Worry about herpes transmission to non-HSV partner- need some perspective

[Kat]

I'm new here and so glad to find this place! I'm coming out of a 23 year marriage during which I have had unprotected sex with my hubby who has never had any HSV symptoms (I had an HSV2 diagnosis 27 years ago). I have not had an outbreak since 2002 and am now seeing a new person, and we had "the talk". He is nervous, of course, but has become educated as much as possible. My primary care doc put me on Valtrex 1gm/day to avoid transmission (high I know) and I have been on it for 6 weeks. I then went in to see my new ObGYN and when I was discussing this with him and told him my new partner and I would be using condoms with the Valtrex, he said "well, there's no need for that- you really don't need to be worried about transmitting to him with the Valtrex on board." So I'm sure you can see where this is going....

 

Anyway, we had sex twice without a condom and then I got back on and did more reading and realize that we need to be using condoms in addition to the Valtrex and my new doc gave me some not great advice. I am terribly worried that I have inadvertently put my new guy at more risk than needed- its only been a couple of days, and I have no symptoms but of course have no idea if I'm shedding. AAARRRRGGGGGHHHH.

 

At this point I am planning to let time pass and then next time we are together to say, you know, we do need to wrap you- he knows there is/was a risk, but we both were feeling like if the doc told me this it was worth taking to the bank. Not so.

 

Is there anything anyone can say to reassure me or advise on real-life experience with this? I know what to do moving forward, but I am feeling terrible and like I really failed him.

[WCSDancer2010]

@Kat

 

First - Welcome!

 

So... a few reality checks:

 

1) You were in a 23 yr marriage and didn't give it to your ex hubby - I'm guessing that you were not on Valtrex then either...

 

2) The risk of passing for female to male is 5% .. with Valtrex about 2% ... add condoms and that goes to 1%

 

.........there is a 1-5% chance of getting pregnant on Birth Control

.........you have a 1-2% risk of dying in a car accident in any given year

 

So as with the above examples, it's all about understanding your risks and deciding between the two of you about whether you need to be using condoms or not. It seems that your body is controlling the virus pretty well on it's own and with the anti-virals you should likely be just fine and I'm sure that is why the Dr said to not worry about condoms. And to be straight up, most 40-something and up me and condoms don't mix well.... so a lot will depend on his feelings about the risks AND his feelings about condoms.

 

Print out (links below) the facts on asymptomatic shedding and the addition of antivirals and condoms from here and then discuss whether HE is concerned enough to use them. If he's ok with not using them, then accept that. He's an adult and he can make adult decisions....

 

Handouts:

http://bit.lyh-opp-diagnosis-handout/

http://bit.ly/h-opp-disclosure-handout

 

Disclosure e-book:

http://eepurl.com/b4IPP

 

(((HUGS)))

[Kat]

Thank so much. All very helpful. Not crazy about condoms but my initial outbreak so many years ago was SO BAD that id hate to have anyone experience that. True no Valtrex with ex hubby but he may have converted without symptoms. In any event, your post and the shedding info is much appreciated and I will share with new guy- HSV is just part of my life now but i want and need to do all I can to be responsible to him- was feeling like I just blew it but have some needed perspective. Hugs to you too- so grateful.

[WCSDancer2010]

No problem -

 

Just because you had a bad initial OB doesn't mean your BF will *IF* he gets it. But again, give him the info and let him decide what he is comfortable with :)

 

(((HUGS)))

[HerryTheHerp]

Hey Kat,

 

Well, doctors know about as much about herpes as I do about car repair...that's to say, they get a 15 minute lesson in school, and then they're about on their own to learn the rest.

 

As far as risk, you definitely should be using condoms. That said, you've had it a long, long time. That means the virus is going to be shedding a lot less, and your transmission risk is lower. Valtrex and condoms, I'd tell your boyfriend not to worry, too much. Be cognizant, but not too fearful.

 

And, I'd say get him in here. It won't hurt for him to read through the stories and information. It's some good stuff and lots of support for both of you.

[Sparklepony]

I agree with everything Dancer and Herry said. Even though your doctor gave you some not so educated advice, you should ALWAYS be using condoms if either of you are worried about transmission since it cuts the risk down quite a bit, he wasn't totally off base. It is a small chance to pass it to your partner, but still a chance nonetheless.

 

Try not to stress about it too much. As hard as that is.

[WCSDancer2010]

I'm just going to step in here and say again....IMO, you don't HAVE to use condoms as long as your partner understands the risk factors with AND without condoms...esp as you are on Valtrex. I was with my last BF for 3 yrs on Acyclovir and never used condoms because he had ED and lets just say using a condom was like putting a pinhole in a balloon.... he had been totally freaked out when I told him I had herpes ... within maybe a couple months he was totally cool with everything... and he never got H from me.. and he had a horrid immune system.

 

Again, it's just my opinion, but I really believe we are all adults and the important thing to know your risks are and then making your joint choices about the precautions you will take ;)

[Kat]

Thanks again to all- so helpful and so wonderful to find a community of thoughtful, pragmatic, vibrant people living with herpes, since that's what we're all trying to be and do, right?

 

I am actually a neuroscientist by training and a university professor and have been scouring the literature about viral shedding to see what it is we know and do not know. I'm noting that there does not seem to be a clear answer out there now (that I've turned up so far, but this is a fairly recent re-entry into exploring this for me) about the relationship between time since initial OB (I know mine was within 3 days of infection- long sad story) and rate/amount/days per month of likely asymptomatic shedding for HSV2. I'd love any references folks have that are recent about this-

 

I have always known when I was "going to get a twerpy" as my ex and I used to refer to it- I did have prodromal prickling, but as I mentioned, the last episode I had was when I had my daughter 12 years ago, which was terrible, btw. May as well share- might be helpful to folks.

 

Had been put on Acyclovir to prepare for my 2nd vaginal delivery (no probs with my son), but I mounted an extreme fever (105- they never figured out why) late in my pregnancy and they induced me- we both almost died. She was delivered vaginally, but, horror of horrors, less than 24 hours later, in the maternity unit, I discovered a small lesion. You can imagine my terror. They tested her, and unfortunately, her eyes tested positive for HSV2 (prior to this I had not had an outbreak for probably 3 years prior to this. She was admitted to the NICU, they did a spinal tap, screwed it up and had to do it again, and happily, she was fine, but was in the NICU for 6 days (over Mother's day). It was terrible- talk about having problems establishing breastfeeding. The happy ending is that she was/is fine and now that she is older (and her older brother too) it has given me a chance to add that to "the talk" about sexual responsibility and the long-term effects of STDs- just that they need to be careful and frankly less trusting than I was years ago.

[WCSDancer2010]

OOOhhh - a neuroscientist .... I expect you have access to most of th eliterature but I'll dig out what I have and send it to you. I'd love to have your input about your interpretation of it all. I know I read somewhere about how they discovered the asymptomatic shedding link. I hope I have it in my links somewhere

 

Regarding your delivery - Wow - what a nightmare. Personally I think the fever was the Herpes trying to break through. As a child, I got "unexplainable" fevers of 105 twice a year accompanied by a huge OB on my chin. It stopped with puberty. Thankfully you noticed the lesion...the sooner they catch it on babies the better. Did they test her for H later? I had 1 by Cesarean and one naturally and they did a routine test at 6 months. It would be useful for her to know if she has the antibodies to it.

 

Thankfully your experience was a rare one.... usually the ones who break through the meds are those in their first year with H.

 

I'll send you the info when I get a chance to dig through by bookmarks...