Good afternoon, I had a question about about HSV2 transmission risk. It concerns a male who has been positive for at least 10 years and is on daily suppressive therapy. The male has never had a genital outbreak, including during the encounter in question; only outbreaks on his mouth even though he’s confirmed HSV1 negative. The male has never transmitted HSV 2 as far as he’s aware. The female parter is negative for both types. The experience involved unprotected frottage (genital to genital rubbing) and brief unprotected penetration; otherwise, the encounter was condom-protected.  Questions: 1) was this a risky encounter for the female and what is the risk of transmission to the female in this case?  2) What is the transmission risk of frottage with suppressive therapy? 3) Is it possible that because the male has never had an genital outbreak but only an oral outbreak, even though he’s confirmed HSV 1 negative, that he has only oral HSV 2?  4) if so, is genital transmission possible or only oral (in other words, would the site of the infection and source of transmission be the mouth only?)?

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Thank you very much for your reply.  That all makes complete sense.  To answer your question, no, the male has never had an outbreak in the genital area.  Only in the mouth (not sure it’s canker soars as the oral outbreak look a lot like herpes, including being right in the upper lip area).  And yes, confirmed multiple times through IGG blood tests.  Does that change your view on whether the male could have oral HSV 2 only?

False positives can happen multiple times - you should be certain that the index value obtained on the IgG test is greater than 5 to eliminate any possibility of a false positive.  And it should never be an IgM test, only IgG, and not combined with HSV 1.---
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Thank you. When you say that HSV1 doesn’t like the oral area, do you mean HSV2?

Whoops yes, that's what I meant - good catch!---