Need Some Advice RE: Preventing HSV-1 Transmission

Posted , 4 users are following.

Dear Dr.,

I am a relatively healthy, 47 YO, white male and was recently diagnosed with a genital HSV-1 infection that I acquired from a previous partner that was not aware they were infected. My current partner has tested negative for both HSV-1 and HSV-2 and is being very supportive. My main concern now obviously is keeping her from getting infected. I have several questions surrounding this that I am having a hard time finding answers to. I'm hoping you can help.

 1) The biggest current issue is that I am afraid to kiss my partner on the lips for fear of giving her an oral HSV-1 infection. It is not clear to me if I can be infected both orally and genitally. I have never had symptoms of an oral infection. Is there any way to tell if I do have oral HSV-1 and, if there is not a way to tell, what are your recommendations for kissing?

 2) Although I am sure you will recommend a condom for every act of penetrative sex going forward (even though we dislike the lack of intimacy when using them), I did have several "blisters" during my outbreak that would definitely NOT be covered by a condom. How should we best proceed in ensuring her safety during vaginal sex?

 3) What are the risks / ramifications of her performing oral sex on me and me on her? Seeing as how I acquired HSV-1 from someone with an oral infection, I suppose I am at risk of passing it to her in the same way IF I have the infection in my mouth (see question one). I am also wondering if she is at risk of acquiring an oral HSV-1 infection from giving me unprotected oral sex.

4) Finally, I am in the middle of a course of 400mg Acyclovir TID and am tolerating it fairly well - a little nausea and diarrhea - but nothing I can't manage. Would you recommend me going on daily suppression therapy to help minimise her risk?

Thanks for your reply, I really appreciate any advice you can give so that we can get back to as close to normal ASAP.

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4 Replies

  • Posted

    It is not clear to me if I can be infected both orally and genitally.

    Yes, it's possible if infected on or around the same occasion.

    I have never had symptoms of an oral infection.

    Most people don't.

    Is there any way to tell if I do have oral HSV-1 and, if there is not a way to tell, what are your recommendations for kissing?

    No, there's no way to tell without symptoms there. If you don't have a cold sore, no mystery bumps or any tingling, then go ahead and kiss.

    How should we best proceed in ensuring her safety during vaginal sex?

    Genital HSV-1 rarely recurs or sheds, and transmission via sex is not common. So long as you are not having an outbreak and feel fine, I wouldn't worry too much. Genital Type 2 is the one you need to worry about.

    What are the risks / ramifications of her performing oral sex on me and me on her? Seeing as how I acquired HSV-1 from someone with an oral infection, I suppose I am at risk of passing it to her in the same way IF I have the infection in my mouth (see question one). I am also wondering if she is at risk of acquiring an oral HSV-1 infection from giving me unprotected oral sex.

    On you and on her in both scenarios, low risk without an outbreak.

    Would you recommend me going on daily suppression therapy to help minimise her risk?

    No. Daily meds for suppressive therapy are typically for genital HSV-2, not Type 1.

    • Posted

      Wow, this was only meant to post once!! There was a weird glitchy server problem earlier. Anyway, apologies for the multiple posts!
    • Posted

      Thanks that's all great information - I appreciate it!  I have shared this with my partner who is also very encouraged.  We made out like banshees the other night for like 2 hours!   *LOL*  :-P

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