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Communicating HSV-1 to a partner
About 1 year ago someone performed oral sex on me. There was no cold sore etc, but lo and behold I was diagnosed with HSV-1 genitally a few days later. I panicked and thought the worse, but its really not so bad I haven't ever had a reoccurance, and I usually forget about it. I haven't been involved with anyone in sexual intercourse so it hasn't been an issue. Well now I have a new partner, and I'm terrified of telling him. The Dr. that diagnosed me told me that there was almost no chance to pass this genitally or if anyone performed oral on me there is almost no chance as well from everything she has seen. Also, she wouldn't prescribe meds, as I later realize, I have no use for them.
I am going to tell him because I really care for him. We haven't gotten too physical, just some touching and our privates have never touched without layers of clothing. No sex yet. I am asking you Dr., what is the best way to convey the minimal nature of this? Will you explain to me, so maybe I can show him, your opinon on genital to genital HSV-1 when the non infected partner has not had oral HSV-1 (not sure if he has or hasnt since people don't talk about it if its above the waist - now that drives me nuts).
Thank you so much.
I am going to tell him because I really care for him. We haven't gotten too physical, just some touching and our privates have never touched without layers of clothing. No sex yet. I am asking you Dr., what is the best way to convey the minimal nature of this? Will you explain to me, so maybe I can show him, your opinon on genital to genital HSV-1 when the non infected partner has not had oral HSV-1 (not sure if he has or hasnt since people don't talk about it if its above the waist - now that drives me nuts).
Thank you so much.
A related discussion, Illegal to not inform partner of STD? was started.
You are so right and thankyou!! Next irritation I get I am going to have it cultured to see if all these redness, itching irritation episodes are herpes. Yes, I am hypersensitive and especially now with the pos blood tests. I will be wondering and trying to figure out what is going on with me with every itch, irritation I have. For example. I itched and had some redness for a couple days and asked my husband to look. It was red in one area. He put some left over yeast cream on the area I had. Well, the next day, no itch, no irritation, etc. So I wonder which time is it yeast and which is it herpes, etc. that is why I want a culture done. I am not prone to yeast infections or anything like that, just wonder what the heck is up. Thanks again, EB
Your partner can go his whole life and never get it. The Valtrex study showed that the risk of transmission from female to male, having sex 2-3 times per week, is only about 4%/year. If you use condoms, it's half that. Suppressive therapy, and you halve that again.
Dr. Handsfield has also said that the risk declines over time in a relationship, probably at least partially because you have more frequent/more intense sex at the beginning of a relationship. Since it's transmitted by skin-to-skin contact, it makes sense that the more friction you generate, the more likely you are to transmit it to your partner. As I'm sure you know, that heat and intensity declines over time. Cardiologists used to tell their patients to wait as much as two years after a heart attack before having sex again... until they realized that the average couple, in the average long term relationship, expends as much energy having sex as they do climbing two flights of stairs :-)
Also, I think that the frequency of outbreaks as well as episodes of asymptomatic shedding generally decline over time, which would in turn decrease the risk of transmission to your partner. That's not always the case, though.
You've also had some genital symptoms that have concerned you for years. Since you admit a huge herpes phobia, I'm guessing you've always been hyper-aware of every genital sensation/possible symptom, and you probably avoided sex during those times. I'm sure that avoidance during any potential outbreak (and probably more) cuts way down on transmission risk.
Finally, sometimes life is just like that. Haven't you ever been around people with a cold (or whatever), and not gotten it? Just because you're exposed to something, doesn't mean you automatically get it.
Dr. Handsfield has also said that the risk declines over time in a relationship, probably at least partially because you have more frequent/more intense sex at the beginning of a relationship. Since it's transmitted by skin-to-skin contact, it makes sense that the more friction you generate, the more likely you are to transmit it to your partner. As I'm sure you know, that heat and intensity declines over time. Cardiologists used to tell their patients to wait as much as two years after a heart attack before having sex again... until they realized that the average couple, in the average long term relationship, expends as much energy having sex as they do climbing two flights of stairs :-)
Also, I think that the frequency of outbreaks as well as episodes of asymptomatic shedding generally decline over time, which would in turn decrease the risk of transmission to your partner. That's not always the case, though.
You've also had some genital symptoms that have concerned you for years. Since you admit a huge herpes phobia, I'm guessing you've always been hyper-aware of every genital sensation/possible symptom, and you probably avoided sex during those times. I'm sure that avoidance during any potential outbreak (and probably more) cuts way down on transmission risk.
Finally, sometimes life is just like that. Haven't you ever been around people with a cold (or whatever), and not gotten it? Just because you're exposed to something, doesn't mean you automatically get it.
I know i have it or have type 2 anyway because of two pos herpes select tests I recently had done. My quest is why the heck doesn't my husband have it after so many yrs with me?? EB
Thanks for the info. I hope the law is for certain circumstances like a rapist that has HIV.
Yes, we do need to racket down the hysteria on HSV. Absolutely.
Yes, we do need to racket down the hysteria on HSV. Absolutely.
Hi,
I was diagnosed with HSV2 about five years ago. I was initially very upset of course, but have learned to live with it and realized that it is not the end of the world, is actually very common, but is just very stigmatized. I have had to tell a few men about my HSV since and all of them were comfortable with sleeping with me and expressed that they appreciated that I respected them enough to tell them. I think it is helpful to just "put it out there", provide some education and see what happens. Just remember that his/her reaction has nothing to do with you.
I believe there is a herpes forum out there too that may help.
Good luck!
I was diagnosed with HSV2 about five years ago. I was initially very upset of course, but have learned to live with it and realized that it is not the end of the world, is actually very common, but is just very stigmatized. I have had to tell a few men about my HSV since and all of them were comfortable with sleeping with me and expressed that they appreciated that I respected them enough to tell them. I think it is helpful to just "put it out there", provide some education and see what happens. Just remember that his/her reaction has nothing to do with you.
I believe there is a herpes forum out there too that may help.
Good luck!
I would definitely agree partner notification is appropriate regarding HSV-2.
My concern is HSV-1. If we're going to present to the public HSV-1
as a sexually transmitted desease (I know 30 per cent by some estimates
of genital herpes is HSV-1--no disagreement there), adocate
partner notification, etc, it will have the following results in my opinion.
One, 70-75 per cent of persons are infected either orally or genitally
or both. Any person infected orally could transmitt it to a person
genitally via oral sex. Are we going to expect 70-75 per cent of the
populations to warn potential sex partners??????? or to be tested
to know their status?
Two, we could ensnare persons in legal issues. In my state, it's illegal
to knowingly transmitt a sexually trasmitted desease (have sex with someone
when you have a sexually transmitted desease). So classifications do
matter.
Three, HSV-1 has no health consequences in normal people or at least no more than any other common "non-sexually transmitted" infections. We need
to "pick our fights" and spend our resources fighting deseases that matter
not creating problems where none exist.
Texas,
Also, there was famous person I believe sued in civil court in
California, and a sports figure sued in another state. Al least I read it in
the news.
In my opinion, we need to "racket down" the hysteria over herpes.
Hi,
Is it really illegal in your state to knowingly transmit to someone? That is scary to me. May I ask what state you live in?
Is it really illegal in your state to knowingly transmit to someone? That is scary to me. May I ask what state you live in?
MEDICAL PROFESSIONAL
I mostly disagree. Genital HSV, whether type 1 or 2, is only acquired sexaully. I agree there is confusion about the truth that oral herpes isn't an STD yet genital HSV-1 is classified that way.
So I think you make a valid philosophical point that cannot be practically applied. There is no chance of educating the general public, or people with genital herpes or at risk, to look at one form as sexually transmitted and the other as not. In my opinion it isn't worth trying.
We certainly agree, though, on counseling infected persons and their partners who might be at risk. They should be made to understand that genital HSV-1 infection is different and generally less a health concern (and therefore should be less a social concern) than HSV-2.
So I think you make a valid philosophical point that cannot be practically applied. There is no chance of educating the general public, or people with genital herpes or at risk, to look at one form as sexually transmitted and the other as not. In my opinion it isn't worth trying.
We certainly agree, though, on counseling infected persons and their partners who might be at risk. They should be made to understand that genital HSV-1 infection is different and generally less a health concern (and therefore should be less a social concern) than HSV-2.
In my opinion, the public is ill-served by treating HSV-1 as a sexually
transmitted desease and advocating partner notification for HSV-1. I realize that it can be transmitted sexually, but so can other deseases (including yeast infections) which are not treated as sexually transmitted.
When the subject of HSV-1 comes up, I believe it should be stressed
that that majority of the population has it, it causes no problems
in immunocompetent persons, some studies show it provides a some
level of protection against certain cancers, and you will probably
contact it at some point in your life (it's unavoidable).
Let's "racket down" some of this anxiety about HSV.
When I talk about having genital herpes with a potential partner - I'm just open and honest about it. I talk about all std's, condom use and birth control while I'm at it. Not the most romantic night out with someone but face it if we all did it all the time this board would be dull and slower than the proverbial molasses in january! Of course I never did it before I got herpes - I've learned a few things over the years thankfully!! But really they are all important topics to talk about with a new partner. You don't want to find out your partner won't use a condom when you are all hot and bothered and naked with them and more likely to say it's ok when you really don't feel comfortable without them using one ( for std purposes and/or birth control purposes!!! ).
I'm pretty matter of fact about my herpes when I do talk about it - it's something I have and it's not a huge deal to me is how I present it. I also tell my partner what precautions I'm willing to take to protect them too. So far in 21 years of having hsv2 genitally - I"ve only had 1 fellow decide it was too much to risk. Just keep in mind that it's so much more than just you talking about having hsv1 genitally - it's about protecting yourself from what your partner might have as much as it is discussing how to best reduce their chances of contracting hsv1 from you. Your partners will always be far more likely NOT to contract hsv1 from you than they will be to contract it no matter what. Unfortunately society has unfairly stigmatized herpes and most folks have never taken the time to learn more about it so when they hear herpes their first reaction is to panic instead of to take the time to learn more about it.
HHH mentioned the asha hotline - they also have a message board over there. There is a terrific anchored post in the herpes folder on it that discusses how to talk about it with a partner. Check it out when you have the time.
grace
I'm pretty matter of fact about my herpes when I do talk about it - it's something I have and it's not a huge deal to me is how I present it. I also tell my partner what precautions I'm willing to take to protect them too. So far in 21 years of having hsv2 genitally - I"ve only had 1 fellow decide it was too much to risk. Just keep in mind that it's so much more than just you talking about having hsv1 genitally - it's about protecting yourself from what your partner might have as much as it is discussing how to best reduce their chances of contracting hsv1 from you. Your partners will always be far more likely NOT to contract hsv1 from you than they will be to contract it no matter what. Unfortunately society has unfairly stigmatized herpes and most folks have never taken the time to learn more about it so when they hear herpes their first reaction is to panic instead of to take the time to learn more about it.
HHH mentioned the asha hotline - they also have a message board over there. There is a terrific anchored post in the herpes folder on it that discusses how to talk about it with a partner. Check it out when you have the time.
grace
MEDICAL PROFESSIONAL
I wish I could help, but I really cannot. You indicate an excellent knowledge and understanding (the 2 things aren't the same!) about genital herpes due to HSV-1. All an online provider really can do is provide the facts about a disease, and some words about transmission probability, which you already know is low. How to convey that information to a partner is not my strength, nor is it the purpose of this forum. The 'how do I talk to my partner' dilemma almost always requires extended reading and/or personal counseling. One approach is for you to contact the American Social Health Association (www.ashastd.org); their personal telephone counseling service is superb. Or by the book Understanding Herpes by Charles Ebel; you can order it from the ASHA website.
Just to provide some more supportive judgments: Your doctor is right about the odds of transmission, because the frequency of recurrences and asymptomatic shedding are low for genital HSV-1 infection. Also, you cannot know whether or not your partner has had HSV-1 already; lack of symptoms of oral herpes means nothing--half the population has it, regardless of whether or not they recall oral herpes symptoms. If he has been infected, he is immune (or at least highly resistant) to catching the same virus type again, anywhere on his body.
I have never seen a case of genital HSV-1 that seemed to have been acquired by genital intercourse; or a case of oral herpes acquired from oral sex. That doesn't mean it can't occur, but it seems to be rare.
Your partner could have a blood test for HSV-1 to see if he is susceptible or not. On the other hand, that might be making too big a deal of it. All in all, the risk is pretty low. Still, it isn't zero--and you are on the right track in your desire to talk it through with your partner.
Good luck-- HHH, MD
Just to provide some more supportive judgments: Your doctor is right about the odds of transmission, because the frequency of recurrences and asymptomatic shedding are low for genital HSV-1 infection. Also, you cannot know whether or not your partner has had HSV-1 already; lack of symptoms of oral herpes means nothing--half the population has it, regardless of whether or not they recall oral herpes symptoms. If he has been infected, he is immune (or at least highly resistant) to catching the same virus type again, anywhere on his body.
I have never seen a case of genital HSV-1 that seemed to have been acquired by genital intercourse; or a case of oral herpes acquired from oral sex. That doesn't mean it can't occur, but it seems to be rare.
Your partner could have a blood test for HSV-1 to see if he is susceptible or not. On the other hand, that might be making too big a deal of it. All in all, the risk is pretty low. Still, it isn't zero--and you are on the right track in your desire to talk it through with your partner.
Good luck-- HHH, MD
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.
