optimist

Maybe an option would be to take the lower dosage meant to reduce transmission on a daily basis, then increase to the suppressive dosage if/when you experience symptoms. I know Terri Warren generally recommends starting at the lower dose and increasing to the full dose if the person finds they are getting breakthrough symptoms. For instance, with Valtrex, this would mean 500mg (transmission reduction) vs. 1000mg (symptom suppression).

What I'm saying is that oral herpes is very common among children your son's age. I'm not speculating on the source of his infection, just that it is common for children of his age to have contracted it. What I was saying about HSV1 testing is that one of the limitations in testing is that it returns lots of false negatives. If 100 people with HSV1 get tested, the test will recognize the infection in 70 of those individuals but will falsely report the remaining 30 are HSV1 negative. If you already have HSV2 and do not have HSV1, it is my understanding that you no longer need to worry about contracting HSV1. I'm not a medical professional, but this is what Terri Warren has stated. She is a clinician who has specialized in herpes for 35 years or so. I've also seen a study she referenced of 8500+ people, none of whom contracted HSV1 on top of existing HSV2 infection during the time period studied. However, many in the study who had HSV1 did contract HSV2 during that same time period. My takeaway was that it may be theoretically possible, but it is very unlikely to contract HSV1 after already having HSV2.

Hm. It's unusual for antivirals to be ineffective. I wonder if a different antiviral might work better? Or a different dosage? Just wondering. I'm not a medical professional but I've seen posts from people who've had better luck with one antiviral over another. My hope for you is that the frequency of outbreaks will diminish with time. For people who get recurrences, I think the first year is usually the worst.

I have a friend with GHSV1 who gets outbreaks with her periods and in times of high stress. If you're using a form of hormonal birth control, maybe you could try a different type to see if it makes a difference? And if you aren't taking daily antivirals, you could give those a try. Or maybe take them for the days leading up to your period if you'd rather not take them daily? Not sure if that would work. Also, is it possible your boyfriend already has HSV1? Has he ever had a cold sore? Most adults have HSV1, so he may well have it already.

It's very common for kids that age to contract oral herpes. If you've previously tested positive for HSV2 and negative for HSV1, it's highly unlikely you have HSV1 now. Terri Warren has said having HSV2 is akin to being immune to contracting HSV1 (though the opposite is not true, unfortunately). OTOH, IgG tests only recognize 70% of HSV1 infections and return false negatives for the remaining 30%, so there's a possibility your HSV1 results were not accurate in the first place.

@Welphmm It sounds unlikely to me. Bear in mind that a majority (55.3%) of single/divorced/widowed women of your age in the U.S. are infected with HSV2 and the great majority of them (80-90%) are unaware, either because they don't have symptoms or because their symptoms are mild enough to go unnoticed. Most women would have a hard time tracing the source of infection by that age. I'm around your age and had the same experience (found out through a blood test when I was 47, don't know when I got it or from whom). Edit to add: Forgot to address your comment about only having been with 3 or 4 men. A large study in the U.S. indicated that 19% of girls/women between the ages of 14-49 with a history of 2-4 sex partners are infected with HSV2, so that would have been the relevant statistic for you by your mid-20s. Unfortunately, there have been a lack of studies on transmission between same sex partners, but HSV2 is transmitted through skin-to-skin contact. Involvement of a penis increases transmission risk, but that doesn't mean there is otherwise no risk, just less risk than when a penis is involved.

My understanding is that oral HSV1 typically sheds about half as frequently as genital HSV2. I'm not sure, but I don't think there is a specific societal standard/expectation for disclosure before kissing, at least not in the absence of symptoms (a weird double standard, but just sharing my impression of how it is). Some individuals may have this expectation, and someone with that expectation might react unfavorably if disclosed to *after* kissing, but it does not seem like standard practice to me. Given your knowledge of the infection, the anxiety you're having around this, and the fact that you do sometimes disclose later on after kissing, you may find you feel more comfortable disclosing before kissing in the future. I would try to put the past experiences behind you and just focus on doing what feels right for you in the future.

It's not that the CDC has it wrong, it's that they present their HSV2 statistics as prevalence among 14-49 year olds, many (29%) of whom have not yet had sex. Infection rates increase with age and sexual contact. It is not that 16% of 14 years olds are infected and 16% of 49 year olds are infected. The 16% is an average for that entire group. The rate among 14 year olds is close to zero and the rate among 49 year olds is much higher than 16%. An average of all autopsies would reflect lifetime risk rather than the average infection rate among 14-49 year olds. Lifetime risk is bound to be much higher.

@cier As far as I know, many doctors recommend antivirals during late pregnancy for women who know the have genital herpes, or at least women who get recurring outbreaks. The goal is to avoid having an outbreak that coincides with labor. I don't know if there is a more general recommendation about safety of antivirals throughout pregnancy.

@cier You might find it comforting to know that in a very large study in The U.S. (more than 8500 pregnant women were tested), 30% of them tested positive for HSV2 prior to labor. Even so, neonatal herpes is a rare complication (1/5500). Most pregnant women with HSV2 don't know they're infected, but those who do know can choose to take antivirals toward the end of pregnancy to reduce risk further. The greatest danger (by far) is when a woman contracts GHSV1 or HSV2 within a few months of labor without having enough time to build sufficient antibodies before labor. In such cases, risk of neonatal herpes increases to somewhere between 1/3 and 1/2.

I'm sorry you're feeling so down. You are not alone. Genital herpes is very common, especially among women. I know it doesn't seem that way because most people who have it don't know it, and those who do know it tend to keep it private, but it extremely common. I wonder if you might find this talk by Ella Dawson helpful: She also has a blog at https://ellacydawson.wordpress.com/herpes/ As for people being willing to risk contracting herpes, you might find it comforting to keep in mind that roughly 80% of adults have herpes of one type or another (HSV1, HSV2 or both), and whether they have it orally or genitally, it can potentially be sexually transmitted to an uninfected partner, so this is a risk most sexually active people take frequently without really thinking about it. The difference with you is that you know your status, so you can make choices that meaningfully reduce risk of transmission based on the knowledge of your status if you so desire. If you poke around the site a little, you'll see many disclosure stories. My own experience so far has been that my HSV2 status has *not* been a deal breaker for most prospective partners. I'd guess about 80% were fine with it and 20% respectfully shared they were not comfortable with the risk. Sometimes this happens in waves of lots of acceptance and then a couple disappointments in a row, and I will admit I can get a little down when the trend is not going my way, but it is fleeting, so I try to take care of myself at those times, maybe take a little break, then put myself back out there. Many people feel as you are feeling now upon diagnosis. Lots of people seem to benefit from educating themselves about HSV, sharing their feelings, and just taking some time for emotional processing and self care. It sounds like you are doing all those things and now it's a matter of time passing until you find yourself feeling better. It will happen. (((HUGS)))

@advice_seeker I would ask the clinic for a copy of the results so you can assess the following: - IgM or IgG test. (If IgM, disregard results.) - If IgG, what was the index value? (If above 3.5, this is considered definitively positive and it is very likely you've had it for longer than the short time between your encounter with JR and your positive blood test. If below 3.5 but in the "positive range," I would consider the possibility of a false positive, or a sign of building antibodies possibly from the JR encounter, and follow up with another IgG in a couple months or seek out a Western Blot.) Stan is a different matter. Hard to say what's going on there. He may only be assuming he has been regularly tested for HSV when getting STI tests (many people make this false assumption), or he may actually be conscientious about regularly requesting HSV testing, but until you have the info listed above, you don't even know for sure that *you* are infected, so maybe you can deal with Stan and whether or not you need antivirals after you confirm your own diagnosis. This whole scenario you've described is a great example of how HSV2 is typically spread. 80-90% of people don't notice upon contracting it, it can then unknowingly be spread to others with an 80-90% chance they won't notice either, but eventually someone in the chain gets symptoms and the search for the source begins.

@katytea3 I have done that before meeting, yes. I really just see how the conversation goes and if it feels like the right time even though we haven't met yet, I go for it. If not, I wait until after the first meeting. I haven't noticed a difference in levels of acceptance one way or the other, but every situation is unique and can't really be compared accurately or second guessed in retrospect.

While oral-to-genital transmission is more common with HSV1, genital-to-genital transmission does happen. HSV1 sheds less often from the genitals than from the mouth. It is estimated to shed roughly 1/3 as often as genital HSV2. Data does not yet exist to pinpoint transmission rates, but Terri Warren has suggested using HSV2 transmission rates as a reference starting point, then dividing by 3 to take lesser shedding into account. So if male-to-female HSV2 transmission rates without condoms and antivirals = 10% annually, this would equate to 3% annually for HSV1. So yes, it is possibly you could have been married for 20 years and only now have contracted it, and contracted it through genital-to-genital contact, without infidelity being a factor. "However, among 48 source partners of people with documented newly acquired genital HSV‐1, HSV‐1 was isolated from the genital area in seven and from the oral area in three (unpublished data). This suggests that genital to genital HSV‐1 transmission is potentially not uncommon." Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564733/

@katytea3 I have mostly done it over text and the timing has depended on several factors, but I don't think there's just one right way. I say go with what is most comfortable for you. Some people include it in the their profile, some go on several dates. For me, because I'm in more casual mode, the conversation sometimes touches on physical things pretty early, and I take the opportunity to bring it up (along with some safe sex expectations), even if we haven't physically met yet. If I meet the person first, and if there's chemistry, I still generally wait to discuss it until they reach out to me for a second date. If the chemistry at the first meeting/date suggested it would move in a physical direction, I discuss it before the second date. If there's no chemistry on the first date, I don't progress to a second date so no need to share that info.

I've dated several people since testing positive. Met most of them on Tinder. One also had HSV2 (just a coincidence), one was in an open relationship with a primary partner who had HSV2 (and they were both fine with me having it, as well), one knew he had HSV1 and didn't stigmatize one type over another, and the rest did not know their own status, as is so common. When you think about the fact that roughly 80% of adults have HSV1, HSV2 or both, and either type can potentially be transmitted to an uninfected partner, the reality is that most people on dating sites are capable of transmitting herpes, most of them just don't know it. And whether they know about it or not, it is clearly not stopping them from putting themselves out there. I don't see anything wrong with trying a herpes specific dating site, as long as you know you are not limited to such sites.

Oops. I meant Stan. I will correct that! Thanks, @Sil88.

Was Stan's test a swab test or a blood test? If a blood test, was it IgM or IgG? And was your blood test an IgM or IgG? And you had no swab test yourself? If you both tested positive by IgG blood tests so soon after the two encounters you described, it seems unlikely either of you contracted it from those two encounters. It can take up to three months for antibodies to build to a level to be recognized by an IgG test. OTOH, if you were both tested by IgM, you should know that IgM test results are unreliable. I would absolutely not rely on IgM results for a diagnosis. If Stan was positive by swab but negative by IgG blood test a few days after your encounter, I can see why he would assume he contracted it from you, assuming he had not had sex with anyone else during the six months encompassing the three month time period before his last test and the three month time period after testing but before your recent encounter (and also assuming his last STI tests included HSV testing which is uncommon). However, if he tested positive by IgG a few days after your encounter, I would assume he contracted it previously, not from your encounter. In the end, it really doesn't matter where it came from. If you are a sexual being interacting with other sexual beings, it is quite common to contract it at some point. Not to say that your anger toward JR is not justified, regardless of whether he was the source of infection. I also felt very depressed upon testing positive and found a lot of relief in talking to others about my feelings and educating myself about HSV. In this particular case, if Stan did contract it from you, or even if he mistakenly assumes this to be the case, you may not be the best person to provide comfort. Some people in Stan's situation would appreciate being in it together while others would want space, so I think you'll just have to be sensitive to those signals. But don't forget to take care of yourself in all this, too.

I don't know when I contracted HSV2 or who I contracted it from. I know that statistically it is much more likely the person who transmitted it to me was unaware of their status than aware of their status, so I don't feel betrayed. I can see how it would feel different under other circumstances so I'm grateful to not know the details. I don't have any negative feelings associated with contracting HSV, though the stigma bothers me. My feeling is that I would have to have lived my life an entirely different way to prioritize protecting myself from HSV, and that type of life does not appeal to me. Whether I contracted it the very first time I had sex or decades into having sex, from a hookup, a boyfriend or a husband, I would not have wanted to erase my sexual history to avoid HSV. It isn't possible to just pluck out one experience, whenever it was. That's not how risk works. I've had the freedom of loving and lusting after people regardless of their HSV status and here I am, HSV1-, HSV2+. That's just how the risk played out for me. I wouldn't want to erase the experiences that led me here, so I accept how those experiences affected me.

Someone asked a very similar question of a herpes expert in a public forum. I'm hesitant to post the link here but will PM it to you. In short, the clinician who specializes in herpes thinks disclosing HSV2 prior to receiving oral sex is unimportant from a risk perspective, but still a very good idea in order to avoid future freak outs such as you have described. She also thinks a partner who reacts in this way is not an appropriate partner. This does not address the HSV1 risk, just the HSV2 risk. I will PM the link in case you find the context helpful. Edit to add: The HSV2+ female who asked the question was taking antiviral medication. I don't know if that was a factor in why the clinician felt the risk was so low as to not be a concern for oral sex.

@PeppaPig It's just one woman answering the questions and I think she usually answers within a few days but I'd give it a week.

@drsuz1 It is my understanding that risk of transmission via oral sex is mostly an HSV1 concern, yet most people with HSV1 continue performing oral sex without worrying much about passing herpes along. It is responsible to inform a partner of positive oral HSV1 status before performing oral sex on them, but I personally have never had a partner disclose this to me, with the exception of those reacting to my own HSV2 disclosure. I am not aware of a societal expectation of disclosure in such cases, except when there is an active outbreak. Different individuals have different expectations around this. As for HSV2, it is possible for a partner to acquire it through performing oral sex on a HSV2+ person, but it is uncommon. My understanding is that specific studies have not been done to pinpoint transmission risk but years of observation suggest it carries less risk than intercourse. Given how many people have genital HSV2, if it was easily transmittable to the mouth, there would be many, many more cases of oral herpes caused by HSV2. People who do contract HSV2 orally tend not to have recurrences and shed the virus considerably less frequently than those with oral HSV1. They are then also largely protected from acquiring HSV2 genitally. That's my understanding through reading lots of info published by Terri Warren. Here's a great and thorough reference guide by Terri Warren: https://www.westoverheights.com/wp-content/uploads/2014/08/Updated-Herpes-Book.pdf

I know Terri Warren (a clinician who has specialized in HSV for decades) has stated that outbreaks in the "boxer short" region are classified as "genital herpes" and are likely to have been contracted genitally and periodically shed asymptomatically from the genital tract, regardless of where recurring outbreaks occur in the "boxer short region." However, I don't know if that's true when the outbreak is as far away as the knee. Maybe someone else here knows. If not, you may want to ask Terri Warren through her Westover Heights Q&A forum for a small fee (I think it's $20 for 3 questions which can be asked with an anonymous username). Also, you should be aware that HSV2 is common and 80-90% of those infected do not know they are infected, so it is possible to have contracted it from a partner with no obvious symptoms. That is how most transmissions of HSV2 occur.

I agree with JeffH on all three answers. I now know that I must have been HSV2+ during at least a portion of my longest relationship (16 years) but neither of us were aware that one or both of us had it. I later found out through testing and then wondered in retrospect if certain symptoms I'd attributed to yeast infections might have been related to HSV2. My doctors tend to see anything other than ulcers as "not herpes" even though most people with herpes do not have ulcers. Also, if you are in the U.S., keep in mind about 1/4 of married women have HSV2 and an additional significant percentage have genital herpes as a result of GHSV1, so it is very common, even among married women. Only 10-20% of those infected are aware they are infected. You might find relevant info in this detailed fact sheet from the CDC: https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm A more comprehensive source of information is https://www.westoverheights.com/wp-content/uploads/2014/08/Updated-Herpes-Book.pdf

@LovePink44 Congratulations! I'm so glad you checked in with an update. It's a relief to hear all went well with the birth. Best wishes!