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Herpes transmission
I have had HSV 2 for over 10 years. My boyfriend does not. I take daily Valtrex (now in the generic form) and we always use condoms. We have had sex between 20 and 30 times, most recently 3 to 4 days ago. This morning he has a noticeable red bump just above his penis in the hair bearing region. He is quick to hope it's something else, such as an ingrown hair, but plans on getting it tested asap. Based on the information and timeline it it safe to assume (sadly) that i have transmitted the virus to him?
MEDICAL PROFESSIONAL
Welcome to the STD forum.
You're doing all the right things to prevent HSV-2 transmission to your partner. That doesn't make protection complete; transmission can still occur. However, many herpes experts tell me they have never seen transmission occur in a couple in their practices, if both antiherpetic therapy and condoms were both consistently used. Also, among monogamous couples in which one partner has HSV-2, if they take no precautions at all (except to avoid sex during obvious outbreaks), the available data suggest an average transmission risk of only once for every 1,000 or more episodes of unprotected vaginal sex. So even if you weren't using condoms and valacyclovir, the likelihood of transmission after 20-30 sexual exposures would have been pretty low.
And from your description, your partner's symptoms are not typical for new genital herpes. HSV transmission is believed to usually require that the virus be vigorously massaged into the exposed tissues. That's why initial herpes outbreaks are most common at the sites that receive the most friction during sex: penis head and shaft in men, vaginal opening and labia minor in women, the anus in people who have anal sex. Few initial outbreaks are in the pubic area, scrotum, labia majora, etc. Partly for the same reason, initial herpes generally is not in hair-bearing areas. In such areas, ingrown hairs, folliculutis, or pimples are much more likely than herpes. You and your partner can get a strong clue by close examination of the "red bump": if a hair is emanating from the center of it, that would go against herpes and strongly in favor of folliculitis. And although initial herpes can occur as a single lesion, usually there are multiple blisters/sores.
So all things considered, I doubt HSV-2 transmission has occurred. But if any doubt remains or if he (and you) would just like reassurance, the only way to be certain is to be professionally evaluated and, depending on the doctor's or clinic's advice, perhaps tested for HSV.
I hope this helps. Best wishes-- HHH, MD
You're doing all the right things to prevent HSV-2 transmission to your partner. That doesn't make protection complete; transmission can still occur. However, many herpes experts tell me they have never seen transmission occur in a couple in their practices, if both antiherpetic therapy and condoms were both consistently used. Also, among monogamous couples in which one partner has HSV-2, if they take no precautions at all (except to avoid sex during obvious outbreaks), the available data suggest an average transmission risk of only once for every 1,000 or more episodes of unprotected vaginal sex. So even if you weren't using condoms and valacyclovir, the likelihood of transmission after 20-30 sexual exposures would have been pretty low.
And from your description, your partner's symptoms are not typical for new genital herpes. HSV transmission is believed to usually require that the virus be vigorously massaged into the exposed tissues. That's why initial herpes outbreaks are most common at the sites that receive the most friction during sex: penis head and shaft in men, vaginal opening and labia minor in women, the anus in people who have anal sex. Few initial outbreaks are in the pubic area, scrotum, labia majora, etc. Partly for the same reason, initial herpes generally is not in hair-bearing areas. In such areas, ingrown hairs, folliculutis, or pimples are much more likely than herpes. You and your partner can get a strong clue by close examination of the "red bump": if a hair is emanating from the center of it, that would go against herpes and strongly in favor of folliculitis. And although initial herpes can occur as a single lesion, usually there are multiple blisters/sores.
So all things considered, I doubt HSV-2 transmission has occurred. But if any doubt remains or if he (and you) would just like reassurance, the only way to be certain is to be professionally evaluated and, depending on the doctor's or clinic's advice, perhaps tested for HSV.
I hope this helps. Best wishes-- HHH, MD
Dear Dr. Handsfield,
Thank you for your response. The detailed information you have provided is not only helpful but truly appreciated.
Best,
Lily
Thank you for your response. The detailed information you have provided is not only helpful but truly appreciated.
Best,
Lily
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
