Dear DWH:
I'm considering getting involved with a woman who has had genital herpes for 20 years and is on suppressive therapy with Valtrex. Would having the virus this long make transmission any less likely??? If we avoid having sex during outbreaks and prodrome - is there a good chance of avoiding transmission (we would be in a LTR and won't be using condoms)??? If I did get it, would I get a milder form since she has had it for 20 years - or no relation to that??? She claims she has never passed it onto a partner - might not sure how anyone could be sure of that with the varying symptoms people get!!!!! Also if she has only HSV-2 of the genitals, could I get oral sores if I perform oral sex on her???
Thanks, Wondering
Dear Wondering:
Every person's situation is different. For most people, the longer they have the herpes virus, the less frequent their symptoms and presumably, the less often they shed the virus asymptomatically. But to know about your friend specifically, she'd have to get tested daily to see how often, if at all, the virus may be present on the skin. That's not terribly practical.
If my memory serves, there was a study from the University of Washington that showed the rates of asymptomatic shedding for people who had been seropositively diagnosed with HSV2 (via blood test) for up to 2 years - and I think the average rate of shedding was around 2% of the time...but don't quote me on that. There were some people in the study who tested positive, but did not shed the virus from the skin at all during the test period. This doesn't mean that it might never happen. But the study did show that some people shed the virus more often and some shed less often and some didn't shed the virus at all during the test period.
As for how you might react to the herpes virus if you were to get it, that's also totally dependent on how YOUR body deals with it, and has nothing to do with how our partner's body deals with it. Most people with herpes have few or mild or even no symptoms, such that they don't even know they have it to begin with. Stats show that about 25% of US adults already have the virus for genital herpes, but up to 90% of them don't even know it! That means that most people with herpes don't know it and are sleeping with partners and not taking any special precautions. Most people also already carry the virus for oral herpes, although most only display symptoms rarely. Both types of herpes are very common and can appear either genitally or orally.
It is extemely rare for genital herpes (of the HSV2 variety) to be spread to your mouth if you perform oral sex on someone with genital herpes. In those cases, there has usually been only 1 outbreak and then no more. However, if you have HSV1 (usually the cause of Oral Herpes) and perform oral sex on someone who does not have herpes, you might give them Genital Herpes of the HSV1 variety. This accounts for 30% of recent reports of genital herpes. Usually, genital herpes caused by HSV1 has less frequent recurrances, but it all depends on the person.
So if your friend knows they have herpes, is taking Valtrex, and you are using condoms all the time, and making sure to avoid sexual contact if there are symptoms coming on...then you are probably safer than if you're just sleeping with someone who has herpes but doesn't know it, and isn't doing anything about it. If you decide NOT to use condoms, that's your choice. Valtrex and condoms reduce the risk significantly. If you decide not to use condoms, another option is to take Valtrex yourself! I've heard this from doctors/physicians who have herpes themselves. They get a prescription for Valtrex for their partner. Apparently, this helps reduce their partner's susceptibility to viruses like HSV2 as well.
I'm one of the many people who didn't know they had herpes at all until they eventually had a visible outbreak - years afer I probably got the virus. I had been married over a year and was with my spouse at least a year before we married. So I had acquired the virus before that. But I never had an outbreak, until a year after I was married. I had a brief outbreak, got tested, and learned the news. At the time, my doctor told me that it was safe to have sex when I wasn't having an outbreak. He knew nothing about Valtrex. Acyclovir was only for episodic treatment. This is an example of what out-of-date doctors are still telling their patients. Some of the advice is OK. Other parts of it are very out of date.
Frankly, you probably already have oral herpes, and might even already have genital herpes and not know it. Have you been tested? Probably not, since most doctors don't test you for herpes in their standard STD screenings. You have to ask them specifically to test you for herpes. So, unless you know for sure that you've already been tested for herpes since your last intimate relationship, it's time to go to your doctor and ask for one of the new and very reliable herpes blood tests for HSV1 and HSV2 listed on http://www.datingwithherpes.org/herpes_blood_tests.htm That's the only way to know for sure if you have or don't have the virus for oral or genital herpes. Chances are, you have never been tested. So get tested.
Then, relax. Herpes is just a skin condition that most people manage pretty easily. Most people have mild, few or NO symptoms. Unfortunately, some people have more noticeable and painful symptoms. Those are the people you hear about. But for the most part, herpes is a very manageable condition except that those people who know they have it want to be more careful with their partners. It's admirable for anyone to tell you that they have an STD and to take precautions to reduce the risk of spreading it to you. That's the responsible thing to do.
There really should NOT be tigma associated with HSV2 vs HSV1 since they can both be spread genitally OR orally, even when no symptoms are present. Everyone should take precautions against STD's but few people really do. Unfortunately, most people with or without STD's often throw caution to the wind occasionally and put themselves at risk. Conservatives and Liberals, Religious and Not-so-Religious - many people are not taking precautions or getting tested for STD's. Everyone is at risk!
So, if you really like this person and you are taking all the recommended precautions, you are pretty safe. Remember, sex is messy and is never 100% risk free, even if the other person doesn't have herpes. There are plenty of other STD's out there. New partners should always get tested before sleeping together. You can't treat something if you don't know you have it!
For more information on how to reduce the risk of herpes transmission, go to:
http://www.datingwithherpes.org/reducing_risk.htm
DWH
Questions? Email: dating with herpes at gmail dot com
