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New potential partner is HSV-2 positive... questions

topic posted Wed, December 20, 2006 - 10:19 AM by  B-Qat
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Hey folks.

I thought I'd ask your opinions, and for some advice here regarding a new potential partner of mine who has told me (sweetly and honestly, yay disclosure!) that he has HSV-2.

So, I know the basics about herpes type 2 (genital herpes)- how it's transmitted, virus shedding, outbreaks, etc etc....and have routinely tested negative for it myself.

My initial reaction to his telling me this is-- dammit, now we can't have penetrative or oral sex. I mean, I'm fine without it, he's a nice boy and I like him no less, but I'm wondering if I'm overreacting, and what the "risk percentages" are.

Bottom line: I don't want HSV-2. I don't want to have to tell my potential partners that I have it, to have that uncomfortable conversation, to be potentially dismissed out of hand as someone not then worth bothering with. (Not that I'd do this to anyone, but I can imagine it does happen to folks).

However, the little pouty part of me that wants to get freaky (safely of course) with this new boy, is going "but how big of a risk WOULD I be taking?"

I know the only way to 100% not get HSV-2 from him is to not have sex with him.
But, if he's not having an outbreak or feeling that tingly-whatever, and we're using a condom, how LIKELY is it that I'd get it? I mean, is it more likely that I'd be hit by a falling piano? Pretty likely? Definitely risky?

I'm wondering if I'm overreacting by saying out of hand "no oral or penetrative sex"....I'm wondering if I'm just doing this out of irrational fear, out of that sense of "I don't want to be socially stigmatized or have to go through telling potential partners". The health risks for HSV-2 seem somewhat small, it's not that I'm worried about (which is a clue that I might just be mentally working myself up over something relatively minor).

As you can tell, I'm feeling a bit scattered. Sorry for the length of this post.

Any advice/suggestions/statistics you could throw my way would be helpful.
posted by:
B-Qat
SF Bay Area
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  • One of the best books on herpes that I've found is called "Managing Herpes." Amazon.com has the whole thing in searchable format, you can only view a few pages at a time though:

    www.amazon.com/Managing-H...785-2252021

    The organization that publishes this book has a newsletter and some herpes info at:

    www.ashastd.org/herpes/herpes_learn.cfm

    HSV-1 and HSV-2 used to be almost exclusive to the mouth/face and genital/pelvic area respectively, but in the past few decades both have been found in both areas, and in fact almost all areas of the body. Some people even have herpes simplex on their hands.

    Some of the health risks include increased vulnerability to acquiring or transmitting the HIV virus. Also, there is a small risk of transmitting herpes to your baby during a natural childbirth.

    Another great source for herpes info is the SF City Clinic. From www.dph.sf.ca.us/sfcitycli...erpes.asp:

    "Acyclovir
    Acyclovir reduces the frequency of herpes outbreaks 80%, and reduces viral shedding by 94%. It is very safe, inexpensive, and has been used to prevent outbreaks by 40 million people for over 10 years."

    Also, outbreaks tend to decrease in frequency and severity over time. So if this person has had it for a while, and uses acyclovir or valtrex to manage the outbreaks, you should have seriously reduced risk. Soap and water effectively kills the virus, and it normally lives for only a few hours outside of a host, although it can live on dark moist surfaces for a while longer. So don't share towels, etc. Clean, dry, cotton underwear is reported to help a bit. There are those who have infections so bad they go without underwear altogether during an outbreak.

    Sores generally manifest in the same spot over and over again. However, during remission the virus retreats to the pelvic ganglia, in this case near the base of the spine, and can recur in any of the areas connected to this nerve plexis. So, basically that means anywhere below the waist in this case.

    So, as you can see, the risk profile is complex with herpes. It's almost like you have to estimate on a case-by-case, incident-by-incident basis: Exactly where is the infection site? Where do the sores normally occur? What was the activity at that time exactly?

    Often a person does not know that they are having "asymptomatic viral shedding" directly before or even without an outbreak of sores. So sometimes it's like putting a mystery together retroactively... "OK, so those sores appeared two days after we had sex with a condom, but since the sores were at the base of your penis, and because of your shape the condom rolls up a lot, and we know that you can thrust your entire length into me, so there is a chance that this itchyness on the lips of my vagina is herpes."

    I've heard people tell me after the fact that they didn't want to worry me by telling me they had HSV-2 when we were having protected sex because the risk was only 2% per incident when there is no outbreak and a condom is used during penis-vagina sex. I don't know where this 2% number comes from, but I've heard it more than once.

    For me, 2% isn't really low enough. What this tells me is the law of probability would suggest that once I've had 50 partners who lie or don't know about their HSV status, I will probably get herpes. Not good enough for me really, since I usually have 20-30 partners a year.

    Something like 75% of the population is walking around with HSV-1 and at least 25% of the population has HSV-2, but most of them don't even know it.

    The biggest problem is that while most clinics will test for HSV-2, few want to bother with HSV-1. This is because pretty much everyone has it, and the test really doesn't tell you where you have it on your body. Plus, my impression is that the medical establishment really doesn't want to take on the treatment and prevention of herpes. I'm guessing in their opinion it would cost too much and cause a lot of unnecessary wailing and gnashing of teeth. Pretending it doesn't exist is way cheaper and looks better.

    We had an HSV scare in our network recently, where a lover's lover had a bump cultured in his pelvic area and it came up positive for HSV-1. There wasn't a lot we could do about it other than all getting HSV-2 tests, just in case he really had HSV-2 and somehow our information got scrambled... we all came up negative for HSV-2. So we're going on the information that he has a genital infection of HSV-1, and so direct contact with this area of him has been suspended until a plan can be worked out... he was really pissed off about it, and the rest of us were a bit freaked out too... hopefully you can avoid the whole STD scare thing this time around HeatherLyn! :)
    • Thanks for all the information! I appreciate you taking the time.

      I've been skiving off at work today for unrelated reasons (ahem laziness), and came across an interesting study & related info @ Herpes.org:

      www.herpes.org/herpesinfo...ction.shtml

      Basically it says that, based upon a study or so of "discordant" couples (where one has HSV2 and one doesn't), the infection rates for the HSV-free partner hovered around 4% in an 8-month period (where only condoms were used), and .4% when daily antivirals were taken AND condoms were used.

      I think that's pretty damned low, actually. I was imagining something MUCH higher.

      This new boy takes Acyclovir when he feels an outbreak coming on, but he's said he would be interested in taking it daily to reduce risk, if he was ever in a situation (ie potentially US) where he'd be having more-than-occasional sex (protected of course) with an uninfected person.

      I was thinking about it this way, perhaps: I imagine the risk is LOWER for having sex with someone who KNOWS they are HSV-2 positive, and on antiviral meds & taking appropriate precautions, than sleeping with someone who DOESN'T know they have it, and/or is lying about it. (And if you factor in that many people have it and don't know it, and still some people have it and don't tell people.... that's quite a few people!)

      Am I totally off-base here?

      I'm not trying to rationalize because I want hot new boy cock.

      I'm just having my first experience with having to THINK about these things (never been with someone who has KNOWINGLY had HSV2 before!), and am trying to get informed before I make any hard & fast decisions.


      • The rates are higher for discordant couples where the infected partner is male. Sucks, but is so. Valtrex lowers the number of infectious days by about 80%. I, however, have some issues surrounding asking people taking Valtrex on a daily basis. It's two bucks or so a pill, there are some health risks associated with it, and HSV-2 isn't such an awful virus to have, anyway, so it's mostly just social stigma driving the practice. Bugs me. Bottom line, while I considered taking it myself to protect people from my HSV-1, I decided it was a dumb thing to spend money on, and while I've offered people the option, no one's ever taken me up on it. (I used to think I had HSV-2, so I considered it somewhat more seriously... Now, it's probably not gonna happen.) Anyway, that's my decision. Glad he told you!
        • "The rates are higher for discordant couples where the infected partner is male. Sucks, but is so. "

          Why is that? I'm curious.
          • Yep, infection is about 4 times more likely from male to female than vice-versa. We've just got a lot more susceptible area. Sigh.

            In terms of risk and someone who knows/takes precautions--certainly this person is a lower risk than random sex without asking or than sex with someone who lies or doesn't know. There are lots who don't know--they speculate that it's well over half those infected with HSV-2.

            Good luck making your decision. It's really a very tough call. I know from experience.
            • "Yep, infection is about 4 times more likely from male to female than vice-versa. We've just got a lot more susceptible area."

              And if it's being spread by an exchange of fluids, there's a lot more fluid going from man to woman than vice-versa, at least if there is no latex involved. That's true of a lot of std's; I'm not sure if herpes actually spreads through semen exchange or not.
      • "I was thinking about it this way, perhaps: I imagine the risk is LOWER for having sex with someone who KNOWS they are HSV-2 positive, and on antiviral meds & taking appropriate precautions, than sleeping with someone who DOESN'T know they have it, and/or is lying about it. (And if you factor in that many people have it and don't know it, and still some people have it and don't tell people.... that's quite a few people!) "

        Very likely.
      • That's really interesting that the transmission rate was the same with/without the drug. I breakout genitally, but I don't know if it's type one or two. People alway ask me if I take the drugs. I take acyclovir when I feel the tingles, but that's all. Considering I have one outbreak a year, it seems silly to fork over a bunch of money to the big drug companies. I'm happy he told you, since I know how hard it is to talk about it. But I recomend not letting social hang-ups get in the way if you like this guy. As was posted before, it really isn't a big deal. Interesting note:I tend to break out when I get freaked out about telling someone. Seems like if I don't think about it, it stays in hiding.
        • They weren't the same. There's roughly a 50% reduction in infection rate, from not-very-high, to very-low, with daily medication. The decimal is just hard to see.
          • the difference between 4% and 0.4% is a **10** times reduction in your chances of transmission, which would make my risk assesment in this situation go from "possible" to "unlikely".

            the drugs are expensive. if you aren't employed or have a low income, the green/blue california health card pays for prescriptions. you can get one at the SF city clinic for a years worth, 30 pills at a time. if you have insurance, it won't be free but you won't pay full price.

            cons: antivirals in my body daily? i don't think so. i have HSV2 and i take the drugs when i feel a cold sore coming on or feel all achy in my lower back (kinda like flu-achy). i haven't had a genital outbreak but those buggies must be in there somewhere or i wouldn't have those wierd symptoms.

            a few lessons i have learned about living and lusting with HSV2:

            i have known about my HSV status for about 3 years and only had two potential partners back away from oral and protected sex as a result. i guess that would be about a 5-10% rejection rate. so, in reality the social stigma exists mostly in our own feelings of guilt/shame ... in my opinion.

            in most cases i drop my status into conversation before things get steamy so it doesn't become a secret or a stressful issue to be brought up during the hot-and-heavy (and this gives them plenty of time to cool things off if they so choose). i encourage them to educate themselves or ask me questions and i answer them without reservation. i actually enjoy this aspect of the process.

            i HAVE been irresponsible - because it is such a non-issue for me and sometimes i might be a little impaired - by literally forgetting the fact that i need to disclose something important. i have done this three times, and each time, telling them after you remember you know something they should have known before ... is awful. fessing up afterwards is incredibly hard - like admitting you have been unfaithful (when you committed to that ;). i don't recommend this approach.

            my $2
            • """"
              i HAVE been irresponsible - because it is such a non-issue for me and sometimes i might be a little impaired - by literally forgetting the fact that i need to disclose something important. i have done this three times, and each time, telling them after you remember you know something they should have known before ... is awful. fessing up afterwards is incredibly hard - like admitting you have been unfaithful (when you committed to that ;). i don't recommend this approach. ""


              I've done the same thing. Also three times, and all impaired. It's easier to forget about than people who haven't had it for a while could imagine. The third time, I was following the advice of my practioner, who told me I didn't really need to tell anyone anymore once it turned out that my genital symptoms were caused by HSV-1. I didn't like having skipped the conversation, and had to go back and do it. Luckily for me, the other woman involved had forgotten to tell me about her HSV-2 status in all the excitement, so everyone was understanding, but it caused a few days of discomfort for both of us as we waited to fess up.
  • Ignoring the suppressent/shedding arguement and focusing on barrier:

    Risk while using a condom depends a good deal on the site of his outbreaks. The main worry with a condom is if normal movement will no longer prevent skin to skin contact with the areas outbreak occurs. For some people the location will pretty much guarantee decent coverage even with a little sliding room or shrinkage for others it may be a bit harder to be sure. Remembering to pull out quickly after ejaculation will prevent those accidental slip offs. A cock ring can help make sure that the base stays put. I've never tried them but I'm told the female condom gives more guaranteed protection as it covers both inside and over the labia.

    Obviously in the end it's all up to you and the amount of risk you are willing to take. Then again it always is and just because it's a known risk doesn't mean it's actually any more risky. Known risks generally feel more frightening because you can't ignore them but in reality you're probably more concious about being safe than you are with someone who hasn't disclosed anything...
    • "I've never tried them but I'm told the female condom gives more guaranteed protection as it covers both inside and over the labia."

      That's if you can get the female condom to stay put. It's not really a hands-free device like the male condom - failure rates as high as 15% are reported, mostly due to the penis missing the condom entirely and sliding in around it or the outer ring getting pushed in altogether.
      • Sounds like a pain.
        I've never tried one, but if it entails having to hold on to it like a bucking bronc, no thanks. <chuckle>
        • confronting the "I dont want to get it, too" issue is a big one. As someone who got it from a gal who didnt know she had HSV 2, i know what you are feeing right now.
          I will also tell you that barring all risks, if you do happen to contract iether 1 or 2, or have it just appear sometime in the future, it aint that bad for most people. The stigma is the worst part of having it. It's mostly an annoyance that most people deal with in a positive manner, and for many its a call to have personal integrity, like your prospective lover.
          I certainly don't want you or anyone else to get it. The risks are all stated above, and this virus has been doing great business for eons. It is a clever little bugger. And also, being on the other side of the sand box as I am now I can say like others do, Dont freak out if fate happens to deal you the card; everyone i know lived thru it and most were empowered by thier experience with it.. i commend you for getting informed, and taking your health seriously.
        • not to mention the "fucking a plastic bag" feeling they have.

          at least some people in the community would be better informed about their HSV status if doctors would TEST for it. Unless you practically beg, they're not going to test you, especially if you have no symptoms.
          • that is, female condoms are like "fucking a plastic bag"
            • I like female condoms and a lot of my partners have preferred them to male condoms.

              I think they work well for men who tend to lose their erections when the male condom goes on their cock, often older men.

              There are some tricks to using it. You do not have to hold onto it either, it is hands free.

              You do need to put more lube inside the condom than between you and the condom. Silicone inside feels really good to the man. Some men can feel the inner ring and it bothers their cock so I take it out, others like it most do not feel it

              If a man is really long, he can push it all the way inside so then it is not safe for him cumming or herpes.
        • I like female condoms. I haven't had trouble with them staying put. They are especially useful with men who can't seem to maintain an erection with a regular condom on and with those who are too big to fit in them.

          :D
          • Hello, I'm totally new to this conversation, and hardly post on tribe in general, but I just wanted to add something about knowing you have herpes and transmission. I contracted HSV2 recently from someone who didn't know they had it, and this was after having regular sex with four different people who had it, but knew for years. I think being aware of your status enables you to feel things like whether or not you have an outbreak coming on, and how to deal with/work around it. I know that I can tell days out from getting an outbreak, and can take acyclovir and stop it dead. I also know that during those times I need to abstain, or only play the role of "giver" (although I'd prefer to abstain typically!). If I didn't know what was happening to me when i felt an outbreak coming on, I'd likely ignore it and continue on with fucking and sucking as usual, as the symptoms of an impending outbreak are subtle unless you're aware of what they are.

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