Giving Your Partner Herpes

Past The New York Times
Dr. Harold Fisher/Getty Images The highest risk of transmitting the herpes virus is during an outbreak.

Can someone infected with herpes go along to accept sex without giving information technology to their partner? Exercise cold sores, which are almost always caused past canker simplex virus type 1 (HSV-1), protect against genital canker acquired past herpes simplex virus blazon 2? Can someone be infected with both types of herpes viruses?

Those are among the questions recently posed past readers of the Consults weblog. Dr. Peter Leone, an expert on sexually transmitted diseases and associate professor at the University of North Carolina Schoolhouse of Medicine and Public Health, responds.

What's My Risk of Spreading Herpes?

I found out that I have herpes simplex blazon ii (HSV-2) almost a month and a one-half agone. My principal partner, who is male, has been tested twice since then, and both results take been negative. Nosotros were fluid-bonded [exposed to each other'due south bodily fluids] and had plenty of unprotected sexual practice between my most contempo negative consequence and last calendar month's positive 1. What are the rates of transmission in a serologically discordant couple where the female partner has HSV-two?

I've read that information technology's:

  • iv percent in couples who don't employ barriers but avoid sex during outbreaks, and where the adult female is not on antiviral suppressive therapy.
  • two percent in couples who employ condoms and no antivirals.
  • 1 percent in couples who apply both condoms and daily antivirals.

Is this accurate? It's really hard to detect comprehensive information on the Internet that gives hard scientific data on rates of transmission.
Stella, Chicago

Dr. Peter Leone responds:

Transmission of HSV-2 to an uninfected partner depends on many different factors, and information technology is difficult to give precise figures. Studies involving discordant couples, in which one partner has HSV-2 and the other does non, introduce various biases. Discordant couples, for example, have non transmitted the virus between them and are encouraged to use condoms and take other preventive measures. Given these caveats, here'southward what we can say:

  • Women are more likely to larn HSV-two from an infected male partner then men are from women. On average, the adventure for women acquiring HSV-ii sexually from an infected partner is most 10 percent per year, though there is a large range — from 7 pct to 31 pct — in different studies.
  • For uninfected men, the risk of sexually acquiring HSV-2 from an infected adult female is about 4 percent per twelvemonth.
  • Having HSV-1 infection may lower the adventure of acquiring HSV-ii sexually, simply studies on this provide conflicting results.
  • Condoms reduce the run a risk of manual by about thirty pct, and daily suppressive therapy reduces the risk of transmission by virtually 48 percentage, studies show. Using condoms and taking daily suppressive therapy reduces the risk even further than either measure alone, though studies were not big enough to provide reliable numbers.
  • Unfortunately, at that place is no bachelor data on the rate of transmission for aforementioned-sex couples.

HSV-2 transmission is more dependent on genitals than gender. What I mean past this is that contact by the penis with either the vagina or rectum is where the greatest risk of manual occurs. Oral sex is more of an issue for HSV-ane manual — from mouth to genitals, and indeed, HSV-1 is a fast-growing cause of genital herpes. Oral sexual activity, though, is not much of a risk for HSV-two, since HSV-2 oral infection is rare and shedding of HSV-2 from the rima oris is extremely low.

Tin You lot Be Infected With Both Types of Herpes?

Tin can a person have both HSV-one and HSV-2? And what would it do to your chances of contracting H.I.V.? Or hepatitis C, for that matter?
cardo, Chico, Calif.

Dr. Peter Leone responds:

Yes. Virtually ten percent of adults in the United States have both HSV-1 and HSV-2. Of those with HSV-2, nearly 40 percent are co-infected with HSV-one.

HSV-2 increases the risk for H.I.V. acquisition. Someone infected with HSV-2 has 2 to 5 times greater adventure of acquiring H.I.V. through sexual intercourse compared with someone who is not infected with HSV-2. HSV-i does not increase the chance of H.I.V.

Your question most whether canker increases the risk of contracting hepatitis C is an interesting one. The biggest take chances for hepatitis C is through sharing needles while injecting drugs. Only hepatitis C can likewise be sexually transmitted, and it appears that the risk may be increased in women and in men who have sexual practice with men who are also infected with HSV-ii.

Do Cold Sores Protect Against Genital Herpes?

Every bit a kid, I had oral canker (painful sores on within of oral fissure, etc.), and then many years afterwards I dated a girl for 2 years who had canker, and I never caught information technology (though we frequently, though not always, used condoms). I'1000 long since married now, but I've always wondered, does having had oral herpes brand ane immune to contracting genital herpes?
Nathan, NYC

Dr. Peter Leone responds:

Cold sores are almost always – 98 percent of the time — caused past HSV-1. Having HSV-1 infection may make information technology more difficult to acquire HSV-2 infection, simply, at best, offers only partial immunity.

If someone with HSV-ane acquires HSV-2, he or she is likely to have a mild first outbreak of HSV-2 — or there may not be any symptoms at all. Virtually twoscore percent of individuals infected with HSV-two are as well infected with HSV-1. Maybe you don't have HSV-2 infection, simply the only style to know for certain is to get a blood test for HSV-ii.

To learn more, see Dr. Leone's earlier responses in the Related Posts beneath, and The Times Wellness Guide: Genital Herpes, which includes an interview with Dr. Leone, "Understanding Genital Herpes."