Best practices for unprotected sex with herpes (with an informed and consensual partner)?

[ClementineK]

Hi all,

I can't begin to express how thankful I am that this community exists, and I'm very glad that I found it. The brochures and other forum posts have been super informative and supportive. I was diagnosed with genital HSV-1 about 5 months ago. I'm 95% sure it was given to me by my former boyfriend, who had oral HSV-1. Despite taking precautions, he had an oral outbreak, and I had my first outbreak nearly 5 days later. We had been intimate (not oral sex), so somehow it must have spread. I wasn't angry because honestly neither of us really understood the risk. I knew he had cold sores and he knew he had them (and he told me early on). We're no longer together for reasons not related to herpes.

 

I've had the disclosure talk twice, and I've been pretty surprised at how well it's gone over. My current partner (maybe boyfriend sometime soon) is very accepting. We agreed to use condoms, but neither of us really enjoys them. My concern is that a couple of days ago, we did have unprotected sex (both of us were sober, he knows the risks, etc.). But then yesterday, I started feeling the signs of an OB, like itching and pain. There are no visible sores yet, but I'm positive that they will appear in the next couple of days. This is only my second outbreak, so either I don't have a distinctive prodrome sensation or I don't know what to look for. But I'm really concerned about whether he could be at a higher risk than what would normally be the case between outbreaks. Is the rate of viral shedding higher immediately before an outbreak? I told my partner and he's not worried, but I am. I would feel terrible if he got it from me.

 

So what is the best choice going forward? Is unprotected sex with an HSV- partner completely out of the question? Am I just unlucky that the one time we slipped up was right before an outbreak? Again, it's been five months since my initial outbreak, so I guess I was lulled into a false sense of security.

 

Also, I'm wondering how you all feel about suppressive medications. My doctor dismissed it as she said my infection was likely not very severe (because it's HSV-1), but my partner asked about it. I'm fine with going on the meds if he would feel more comfortable with it, but I'm horrible at remembering to take pills and I heard they were expensive, and if the risk is already very low for transmission (I read 4% for unprotected), is it worth it to take them when I don't have frequent outbreaks? My doc gave me a prescription for acyclovir for my outbreaks, but I haven't used it yet.

 

My apologies if this post is redundant with another on this site. I did some searching but couldn't find exactly what I was looking for.

[Boba_Femme]

Hi CK-

 

I guess you should wait and see what happens to your boyfriend, but I would highly recommend getting on antivirals (reduces transmission as well) and using condoms.

[WCSDancer2010]

@ClementineK

 

Hello! Glad you found this us!

 

Your Dr is right - the risks of transferring HSV1 when you have it genitally is much lower than HSV1 oral or HSV2 genital...its not in it's normal place so it is less likely to shed as much...

 

Odds are the sex itself is what made you break out... some people find that sex sets it off ... and likely over time that will get better.... as the area "toughens up" if you have regular sex it may well slow down. Make sure to keep the area as dry as possible (going commando helps) and use epsom salts baths (dump the salts between your legs so it's concentrated there) to help it dry out.

 

The anti-virals are about as safe as any meds can be (and I'm an anti-med person). It literally only activates in the presence of the virus and only affects the virus. Acyclovir isn't horridly expensive and if you can't afford it, go online and look for "RX discount Cards" .. there are a bunch of online card offers that you register for - they send you a card and you can get a discount up to 75%. I think my last script cost maybe $12.

 

AND, in the end, you have to also trust your partner to be able to make his own ADULT choices including taking those risks as long as you have done your best to get him educated.

 

(((HUGS)))

[ClementineK]

Thanks @WCSDancer2010, you seem to always give the best advice.

 

I'm not sure that sex set me off. My ex and I were together for a while having fairly frequent sex, and I didn't have an outbreak until now. I know triggers can change over time, but I am super stressed right now (I'm in grad school and everything is piling on me at once). I also read that triggers could be hormonal, and both of my outbreaks have coincided with my period. It's probably too early to tell these things, though.

 

I read on another post that you've been on and off suppressive meds depending on the comfort level of your partner. Did you ever feel like it was necessary, or was it just for everybody's peace of mind that you took meds? I don't honestly mind taking them, but I'm not sure there's a huge benefit. Thanks for the tip on the Rx coupons, btw.

 

Also, do you know if there are any data on transmission rates for HSV-1 only? The pamphlet this site has seems to collapse across the two, and I would imagine it's smaller for HSV-1 than 2. That seems to be what my partner wants (exact numbers) and all I can really ever say is "small, but non-zero."

[Sparklepony]

Dancer pretty much summed up anything that I would have said. She's so damn wonderful!!

 

I just wanted to add that while sex can be huge trigger for some people, a new(er) partner can also set things off too. Kind of the same way that a new partner can cause yeast infections for the first little while. You body's PH gets thrown off causing all sorts of imbalances which your body will interoperate as stress. From everything I've read, prodrome times vary anywhere from a few hours to a few days so it's hit or miss as to if you could have passed anything also to your manfriend.

 

Honestly, I would consider suppressive meds if you intend to regularly sleep with anyone. It cuts the risk of passing things along to your partner and for most people have very little side effects. Cost wise, if you have insurance then they are fairly reasonable. My insurance doesn't have the best prescription coverage and I paid 10$ for a monthly supply.

[WCSDancer2010]

Sparklepony got it right about the new partner thing... our body sees their cells (fluids, skin cells, etc) as a possible invader and will react to it at first...eventually it realizes this is ok and it settles down :)

 

I found when I was on the supressive meds I broke out a lot less so I would say they made a difference. My OB's are not that bad and I can usually get them under control quickly so if I'm not with someone I just deal with them... certainly the guy I was with who was the most worried about it never got it and I'd say his immune system wasn't that strong... so I have to assume they helped. I dated another guy go wasn't worried about it and so I only took the meds for OB's but I wonder looking back if he actually had it and just never admitted it...tho he did have a stronger immune system... who knows???

 

I don't know of any data about transmission of HSV1G vs HSV2G but you are right to assume it will be reasonably lower because the shedding is a lot lower. What you told your partner is about right ... probably around 1-2% without meds would be a good guess. The big thing to think about is how he may react *IF* he actually gets it. For me, the unconcerned guy really would have just taken it as part of life ... the concerned BF would have been devastated. So you may need to judge whether your partner would accept it as just something that happens if he got it. If he freaks out at a pimple on his face or can't deal with a cold, you may want to take the meds... if he just takes those things in stride and says he's ok with it, then do what feels right for you with the meds.

[ClementineK]

Thank you guys for all the help, you rock!

 

I asked my guy how he felt about getting it, and he just said that he wouldn't care, because it was his choice. I'm pretty stoked on this guy...

 

I tried Epsom salts tonight, so we'll see how that goes. I'm really hoping this OB doesn't last as long as the first.

[Hermia87]

@ClementineK

Thanks for the post. Great questions. You mentioned that this is only your second outbreak...how severe compared to your first? I've read that OB's can be triggered by sex... Just wondering if condoms help prevent this at all, maybe by blocking the transfer of new cells that your body sees as invasive? Or is the risk of an outbreak the same with or without condoms?

[ClementineK]

Hi @Hermia87! So far, this OB is less severe than my first, but it might be too early to tell. My first OB came in two waves, with the second being much worse. I'm crossing my fingers that doesn't happen this time. I'm also taking acyclovir three times a day right now, so that will likely help reduce the severity.

 

For your other question, based on what Sparklepony and WCS said, I would assume so? Wrapping it up could theoretically reduce the assault on your immune system, but I honestly am just guessing. My partner and I had been having sex with condoms for about a month before we didn't use them this last time, and that's when I had my OB. That could just be a coincidence though.

[WCSDancer2010]

My advice would be to try condoms and see if they help... BUT..rough sex is also known to trigger an OB... so make sure to use plenty of lube and try starting with gentler sex and see how you go.

 

Everybody has different triggers ... it will be a bit of trial and error for you at first. But before long you will know what works for you ;)