 transmittion to someone orally are so low that one should basically consider it as "getting hit by lightning"?  I like how the other doctor in all his answers says, "if somehow I found myself in your position" so my position is I really want to give oral to my partner!  
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Terri Warren, RN, Nurse Practitioner
35 months ago
Ha!  I don't know about the comparison to getting struck by lightening and the reason I don't know is that having HSV 2 orally is so uncommon that we really don't have good statistics about it.
Also, when people get oral lesions, most often it is assumed that they are caused by the HSV 1, not HSV 2 because HSV 1 causes the vast majority of cold sore, and rarely is a lesio swabbed and then typed (HSV 1 or HSV 2).

So I could answer your question about what would I do.  If there was a lesion present on the penis, I would not give oral sex to that person.  But if the person was someone I really cared about, and no lesions were present, I would give them oral sex, yes.  Since your partner is female, it's different, I know.  But here's the interesting thing: if someone gets HSV 2 orally, they are essentially vaccinated against gettting it in a new location, ie. genitally.  In a long term relationship with discordant couples, that's not so awful.  Right?

Terri
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35 months ago
That is a plus!  But the great thing about genital herpes is no one knows who you don't want to know.  Can we evaluate the downside scenario of contracting HSV-2 on the mouth.  If I were to google it I know I'd see unreal pictures of mouth lesions.  For the ones you've seen orally, is there a standard for how bad it is.  Hidden lesions are one thing, open sores for the world to see are quite a bit different.  Its hard to decide whether to go down on someone with herpes!  
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Terri Warren, RN, Nurse Practitioner
35 months ago
From the ones I have seen, they look just like a cold sore.  you've seen cold sores, I'm sure.  That's why it looks like.  There are also some interesting new panties, that are very very think, for giving oral sex to someone who has HSV or HPV, without coming into direct contact with potentially infectious area.



Terri
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