Any men passed the virus on while wearing condoms and taking anti-virals?

[Torres]

Although they are not 100% effective, I know condoms are meant to work better at preventing men passing it in on to women than the other way round. So it seems to me that the risk for men of transmitting herpes if they are wearing condoms AND taking anti-virals must be very small. Has anyone got any experience of this happening? (Just trying to put my mind at rest...)

[Herpeppotomus]

Yes, I was wearing a condom when I got it. My initial (and maybe only) outbreak was on the scrotum, unprotected by the condom obviously. I'm glad you are bringing this up because other than my post yesterday, this is the only time I've seen it mentioned. But it needs to be said, since skin on skin contact is all you need, the condom is utterly irrelevant for non-shaft genital areas. Apparently there are things such as labial condoms for woman, and latex pants for men which aim to address this (i'd probably rather take my chances then use the pants, lol).

 

So then the question becomes, what is the likelyhood of shedding/transmitting while on virals but not using a condom (e.g. for the scrotum, etc)?

[WCSDancer2010]

Well the risk of Male-Female transmission for HSV2 is about 10% with no protection and no OB's

 

If you add antivirals and condoms, the risk goes down to about 2% ... the same risk as the possibility of getting pregnant while on BC ... (and my daughter got pregnant on BC, so I know it happens!).

 

One of the biggest "risk" factors in this case will be WHERE your OB's are because if you get them on your scrotum, the condom isn't much use for protecting your partner. If it's on the penis, then your risk goes way down. That,combined with your personal awareness has a lot to do with transmission rates :)

 

 

[Torres]

Thanks very much. That's what I was thinking... I only have (very mild) outbreaks on the tip of my penis (if they do occur elsewhere I've never noticed them). So I imagine condom use should be very effective. Apart from the very first time I had an outbreak, having HSV causes me no physical problems whatsoever - just the odd sudden painless red rash, which comes and goes very quickly. My main concern is therefore giving it to someone else. Comforting to know that using condoms should work well in my case.

 

I noticed you said on another thread that anti-virals take ten days to become an effective preventative measure for transmission. Is this correct? I remember seeing an academic study which said that four days was enough time for them to prevent shedding effectively. The reason I'm interested in this is that, because of work, I can go long periods without seeing my partner and, as I don't want to take suppressive therapy continouusly, I want to know how far in advance of seeing her again I need to start taking the drugs.

[Torres]

Herpeppotomus - you mean you contracted it when wearing a condom yourself? I meant what are the chances of transmitting it when wearing one. I understand condoms offer men a lot less protection because women have a larger exposed area likely to be transmitting the virus.

[WCSDancer2010]

I was told 10 days - but that was many years ago - thinking can change around these things ... so I would ask your Dr or contact Westover Heights to ask about your situation

[Herpeppotomus]

Torres- Yes i contracted while wearing a condom.

 

Dancer- And i understand the probability of transmission with no condoms and no medicine. And i understand it with the use of both. But what about with just the use of medicine (since my main area of concern is unprotected by the condom anyway)?

[WCSDancer2010]

Anti virals reduce the risk by 50% (some reports are even higher... I wonder if it depends on how long we have had it... ie if the population in the group with a higher % may have also had the virus longer on average?) Either way - it reduces the risk of M-F transmission from 10% to 5% ...

 

One thing I have heard is shaving is more likely to both trigger OB's and also open the skin to OB's in the non-carrier. There's even the thought that having hair possible acts as a barrier ... which bums me out as I've come to like the shaved experience but worth at least keeping that in mind ;)

[Herpeppotomus]

So given that as you said the virus is likely to shed in the place of my initial outbreak and that that place isn't covered by the condom, is it a) accurate to tell a girl that her chances of getting it from me while i am on anti virals and wearing a condom is 2.5%, and b) is there a point of wearing a condom to protect against transitting HSV2, that is, is there still a greater than mere theorhetical chance (the kind that exists but, according to Dr. Loene, ought not deter from unprotected oral sex) of sheding on other parts of my penis?

 

 

[WCSDancer2010]

Male to female transmission is 10% without meds or condoms ... if the condom doesn't cover the area where you get your OB's, then the meds will give you a 50% reduction (ie, 5%) ... the condom wouldn't hurt ... (and I'd use it to start with at least to protect YOU from getting anything else!) ... if you use the FC2 (female condom) you would protect more area (it pretty much covers the whole labia area... which is where it REALLY hurts when we get it) AND it doesn't restrict YOUR feeling (or hers for that matter) ;)

 

http://tinyurl.com/FC2-condom

[Herpeppotomus]

Thanks that makes sense. So is it possible to shed from elsewhere?

[WCSDancer2010]

It's *possible* simply because you *may* have acquired it elsewhere but the likelihood is pretty low. Just keep getting to know your body and try to be "quietly vigilant" about any symptoms you may have ... over time you will get to know your symptoms and such ;)

[Jayz]

My understanding is that the percentage (e.g. 5% or 10%) actually means the risk of transmission in a year, assuming you have sex more or less twice per week. That suggests that the "percentage" is actually much smaller for any one encounter.

 

However, I've read (skimmed) the study that this comes from, and it seems a pretty skimpy basis for these "percentages." And I don't think there is much else in the way of studies. I've had this discussion with someone at the Westover Clinic.

 

So I'd be cautious at getting hung up on these percentages. And I realize your original question was for anecdotal stories from forum users - I also sought anecdotes because I wanted to get a sense of whether people's experience is consistent with the study. We didn't really get that answer.

[Torres]

I would be interested to hear what the Westover Heights people said.

 

The quoted transmission rates are *very* confusing. We are told 10%, but the studies, as you say, are over the course of a year (I have seen two studies that also cite a separate figure, the chance of transmission per 10,000 acts).

 

If it is 10% divided by, say, 100 sexual acts then that is very low (and even lower with the use of condoms and anti-virals) - 0.1%.

 

However, a recent study I saw based on mathematical modelling (by some of the same Univ of Washington researchers) used a transmission rate of around 1% per sexual act, so that doesn't make sense either.

 

As I keep finding when carrying out my own research into the virus, there is so much false and unsubstantiated information out there. Even the 'experts' disagree on a lot of fairly fundamental issues.

 

I find it amazing that in all studies no-one can actually tell us what the approximate chances of transmitting the virus are for every time we have sex.

[WCSDancer2010]

I find it amazing that in all studies no-one can actually tell us what the approximate chances of transmitting the virus are for every time we have sex.

 

Because how much virus YOU are shedding at any one time may be VERY different from what I am shedding ... so while they may come up with these statistics, without doing a study on how much you *personally* are shedding, you will not be able to come up with a true reflection of your personal risk.... and I assume that is why they are not trying to do huge studies on this ... because there will always be the ones that never pass it on and those who pass it on the first time they have sex with a condom and no symptoms with a new partner.

 

There are soooo many variables .... asymptomatic shedding, hormonal fluctuations (especially in women...really affects our OB's and thus likely shedding rates), how long you have had it, how old you are, your state of health, stress levels, foods you eat (and your understanding of how they may affect YOU personally), each persons ability to listen to their body and know when they just need to not have sex, etc .... that as Jayz said, you need to be careful about getting caught up on percentages. Use them as a guide and do what you can to keep your body in good health so you minimize your shedding.

 

When you are having the talk, don't try to down play things by trying to figure out how high the risk per sex act is (because if you DO pass it on, it will make you look like you glossed things over). A 1-10% risk over the course of a year isn't a scary number. Point out that the more YOU do to keep your body healthy the lower the risk is.... that med and/or condoms reduce the risk by 50% each....and that you respect them enough to make sure you will do everything you can to reduce their risk. Point out that 80% of people with Herpes don't know they have it, (and many *believe* they are H- because they don't know they have not been tested) so they don't know how to protect their partners. THAT is honest and believable. ;)

[Herpeppotomus]

Yes i appreciate all of the above thanks. However, i am just concerned about even mentioning the condom use percentage reduction because i think, in my case, it's a mute point. It would just be to gloss over the fact that where i might be most likely to transmit isn't protected by the condom.

[Jayz]

Re: Westover Heights Clinic (not to hijack the thread . . . ): When I was diagnosed last summer I had really great advice from my really great dermatologist in Portland, whom I see regularly for skin exposure checkups. At some point I went to see someone at the Westover Heights clinic - a PA I think? Or an ND? I talked to two different people there and they were great too, but she asked why I came there and I said I wanted to have an ongoing relationship with a clinic to be able to prescribe antivirals and generally give me the best advice. And everyone says they're the best and they're on the cutting edge of research and all. She said (and I might not have this exactly right but this is the idea): to be honest, the clinic was founded by a doctor who was on the cutting edge but that person or persons left long ago, and while the staff there are totally top notch and follow all the latest info, I am just as well off staying with my dermatologist (whom she knew by name), because she's great and also stays on top of this. I had thought the W Clinic, as specialists, would be more knowledgable. I mention this because people here from around the country seem to hold out that clinic as the ultimate authority . . . .

 

Not to take anything away from the Westover Clinic, but if you live across the country I wouldn't make a pilgrimage to Portland, or even make a telephone appt, if you have a good doctor or clinic in your home city. It's certainly nice to be able to have a face to face with someone local.

 

I hesitated to make this a new thread because I don't want to take anything away from the W Clinic, especially since she was so forthright with me. And I hope that I paraphrased the gist of her conversation accurately enough.

[WCSDancer2010]

@ Jayz

 

We've never told anyone to take a pilgrimage ... ever! ;)

 

But Westover has a Dr (Dr. Lisa Taulbee) who has taken the place of Nurse Terri Warren (who used to be to go-to person) and who can prescribe the Western Blot test over the phone and give better advice than *most* doctors (especially family Dr's, PCP's, Clinic Dr's, and such) that many people have had to deal with on here.

 

You have no idea the amount of horrendously BAD advice many have been given on here ... and I would rather have someone pay $50 to get sound advice from them (they will still be FAR more on top of Herpes than many GP's) when we have someone with a difficult or hard-to-advise case on here than to take the chance of MORE bad advice :p

 

Also, your local Dr likely can't/won't be able to set up the Western Blot test (that's been the experience of most on here)... the clinic has a deal with Quest to get it done.

 

Certainly if you happen to have a Dr that DOES stay up to date (and not all dermatologists will either) on info, then stay with them and only use WH for the WB test if you need it. But for the many, MANY people who have incompetent/undereducated Doctors on here or who have inconclusive results, or who are dealing with symptoms that don't match their results, I will send them to Westover every time ... they are the only resource we have that I trust to give people HONEST info (as they did for you too ;) )

 

((HUGS))

[Herpeppotomus]

What is the westren blot test please? Thx

[WCSDancer2010]

Its a test done through the University of Washington that is considered the Gold Standard of Herpes testing. The Elissa test only tests for 1 protein ... Immunoblot tests for 2.... WB tests for 14 ... so it's a LOT more accurate.... but sadly for some reason they only do it there and most doctors/insurance don't offer/cover it :(