Where shedding occurs, HSV2 levels and overall risks

[Sven1234]

Hi Terri,

I am a 35 y/o male and considering a relationship with an amazing, caring, loving woman that informed me that they are HSV2-positive

Couple questions...

1. I've seen conflicting opinions on this online and hoping for some clarification.  Does the bulk of the shedding occur at the point at which any breakouts have occurred?  For example, if there has only been 1 outbreak in 6 years and it was not in the vaginal or anal area (ie, it appeared 3-4 inches north of the anus), it is likely that that is where any shedding that does occur will occur?  Or is shedding likely to occur anywhere since it is technically everywhere down there (also an idea with varying opinion).  And does this location provide less risk given that it is more out of the way?

2. I see others post about their HSV levels (ie, 2.0, 5.5, etc).  Is this considered a level of positivity or strength of virus?  Or is positive just positive and these levels don't matter to much in terms of transmission risks.

3. I see risk percentages that are hard to put into real numbers like 4% chance over the course of a year with someone with no protection/meds, 2% with the meds, 1% with protection/meds.  So equate this into an idea you would have sex everyday so they come up with these 1/10000, 1/20000, 1/40000 odds at any given time you have sex which seems to be too slim odd actually.  Any clarification on that?

Thank you.

[Sven1234]

There are many sites showing this daily breakdown of Terri's report which I think actually brings people's guards down too far about the odds.  I think it creates a false sense of security and it potentially makes people think that using condoms and meds to control the risks (or even telling partners) is not really necessary.  

The inflated 1/10000 risk "on any given night" without condoms/meds (for female to mail transmission) is chance most people will take on and inflict on others without too much thought if they believe it.  And, this can only further spread HSV2.  

I'd rather other sites that reference Terri's WebMD report from 2005, just take it as it is.  Clearly having HSV2 is a big deal and from 90% of the posts here does cause people stress and trauma...it doesn't at all mean that you will not find love and live an amazing life (tons of people do that everyday with HSV2). HSV2 is life impacting without a doubt, is anywhere from a mild one-time annoyance to a horrible regular experience and is something to no one wants (or should want anyone they care about to have).  With that, websites (whether they are on the side of the HSV2 person or their uninfected partner) should portray the rare odds accurately so people can make a proper decision on how to protect themselves (and how they should protect their partners).

Thanks for your work and help in this community.

[gracefromHHP]

really , what difference does it make to try to break it down to risk per sex act?  

[Sven1234]

Thanks for your answer on #1.  

I had been tested prior to meeting this person and had the test about 4 months after my previous intimate partner (and was not intimate with anyone after the test until meeting the person that is HSV2 positive).  So from that, I am negative.

For the 3rd question, I am referring to the odds extended from an often referred to study of Terri Warren's where there are hundreds of couples where one partner is HSV2 positive and the other is not and what percentages of transmission exist over the course of a year.

On http://www.hsvblog.org/herpes-simplex-virus-hsv-101/, they say

"By avoiding sex during an active outbreak, chances of virus transmission are 4% a year (Terri Warren, RN, NP – WebMD, 2005). Yes, per year, not sexual session. Dividing this figure by 365 days (or nights), this makes the possibility of spreading the virus on any given day/night .0001%, or 1/10,000 (.04 / 365 = 0.000109589041)."

Further on they add "that using a condom makes it 1/20000 and using a condom and anti-viral meds make it 1/40000 on any given night".

While they have done an extrapolation of Terri's findings down to a daily level, I dont think it's helpful to think of it in this way and while the odds of getting herpes are rare, they almost make it too rare by taking it to a daily level (when most aren't intimate daily anyways).

I'm curious about your thoughts on the 1/10000, 1/20000, 1/40000 odds that they've extended Terri's finding to be.

[gracefromHHP]

have you been tested to know your own status?  

shedding happens from the entire anogenital area and the area of actual lesions when they are present. in between obvious lesions, shedding occurs from the entire anogenital area.   shedding occurs at about the same rate regardless of the number of recurrences if not on daily suppressive therapy.

the numeric result on the blood test doesn't have any meaning than positive or negative. we only ask for the numeric results to help see if there is a need for additional confirmatory testing to confirm status due to the known false positive issues with low positives.

I'm not sure what you are asking in your 3rd question.

grace