discordant couple safe sex practices: GHSV2 positive woman, HSV2 negative and HSV1 negative man

[OceanWaves]

Hello wonderful folks!

 

So the above is my situation, I've met an amazing guy who is negative and we are figuring out what safe sex options and practices will make sense for us.

 

I'm interested in hearing from those of you in discordant relationships - what safe sex methods do you use to reduce the risk of transmission to your partners? Particularly interested in hearing from genital HSV2 positive women with partners who are negative for HSV1 and negative for HSV2.

 

I'm familiar with suppressive therapy which I am starting, and its reduction of transmission rates (approx 4% transmission rate from female to male w/o male condoms which is reduced by 48% using suppressive therapy according to published studies). Neither I or my partner are fully comfortable having sex without protection due to my HSV2 positive status and other reasons so I'd like to hear the experiences of other couples - what methods do you use besides condoms, suppressive therapy.

 

In particular what's the story with these:

-he can keep his boxers on to prevent skin to skin contact: haven't tried this yet but it seems sort of impractical/could cause more friction and risk of skin irritation/tears for me?

-what dosage of drugs do you use? 500 mg? more? is higher dosage more effective at reducing transmission rates as far as you know or have you seen studies on this?

-female condoms: are they any more or less benefits to using these than a male condom?

-what about if I use alcohol rub on myself....seems like it'd be harsh on my skin but maybe there is another gentler product?

-what herbal products or other immune system boosters do folks w/o HSV take to reduce risk of transmission to your negative partner?

-are you aware of research showing the transmission rates from GHSV2 positive woman to negative man using both condoms, and supressive therapy!

 

Thanks!

 

[MMissouri]

I can't answer all of those but I'll take a shot at a couple. The type of protection you use depends on where your OBs are. If they are internal then a condom should be sufficient. If they are external then you would want a barrier between that area and him. (That's where female condoms and boxers come in).

Can you tell when you are having prodomes?

 

[OceanWaves]

Thank MMissouri! The OBs are external. And yes I can tell when I am havign prodromes, at least I think I can, but I'm not always sure. Until now I've erred on the side of taking acyclovir when I have extra sensation or an unfamiliar sensation in the OB area. That is a concern of mine though: I've been HSV2 positive for less than a year and OBs have decreased but I don't think I've mastered symptom recognition --- figured the suppressive therapy would help/make that moot???

[MMissouri]

If your outbreaks are external and in an area that a female condom would cover, then I would try them. I have to agree with you on the boxer issue. I think it would be uncomfortable/bunched up. Whatever works though! lol

The first year with H is the questionable one. After that I think people get more in tune with their OBs and prodomes.

Hopefully someone with statistics and suppressive information will come on soon!

 

[sickoflifelessons]

I am a H2 female with a H- boyfriend. I use suppressive therapy (500 mg valtrex per day) and we use condoms. I haven't had any outbreaks since my first one, but I pay really close attention to my body so we can avoid sex if I even suspect any symptoms. We haven't tried female condoms (mostly just because we haven't found them at the store by me and we're not motivated enough to search for them) or any of the other measures you mentioned because he's not uncomfortable with the risk he is taking, and we will probably stop using condoms at some point (his choice). We have both been tested for all of the other stuff and I've been on the pill forever (for other reasons), so that's a personal choice we'll make when we are ready.

 

I don't take any supplements, but I do have a green smoothie every day and have a generally healthy diet and very active lifestyle. I do think that keeps my immune system strong (not just in keeping H under control; I also don't really get sick often at all).

 

Another thing I have read that can help prevent transmission is using a lot of lube during sex. That prevents excessive friction that can lead to transmission.

 

While I think it is important to do your due diligence and take all reasonable precautions to protect your partner, I also think you shouldn't drive yourself crazy worrying about that last little 1-2% risk. With suppressive therapy and condoms, his risk of getting it is is very low. How much are those additional steps (e.g., rubbing alcohol, herbal supplements) going to do to reduce the risk? If they make you feel better and give you peace of mind, I think that's really good, but they are not proven and I think at a certain point it you can do everything right and it still comes down to luck, unfortunately.

 

The only statistics I know of that are published are in the valtrex article: http://www.nejm.org/doi/full/10.1056/NEJMoa035144

 

That article studied couples who were counseled to use condoms, but many of them didn't, so the statistics are more representative of couples not using condoms.

 

I'm sure there are other articles, and I think I read them when I was first considering disclosure, but I actually got a new computer since then and I didn't move my bookmarks over :(

[WCSDancer2010]

@OceanWaves

 

Hello and Welcome!

 

I've had 2 relationships with H- men since my diagnosis...both were for 3 yrs each - both are H- to my knowledge. For one, we used nothing (his choice) for the other I took antivirals. The big thing is to not do anything if you have any inkling that you might be shedding (prodromes, etc) ... and that just takes time to figure out ... the great thing is that you have plenty of excuses to explore other ways to get your freak on >:) I'll post a link to a great discussion we just had with ideas for you :)

 

http://herpeslife.com/keeping-your-partner-herpes-free-can-be-super-sexy/

 

http://herpeslife.com/herpes-forum/discussion/5807/list-the-ways-to-protect-my-partner-from-getting-herpes-hsv2 Safe alternatives to sex

 

As for your questions

 

In particular what's the story with these:

-he can keep his boxers on to prevent skin to skin contact: haven't tried this yet but it seems sort of impractical/could cause more friction and risk of skin irritation/tears for me?

 

Some people have tried that - I would suggest you just try it ...maybe you could have fun shopping for some really "special" boxers for your intimate time.... make it FUN to use them rather than it being something you do because of Herpes :)

-what dosage of drugs do you use? 500 mg? more? is higher dosage more effective at reducing transmission rates as far as you know or have you seen studies on this?

 

If you are using Valtrex, 500 mg seems to be the regular dose... you just have to see how it works for you at that dose and talk to your Dr if you have some outbreaks that come through on a regular basis...

-female condoms: are they any more or less benefits to using these than a male condom?

 

Some people love them, others not so much :/ Again, try them and see if they work for you... Here's a link to them on Amazon :) http://tinyurl.com/FC2-condom

-what about if I use alcohol rub on myself....seems like it'd be harsh on my skin but maybe there is another gentler product?

 

Nope - no rubbing alcohol...you are more likely to irritate the area and induce an OB. If you want to try it, perhaps Hydrogen Peroxide... but I never did anything like that when I was in a relationship.

 

-what herbal products or other immune system boosters do folks w/o HSV take to reduce risk of transmission to your negative partner?

 

Sorry - you meaning you or your partner? L-Lysine is the most common supplement for the H+ person ... it cuts down OB's for some ...but not everyone. Might not hurt for your partner to try it ...but there are no studies to show what the H- person can take to help out.

 

-are you aware of research showing the transmission rates from GHSV2 positive woman to negative man using both condoms, and supressive therapy!

 

Meds reduce transmission by roughly 50% ... condoms also 50% but a LOT of that has to do with the location of the OB's... but on average you will take the risk from about 4-5% to 1% with both methods.

 

Communication is one of the key ways to reduce transmission ... also, be careful about shaving/waxing ... the irritation *may* cause an OB and the pubic hair is thought to help to make a barrier to keep the virus from reaching the skin... so a little "pube-scaping" with clippers rather than a razor may also help ;)

 

(((HUGS)))