How can genital herpes be prevented?
There is not yet a vaccine to protect against the herpes virus. There are a number of things to consider which may reduce your risks of getting genital herpes or of passing it on to others. These include:
- Consider the use of condoms always, even in settled relationships. This is because a person can carry the herpes virus for a very long time and pass it on without ever being aware of it. Condoms do not completely protect against herpes but they reduce the risk.
- The more sexual partners you have, the more the risk of picking up any sexually transmitted infection, including herpes. So avoiding having too many partners will cut down your risk.
- Avoid having sex with somebody with an active genital herpes infection (ie somebody with visible genital sores or blisters).
- Also avoid intimate contact with a person who has a cold sore.
- If you have an active herpes infection yourself, avoid having sex with anyone else in order to prevent passing it on.
- If one partner finds out they have herpes, it is wise to tell the other. This can reduce transmission rates.
- If a person knows they have recurrent herpes, taking a regular antiviral medicine can reduce the risk of passing on the virus.
- In particular, a pregnant woman should avoid having sex with somebody with active herpes, because of the extra risk to the baby during delivery.
Should I have sex if I have genital herpes?
When you have symptoms (during a primary episode or recurrence)
Herpes simplex virus is very contagious when blisters are present. There is a high chance of passing on the virus if you have sex. You should not have sex from the time symptoms first start until they are fully over. If you do have sex, using a condom may not fully protect against passing on the virus, as the condom only protects the area that is covered.
When you do not have symptoms (which is most of the time)
It is less likely that you will pass the virus on when you have sex. However, some virus will be present on the genital skin surface from time to time, although infrequently. So, there is still a small chance that you may pass on the virus when you have sex when you do not have symptoms. It is best to discuss things with your sexual partner. Using a condom each time you have sex is thought to reduce the chance further. However, using a condom cannot completely stop the chance of passing on the virus.
Taking antiviral medication long-term to prevent recurrences (suppressive treatment) also reduces the risk of passing on the virus. However, very few people need to take this treatment all the time.
Note: if your sexual partner already has the same virus then you cannot re-infect each other. Your partner may be infected but may not have symptoms. It may be helpful to discuss things with a doctor or nurse at a GUM clinic.
Further reading and references
Herpes simplex - genital; NICE CKS, September 2012 (UK access only)
2014 UK National Guideline for the Management of Anogenital Herpes; British Association for Sexual Health and HIV (2014)
Management of Genital Herpes in Pregnancy; British Association of Sexual Health and HIV and Royal College of Obstetricians and Gynaecologists (Oct 2014)
2017 European guidelines for the management of genital herpes; International Union against Sexually Transmitted Infections (IUSTI) (2017)
2015 Sexually Transmitted Diseases Treatment Guidelines - Genital Herpes; Centers for Disease Control and prevention CDC, (2015)
Hollier LM, Wendel GD; Third trimester antiviral prophylaxis for preventing maternal genital herpes simplex virus (HSV) recurrences and neonatal infection. Cochrane Database Syst Rev. 2008 Jan 23(1):CD004946.
Kang SH, Chua-Gocheco A, Bozzo P, et al; Safety of antiviral medication for the treatment of herpes during pregnancy. Can Fam Physician. 2011 Apr57(4):427-8.
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