Genital Herpes: Useful info for those looking for answers like me!

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This discussion has been locked due to a period of inactivity.

Ever since I suspected genital herpes (GH) and was recently confirmed to be going through a primary outbreak of HSV-2 (ugh, the "bad" one), I have been researching the topic like crazy! Guess that's a pretty normal thing to do, lol, and I'm sure many others here have done the same.

Anyway, I thought it would be helpful to share everything that I have learnt thus far, and I will continue to add to this thread as I come across more useful, interesting and/or relevant info.

Genital HSV symptoms https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1776485

Testing for HSV https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1776488

Does having one HSV type protect you against the other? https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1776489

Autoinnoculation (self-contagion to other areas) https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1776492

When is genital HSV most contagious? https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1776494

Genital HSV transmission risk https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1776497

Antiviral meds for genital HSV https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1776501

Natural treatments for genital HSV https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1776503

Genital HSV and increased risk of HIV https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1776505

Transmission risk via inanimate objects, swimming and blood https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1778698

Genital herpes and menstruation https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1778703

Genital herpes and BV and yeast infections https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1778708

Is there a vaccine for HSV-1/2? https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1778714

Possible complications of genital herpes https://patient.info/forums/discuss/comment?discussionid=482438&commentid=1782789

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  • Posted

    When is genital HSV most contagious?

    Genital HSV-2 is more contagious than genital HSV-1, since it is associated with more outbreaks and more asymptomatic shedding in between outbreaks.

    New infections are more contagious, and newly infected individuals would appear to be more contagious during the first year, which is why suppresive therapy may be advisable in some cases.

    An individual is also most contagious just before and during an outbreak, so during the prodrome period (usually one day before the appearance of lesions) until the lesions have fully healed. Sex should be avoided during this time.

    Even if a full-blown outbreak can be avoided by taking antiviral meds, I have read that it is advisable to wait 3-4 days before sex.

    http://advocatesaz.org/2013/05/28/std-awareness-asymptomatic-shedding-of-herpes/

    HSV-2 shedding in symptomatic vs asymptomatic individuals -http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144252/

    • Posted

      Newly infected individuals, especially those newly infected with HSV-2, are most infectious during the first three months of the initial outbreak. Asymptomatic shedding was found to be notably higher in such individuals, so extra precautions are required if engaging in sexual relations with a negative partner during this period.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4084907/

      Autoinoculation is also more likely during this period, since antibodies are still developing, so ensure common sense hygiene practices like handwashing after touching infected areas, especially if lesions are present.

    • Posted

      How do I follow you? The information and links you provide in your posts is vauable and useful. I'm still trying to get answers on how if I'm HSV 2 positive with recently updated IgG boodwork resulults I could transmit HSV 1 to my male partner during oral sex? I can't find any info on this specific question.. the clinical and sub clinical information I've been reading does not indicate that is or is not possible.. Do you have any information or source on this question?
    • Posted

      He could have had it before you. HSV-1 can be a cold sore as well. Unless he specifically had an outbreak on his genitals then I don't think you should take blame for that!
    • Posted

      He didn't have HSV before me. He had bloodwork.. That proved this and why I'm baffled..
    • Posted

      There is no way you could give something you don't have. It's possible to get false negatives.
    • Posted

      You could be a carrier of oral HSV-1 without knowing it, OR he already had it genitally. The IgG test has more false negatives for HSV-1 (25%) than HSV-2 (only 2-3%), so it is possible it was missed in either you or him.

      P.S. I'm not sure that there is a way to follow someone on here, but I will message you a link.

  • Edited

    Genital HSV transmission risk

    You cannot pass genital HSV back and forth if both partners are infected with the same type.

    In discordant couples (where one partner has it and the other doesn't), steps can be taken to reduce transmission to the non-infected partner. These include avoiding sex during periods of prodrome/outbreak, daily suppressive therapy (starting *at least* five days before commencing sex), and condom usage.

    Suppresive therapy (1 x 500mg valacyclovir daily) has been shown to reduce HSV-2 transmission in discordant couples by around 50%. Proper condom usage reduces general HSV transmission by another 30-50%.

    It is also worth noting that compared to men, women are generally more likely to acquire genital HSV, to suffer worse symptoms (though supposedly fewer outbreaks) as well as possible complications, due to the greater (mucous) surface area women possess, etc.

    Daily valacyclovir in discordant couples - http://www.ncbi.nlm.nih.gov/pubmed/14702423

    • Posted

      "Women are more likely to acquire HSV-2 from an infected male partner then men are from women. On average, the risk for women acquiring HSV-2 sexually from an infected partner is about 10 percent per year, though there is a large range - from 7 percent to 31 percent - in different studies.

      "For uninfected men, the risk of sexually acquiring HSV-2 from an infected woman is about 4 percent per year.

      "Having HSV-1 infection may lower the risk of acquiring HSV-2 sexually, but studies on this provide conflicting results.

      "Condoms reduce the risk of transmission by about 30 percent [edit: some say 30-50%], and daily suppressive therapy reduces the risk of transmission by about 48 percent, studies show. Using condoms and taking daily suppressive therapy reduces the risk even further than either measure alone, though studies were not large enough to provide reliable numbers.

      "Unfortunately, there is no available data on the rate of transmission for same-sex couples."

      Source: Dr Peter Leone, STD expert and associate professor

      http://consults.blogs.nytimes.com/2010/06/18/giving-your-partner-herpes/

      Remarks: Genital HSV-1 both recurs and sheds less, plus HSV-1 prefers the oral region, so the risk of genital-to-genital transmission is much lower than HSV-2. Genital HSV-1 is mostly acquired via oral sex, with individuals who have never had oral HSV-1 being the most susceptible and likely to show symptoms if infected.

    • Posted

      Your input is excellent and very beneficial thank you, however I really must disagree with you in regard to women being more likely to be infected from a male partner rather than the other way around. Yes, perhaps so from a promiscuity point of view but from a physiological view point it is my opinion and others that a sexually active and infected female due to vaginal secretions is much more likely to pass on GHS 2 to a male.

      Also, it is virtually impossible for a patient in my opinion to acquire Oral Herpes if that patient is already infected by the GHS 2 strain.

    • Edited

      Thank you! Yes, I couldn't find anything online about genital HSV-2 affording protection against oral HSV-1. The head doctor at my local STD clinic, however, said it is still a possibility, but not genital HSV-1.

      Women, being the receptive partner in heterosexual relationships and given the large mucous membrane surface area in the vaginal area, are generally more susceptible to STDs, HSV being no exception (more women are infected with HSV-2 than men, for example). Also, the info I quoted above is from Dr Peter Leone, a leading STD expert.

    • Posted

      Fine, I won't argue the point but as long as any human fluids are exchanged or open genital sores are present the chances of infection from either male or female are equal as far as I am concerned.

      ​The moral of the lesson is: Caution and Awareness.

    • Edited

      Most transmissions in new discordant relationships occur within the first 3 months.

      In longer-term monogamous heterosexual discordant couples where the negative partner is aware of the other's GH-positive status and where only sex during outbreaks is avoided (so no daily antiviral meds for suppressive therapy, and no regular condom usage), the annual transmission rate of HSV-2 from +male to -female is 10% vs 4% from +female to -male.

      Suppressive therapy reduces the above by about half, so +male to -female = 5% and +female to -male = 2% per year.

      With the addition of condoms, a further 30% (some say 50%) reduction can be achieved, so +male to -female = 2% and +female to -male = 1% per year.

      It is worth noting that these figures are general and based on longer-term couples, presumably with more established infections. As noted above, a newly infected individual is more infectious during the first 3 months to a year. Specific sexual activities were not examined.

      These transmission rates are for HSV-2. No similar study has been done for genital HSV-1, but the transmission risk in each of the above scenarios is even lower due to much less viral shedding. No studies have been done on discordant same-sex couples.

    • Posted

      All of your information is incredibly helpful but there is one thing I have searched all over the web for with no luck! Something I have experienced which may just be a conincidence but after having unprotected sex with other HPV sufferers I have then had an outbreak (this has only happened on 2 occasions) however I don't believe at the time they were having an outbreak so does this mean I need to avoid having unprotected sex with herpes sufferers altogether (out tbreak or not)

    • Posted

      I think you mean HSV, not HPV. Having unprotected sex with another same-type HSV carrier, outbreak/shedding or not, should not have any impact on your outbreak/shedding status. The friction from sex in general can trigger an outbreak, however, so perhaps that's all that it was, and coincidentally it occurred in those two cases.

    • Posted

      FelizCastus!

      I'm positive for both genital wart (Aug 2018) and genital hsv (Sept 2019). My primary OB occured March 1st 2020. Since then I have been having reoccurring OB every 3weeks. My warts seems to spread more and stings which i treat with podophyllin paint. Though the flat warts are very difficult to notice, I know a reoccurring one with its stings. My worst symptom is a genital and inner thigh nerve burns especially when i walk or feel cold. I started my suppressive therapy on 1st May 2020 but no favourable changes with my symptoms and signs. I have never had peace since Sept 2019. I need your advice, what should i do, what should i expect, will hpv vaccine help reduce my signs about wart, is there any complication for having both hsv and hpv?

      I am male, 28years of age. I don't even think I can marry again. The depression is so devastating.

    • Posted

      ... continuation!

      Like I said, my suppressive therapy is ( Val 1g once dly). For how long does one have to continue this therapy?

      What are the side effects of taking a daily dosage of valacyclovir? Its effects on the immune system, kidney, bone and joints.

    • Posted

      ... continuation!

      What effect does masturbation has on hsv reoccurance, probably including hpv spread? Especially in male

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