A physicists' thoughts on "one-night-stand" or getting herpes per-exposure probabilities

[aep001]

Thank you all for making this very friendly and supportive community. I'm new and it has helped a lot.

 

I'm a physicist who now works in infectious disease research (irony!), and one thing I've been reading about is the single-exposure probability calculation present in many posts, most comprehensively here. Though they get to the right answer eventually, I'd like to try my shot at consolidating and simplifying the problem.

 

I think the clear take away from all the analysis is that you can feel comfortable stating the following - anything more or less is over or understating it:

 

"The chances of transmitting genital herpes (HSV2) from a single sex act is much lower than 1%."

 

PLEASE do not state anything more than this. I'll do the calculations below, and they will shock you. But please resist the temptation to cite the actual results that arise from them. I'll go into details at the end.

 

I think the more pedagogical way to do this is to assume the transmission rate is 1% and prove it is wrong ("rejecting the null hypothesis"). This is equivalent to saying we have a 100-sided die, and we roll it twice a week for a year (I assume Friday and Saturday nights!). What are the chances you never roll a 69?

 

The first time you roll it you have a 1 in 100 chance of rolling a 69. The next time you roll it, what are the chances of rolling a 69? You guessed it - 1 in 100. You can say this because each roll is an independent event (a huge assumption that we will discuss later and I believe the reason why health professionals don't share these calculations).

 

During the two rolls, how many total combinations of rolls could we have had? We have 100 possibilities for the first roll and 100 for the second, so the total number of combinations is 100*100 = 10,000. How many of them have at least one 69 in them? Well, if we first roll a 69 then it doesn't matter what we roll next - all one hundred possibilities will give us a case in which there was at least one 69 rolled. Conversely, if we roll a 69 on the second roll, it didn't matter what we rolled in the first roll. Thus the probability is 200/10,000 = 1/50. (Yes, we did double-count the case in which you roll two 69s, so the true probability is 199/10,000).

 

An easier way to do this is to ask, what is the probability of rolling no 69s in two rolls. There is a 99 in 100 chance, per roll, that you will not roll a 69. So the probability of not rolling any 69s in two rolls is the chance of not rolling it in the first roll times the chance of not rolling in the second role, or 99/100 * 99/100 = 9801/10,000 = 0.9801. So you have a 98% chance of not getting a 69 in either of two rolls.

 

How about if you roll this die twice a week for a year? That's 104 times. So the probability of not rolling any 69s in a year is (99/100)^104 = 0.35. What's the probability you will roll at least one 69 in that year? Well, it is 100% minus the probability you will not roll any. 100%-35% = 65%.

 

So let's get back to the H. The calculation I just did states that, if the chances of a single-exposure transmission were 1%, the annual transmission rate would be 65%. But the number from Adrial's handout is 10% for male-to-female transmission with avoidance of outbreaks (Adrial - it is crucial that you change "Unprotected Transmission Rates" to "Annual Unprotected Transmission Rates" in your handout. I'd also add the "sex twice a week" to the "assumes the following" section).

 

So we can do the reverse calculation. What is the per-exposure probability (I'll call this value x) given the annual transmission rate is 10%?

 

x^104 = 0.9

 

This makes x = 0.999. There's a 99.9% chance we won't transmit during a one-night stand. What's the probability of transmission? You guessed it, 1-0.999 = 0.001. There's 0.1% chance of transmitting.

 

Now, we know condoms and suppressive therapy reduces the annual rates, and they are likely multiplicative in their effect. So here are the numbers in that case, using the numbers in Adrial's handout:

 

Male-to-female:

Avoid outbreaks only: Annual, 10%, per-exposure, 0.1%

Suppressive therapy: 48% reduction. Annual, 5.2%, per-exposure, 0.05%

Suppressive therapy + condoms: An additional 30-50% reduction. Annual, 2.6-3.6%, per-exposure 0.03-0.04%

 

Female-to-male:

Avoid outbreaks only: Annual, 4%, per-exposure, 0.04%

Suppressive therapy: 48% reduction. Annual, 2%, per-exposure, 0.02%

Suppressive therapy + condoms: An additional 30-50% reduction. Annual, 1-1.4%, per-exposure 0.01%

 

Why not to cite these exact numbers:

 

Here I assumed every roll is the same. Every die is the same. In the statistics parlance we assumed each roll was "independent and independently distributed." But we know this is not the case with the H.

 

Rough sex may open micro-tears and increase your chances. Your shedding rate varies over time and so each sex act is a roll with a completely different die. People are different and not "independently distributed." So just go with it and tell your partner the chances for tonight are "much less than 1%." Besides, I'm not sure putting on your spectacles, speaking like Urkel, and stating "there is a zero point zero four percent chance I will give you herpes in this encounter" would have the desired effect anyway. (But hey, if that's your thing, run with it. If you are courting a super nerd you may even want to amp it up to "given an aggregate annual transmission rate of 3.6% assuming two sex acts per week, condom use, suppressive therapy, and avoidance of outbreaks, our per-act transmission probability, assuming it is independent and independently distributed, is 3 times 10 to the negative fourth power. The expectation value of the number of sex acts we will have before transmission is 2805.3.")

 

Is this justification to not disclose?

 

There's so much about this on this forum (e.g. here and here), so I doubt I can add anything new to that subject. I will say it's been 3.5 months since I've had sex - since leaving a lying, cheating girlfriend that I stayed with for 3 months too long because of this stupid disease - and the temptation for me is large. I've had at least three chances to have my "rebound," and this is important because not only do I need to get over the trauma of the H diagnosis, but also the trauma of being so unbelievably deceived, cheated on, and lied to. But have stayed strong and not done it, for I pride myself on being a moral person who struggles to always better myself. Not disclosing would be a betrayal to myself.

 

Another note, I really love @hippyherpy 's thread entitled "The Ladies' Man's Disclosure Success Thread." It has, at least temporarily, snapped me out of the depression of thinking I'll never have sex again (or at least I have to wait for love to have it again). His work was the real inspiration for me to write this, and to hopefully have my first real disclosure this weekend (besides to the cheating GF who probably had it anyway). We shall see.

 

Well, this was a monster first post. Apologies for the tome - I suppose it was a bit of a catharsis. But thank you all once again, especially Adrial, for creating such a supportive and informative group. If people have questions, concerns, corrections, or comments, I'd love to hear them.

[janedoe]

When I asked the transmission rate per sex act question, I assumed that researchers assume a sex act as a discrete event like you did in your calculations. After some researching I concluded that they just assumed a continious probability distribution (I haven't read journal articles abt H but I am planing to) - that is why they cannot estimate a transmission rate per sex act (I was kind of wrong apparently). Your calculations are to the point (I have a B.S. in Mathematics), and they finally answer my question. Thanks for this. Seeing the calculations made me feel a lot better.

[WCSDancer2010]

First off, Thank you @aep001for this ... we actually had a similar reply here from Dr Leone but without all the extended mathematics..

 

http://herpeslife.com/herpes-forum/discussion/5255/from-dr-peter-leone-herpes-transmission-risk-per-sex-act-explained

 

BTW.... this was funny as hell - I kinda wanna make a Meme or a GIF with it...LOL

 

"given an aggregate annual transmission rate of 3.6% assuming two sex acts per week, condom use, suppressive therapy, and avoidance of outbreaks, our per-act transmission probability, assuming it is independent and independently distributed, is 3 times 10 to the negative fourth power. The expectation value of the number of sex acts we will have before transmission is 2805.3."

 

That's HAWT...LOL

 

As for you finding love, you need to read this guy's story... I've watched him through most of his journey and he had quite the ride but what a beautiful ending :)

 

http://herpeslife.com/herpes-forum/discussion/3439/tonight-is-my-night

 

Glad to have you aboard :)

[hippyherpy]

I'm glad to see my cad ways having some mathematical resonance.

 

Correct me if I'm wrong, but the takeaway here is that compared to Adrial's handout, the risk of giving it to your long term girlfriend over the course of the year is higher (like almost 4% instead of 2%) and the risk of giving it to a one night stand girl is much smaller (.03 % compared to 2%)?

 

 

It's interesting because the smaller the percent brings disclosure and non-disclosure closer together for the one night stand. At zero percent risk they do come together.

 

What about even longer term than a year. Two years? Three, five, ten, etc.? Does the risk of transmitting to your partner increase as you add more years? Does it bottom out at some point to a percent and not get bigger from there?

 

 

 

We talk a lot about the stigma of herpes here, but there is also a stigma of non-disclosure which probably a lot of people are feeling, "I didn't disclose, so therefore I'm going to stay silent" for guilt reasons or fear of litigation.

 

I've had doctors tell me it's ok not to disclose on a one night stand and only if I'm going to get into a relationship. Your math could back that up.

 

The math you present also bolsters disclosure on a one night stand because it really is almost impossible to transmit- to me .03 is getting close to zero.

 

Now all we need is a funny video showing this like the " Adam Ruins Herpes " video.

 

Also some more analogies along the lines of the "car accident" risk but ones that go even further to explain how little the risk is for a one night stand.

 

 

I deduced a similar number, .02% from the stats I found on line that said it was something like 1/233 chance of passing it.

[MMissouri]

@hippyherpy if you take the disclosure away, where's the challenge in you getting laid? It sounds like it happens pretty frequently even with your H disclosures. It'd just be too easy for you then. Where's the fun in that! LOL

[hippyherpy]

Ha

 

Good question.

 

It's just a different thing now. I always have to move forward with the disclosure in my mind.

 

Hmm.. now I'm thinking about getting laid again. Maybe today!

[Katidid]

Very interesting and got a huge chuckle out this today.....I guess the H does have a humorous side at times

 

 

[MMissouri]

@hippyherpy A part of me wants to roll my eyes and a part of me wants to cheer you on. lol

 

@katidid I've gotten a chuckle out of this too. :)

 

@aep001 Sorry to hijack your post. I did enjoy the information you provided. I'm not a fan of math, but I do like the end results of your equations. Every bit of information helps. So thanks for that.

[WCSDancer2010]

I'm glad to see my cad ways having some mathematical resonance.

 

Correct me if I'm wrong, but the takeaway here is that compared to Adrial's handout, the risk of giving it to your long term girlfriend over the course of the year is higher (like almost 4% instead of 2%) and the risk of giving it to a one night stand girl is much smaller (.03 % compared to 2%)?

 

It's interesting because the smaller the percent brings disclosure and non-disclosure closer together for the one night stand. At zero percent risk they do come together.

 

Two things:

 

@aep001 suggested that if you want to talk about a "per sex act" number on things to say "less than 1% chance"...

 

HOWEVER - if you are having sex with different women over the course of weeks or months, your risk factor is by all rights, INCREASING that *someone* will be the "unlucky one".... in which case *IF* you happened to give it to someone after sugar coating things with the "less than 1%" concept, there's a good chance she will come back and rip you a new asshole (if not worse) if she sees that the risk to her starts at 10% (before condoms and meds).

 

My point is: PLEASE STOP looking for excuses to not disclose by trying to find a low enough number to justify not telling. Once again, our policy here is always disclose. It's really disconcerting to have you constantly challenging the disclosure issue. There's a thing called INTEGRITY. We believe in that here. If you can't accept that and need to keep challenging this please, find another forum that will tell you what you WANT to hear. Because you won't get it here.

 

Bottom line: every sex act brings a risk... that we pass it on AND that we get something else. Having H (as you have discovered) gives us the excuse to have the STD talk so that (hopefully) our partners will be honest with us about anything they know about (as you have seen with HPV). That alone is a good reason to disclose - not that they will know or even be honest but at least it opens the conversation and may save you a lot of angst some day *if* you happen to get unlucky and pass it on. The more honest you are about the risks, the less comeback anyone would have... just as if you got HPV/warts from a girl who told you she had them 6 months ago and you chose to go ahead anyway. You made an adult choice based on certain knowledge and you couldn't blame her if it happened....but if you didn't know better and she said "you risk is .004%" and you got it, odds are you might not be as accepting of the situation.

 

Please refer to the link I posted above:

 

http://herpeslife.com/herpes-forum/discussion/5255/from-dr-peter-leone-herpes-transmission-risk-per-sex-act-explained

[Allyb1123]

My ex never disclosed that he had H to me. We were together for two years before he came to me and said he thinks he might have herpes. When we first started dating I told him I had been raped about 6 months prior and I got tested for everything because of that, about a month before I met him. I had been dating someone prior to the rape and we hooked up a few times before I met my ex, the situation was too much for him. So when I was with my ex for about 4 months he was always bringing up things about std's and said his best friend had H. I remember the feeling I had when he told me his friend had it and that he was out there having sex with women and not disclosing it with them. It was truly disgusting to me. Then here we were building our lives together and bam! He tells me that, at first he says you go get tested and hopefully you don't have it, when I came back positive his whole attitude changed he said I have it to him. Then it was well who knows which one gave it to who. But it always came back to me being the one. He knew my past and played it against me and I took it all and desperately tried to make it up to him for the next 3 years as my despise for him grew stronger. He started treating me like his own personal sex slave and I did it because I was already so beat down in life, I thought he was my only happiness, I was wiling to do whatever to make him happy and stay with me. I finally opened my eyes to everything and I left him. He screamed " you gave me herpes!!" I said how do I know you didn't give it to me mf! And he never mentioned it again. I have since spoken to the man I was with prior to him and he said neither him nor his now wife have anything. The whole point being he eithe cheated on me and got this or he had it the whole time and was on suppression therapy and it took two years for it to come out. I let the herpes be a death sentence, like well I guess I'm stuck with a man who treats me like crap! Now I'm trying to heal from all those things I haven't dealt with and its so hard. Single for the first time in 5 years with a std and baggage!! Winner winner right here! I'm trying to figure it out and I'm glad that there is a place like this I can learn and grow in myself and my knowledge of H. The hardest thing for me is the disclosure part. How do I tell someone!? I have went on some dates with people I have really felt a connection with, and I push them away the min sex is either brought up or I feel like I have to push them away because they don't deserve to have herpes. Is this a normal reaction? How to I help stop that train of thought?

[hippyherpy]

I'm glad to see my cad ways having some mathematical resonance.

 

Correct me if I'm wrong, but the takeaway here is that compared to Adrial's handout, the risk of giving it to your long term girlfriend over the course of the year is higher (like almost 4% instead of 2%) and the risk of giving it to a one night stand girl is much smaller (.03 % compared to 2%)?

 

It's interesting because the smaller the percent brings disclosure and non-disclosure closer together for the one night stand. At zero percent risk they do come together.

 

Two things:

 

@aep001 suggested that if you want to talk about a "per sex act" number on things to say "less than 1% chance"...

 

HOWEVER - if you are having sex with different women over the course of weeks or months, your risk factor is by all rights, INCREASING that *someone* will be the "unlucky one".... in which case *IF* you happened to give it to someone after sugar coating things with the "less than 1%" concept, there's a good chance she will come back and rip you a new asshole (if not worse) if she sees that the risk to her starts at 10% (before condoms and meds).

 

My point is: PLEASE STOP looking for excuses to not disclose by trying to find a low enough number to justify not telling. Once again, our policy here is always disclose. It's really disconcerting to have you constantly challenging the disclosure issue. There's a thing called INTEGRITY. We believe in that here. If you can't accept that and need to keep challenging this please, find another forum that will tell you what you WANT to hear. Because you won't get it here.

 

Bottom line: every sex act brings a risk... that we pass it on AND that we get something else. Having H (as you have discovered) gives us the excuse to have the STD talk so that (hopefully) our partners will be honest with us about anything they know about (as you have seen with HPV). That alone is a good reason to disclose - not that they will know or even be honest but at least it opens the conversation and may save you a lot of angst some day *if* you happen to get unlucky and pass it on. The more honest you are about the risks, the less comeback anyone would have... just as if you got HPV/warts from a girl who told you she had them 6 months ago and you chose to go ahead anyway. You made an adult choice based on certain knowledge and you couldn't blame her if it happened....but if you didn't know better and she said "you risk is .004%" and you got it, odds are you might not be as accepting of the situation.

 

Please refer to the link I posted above:

 

http://herpeslife.com/herpes-forum/discussion/5255/from-dr-peter-leone-herpes-transmission-risk-per-sex-act-explained

 

I'm not looking for excuses to not disclose and have been disclosing to every girl. It's so bad to talk about things? I thought we were all about having open discussions here.

 

I'm interested in why herpes disclosure is so necessary compared to other viruses. It can't hurt to at least be able to discuss this.. if anything this discussion would bolster the disclosure side, as it did for me.

 

It seems as if a few things come into play with disclosure necessity

 

- Risk of transmission

- How prevalent the disease is in society

- Potential harm of virus for giver and receiver

 

If the risk of transmission drops down to a significant number like .004%, and the prevalence of the virus in society goes up to as much HSV1 oral or HPV, and the potential harm of herpes is actually lower than HPV or some of the other viruses, it does make the question of why we have to disclose worthy of discussion.

 

 

Also, I don't sugar coat anything.

 

I tell the girls I have herpes. I tell them I take pills and we use condoms and that's not 10% risk.

 

This thread is telling me that the risk is even lower than Adrial's handout.

 

When you start getting into 2% vs. 1% or . 04% that's very low risk in my mind. That's not hiding anything.

 

 

I don't see how someone could "rip a new asshole" if you've disclosed. Once you've disclosed, you've done your part. For me, I give more info because I think the info actually works in my favor and it's good for people to be educated, but I don't think people are even obligated to anything like that so long as they disclose. I don't believe that a disclosure without providing some info will have a high likelyhood of a "success"

 

The handout says 2% risk of transmission, this thread says less than one percent. I wouldn't go around saying .04% or whatever because I don't think has meaning for most people.

[janedoe]

@hippyherpy The calculations assume iid. which is the same as rolling the same dice everytime. But when you have sex, you are NOT rolling the same dice... You might be shedding virus more on some days, other person might have a tear in his/her genitals, you might have rough sex, your immune system or your partner's immune system might be down when you are having sex... All these possibilities bumps up the transmission rate. So let's say your t.r is 0.04% but tomorrow it might be 1% etc. So, 1% transmission rate is sort of like an upper limit. It might be a good idea to disclose that upper limit.

[hippyherpy]

Let me get this straight, if I have sex 365 days out of the year, don't take meds or use condoms, then about 36 of those days I will give my partner herpes? And these are the days that I don't have symptoms?

[WCSDancer2010]

@hippyherpy

 

You said It's interesting because the smaller the percent brings disclosure and non-disclosure closer together for the one night stand. At zero percent risk they do come together.

 

That sounds a lot to me like you are still looking for a reason to not disclose.

 

Again, IMO, if you have the HPV strains for genital warts or cancer, you should disclose ... at least if you are within the 2 yr post "all clear" point when (as *I* understand it) it's safe to consider that it's either gone dormant or disappeared (last I checked there are are still conflicting info on this).

 

As for the other 36 strains - they seem to be harmless AND only we women will know that we have them ... you guys get off the hook on all the HPV except warts as far as knowing what you have (unless you get it in your throat... but that seems to be later in life and they don't seem to think it's important enough to swab you guys for it). So not sure what good it would do to disclose about them.

 

Herpes doesn't affect most people badly... but it DOES affect a small amount of the population and a small number of those people get some pretty rough symptoms. THAT is why we disclose.... for the (my guesstimate) 1% of the population that bets the nerve pain, constant OB's, or other longer term symptoms. We don't know which partner may get symptoms like that. Or if they will get any at all.

 

If you had had a really rough ride with this I bet your POV would be different. But you guys mostly don't get it that bad and the few who do still don't have the kind of folds and areas we have (unless, perhaps, you are uncircumcised) to create the immensely painful sores we women can get. I got a bad OB once when I was planning the last weeks of my wedding. Had to sit on a plane for a few hours. You have NO IDEA of the pain of having a crusted over scab sticking to your underwear and rubbing every time you move. Back then I didn't have access to Valtrex. I was hardly able to move for a week without wanting to cry. THAT is why I'm so adamant about disclosure. I got H on my first sexual experience and in THAT instance, if I had known that guy had H, I probably wouldn't have had sex with him because I really did it to get it over with and see what it was like. Now, knowing what I know now, I would proceed with caution with a partner.... use condoms and such... and for *me*, I can only enjoy sex with someone I see some kind of longer term relationship with...so disclosure would make me really look at whether I saw any kind of long or even short term future with the person.

 

Yes - we are here to discuss things but one thing that we are adamant about is our POV that people should disclose about Herpes. If you want to discuss whether people should disclose about HPV perhaps you should join a forum for that and put in your 10 cents worth.....

 

And I think it's a great thing that people who like the casual sex lifestyle can see that you CAN still find plenty of partners with disclosure. So I appreciate what you bring to us with regards to that discussion.

 

We are not going to change our stance on disclosure here, no matter what stats you come up with. We can't TELL you what to do... but we don't want people to start looking for every excuse to not disclose.... there's a thing called INTEGRITY and we value that here. For that 1% who, like myself, *might* have a tough start with H.

 

Let me get this straight, if I have sex 365 days out of the year, don't take meds or use condoms, then about 36 of those days I will give my partner herpes? And these are the days that I don't have symptoms?

 

Again... there's no way to know YOUR shedding rates... and the 10% for women is our RISK .. **Shedding Rates for GHSV2** are 15-30% of the time ... which can be for 1 hr or sustained for days at a time. Rough sex, illness, certain foods, stress, etc can take you from hardly shedding at all to shedding a whole lot for days or weeks at a time. And those are likely the days you don't have symptoms. The CDC says *most people* get HSV from someone who doesn't have symptoms and likely doesn't even know they have H. So to answer your question - it's not that you WILL give your partner H 36 days of the year ... but 15-30% OF THE TIME there's a **higher risk** of you shedding enough to POTENTIALLY pass it to your partner.

 

And again, go read the Dr Leone link ... none of the Dr's that I know who are specialists in the H world support any kind of "per act" stats ... because, as @janedoe said, YOU don't know when you might be shedding heavily asymptomatically ... and stats are only useful in this kind of thing (ie: per act) if you can exactly replicate the data. Because of the variability of the issues of shedding, micro-tears, the other person's immune issues, etc, you CAN'T go on a per-act stat.

 

[hippyherpy]

Sorry to eat about your outbreak. I definitely do disclose, as you can see in that other thread. Knowing that the risk of transmission is lower than I thought only gives me more confidence in disclosing that I'm less likely to pass it on, not that I wouldn't disclose.

 

Even when I'm buzzed I disclose. It's been baked into my ways at this point.

[Katidid]

I think often times, we are so inquisitive about the "per sex act" rate of transmission because we want to keep our partners more safe and have better stats to share with them (and to feel better ourselves about having herpies to begin with) rather than hoping to not have to disclose. Disclosing, in my opinion, (thankfully I've only had to do it twice and both were successful) is a very personal choice and it's equally the responsibility of the "other" person to ask....after all, its a shared partership even if for a one night stand. It's all very tricky anyway...... the "other" person may even have it and not know all the while they are asking if you are STD free...or they knowingly have cold sores and don't give that a second thought! Really, it's a small wonder it's not 1 out of every 2 people have this.

[WCSDancer2010]

it's equally the responsibility of the "other" person to ask....after all, its a shared partership even if for a one night stand. It's all very tricky anyway...... the "other" person may even have it and not know all the while they are asking if you are STD free...or they knowingly have cold sores and don't give that a second thought! Really, it's a small wonder it's not 1 out of every 2 people have this.

 

Totally agree that it's a 2 way thing but sadly *we* are the ones in the know. We were likely "that person" on the other side that should have asked the other person about their status. (I know *I* was! LOL ) Because we are here, discussing this, getting educated, we now know better. So *more* of the burden, IMO, is on us to start the conversation... both because we know AND because we need to know how educated they are and whether THEY are a risk for *us* to get involved with.

 

I briefly dated a guy who just could not get in his head that he couldn't "tell" if a person carried an STD.... he was convinced he would "know" by how they acted, or that he would see/smell something that would tell him they were not "safe". The concept of silent carriers (of HPV/Herpes/Aids/etc) just wouldn't enter his head. We parted before things got too sexual but I wouldn't have got into a relationship with him without him getting a test simply because I felt that odds were he had likely been exposed to at least 1 STD along the way....LOL

[janedoe]

@WCSDancer2010 I was like him before my diagnosis. When I had my first OB, I went to the doctor just to ease my mind and get some medication for the itching... I could never have suspected that those paper cut things were herpes... anyway the second guy that I disclosed to is the same. I think that is because of those google images. They are kind of extreme, it makes you think that if I had those, I would know.

[hippyherpy]

It doesn't have to be "sad" and you don't have to be thankful that you've only had to disclose a couple of times.

 

In my experience, the disclosure is not any where as scary or bad as people might think.

 

I think it has it's own kind of stigma in that sense. The rejections aren't that bad either. If the person doesn't like it, then you move on to someone else.

 

I've had many more successes with disclosure than rejections so far.

 

What I'm saying is that, in general, having herpes isn't a big deal, and neither is disclosing. It's just something you do. It doesn't have to be this big dramatic event.

[aep001]

Sorry for my absence. It has been a wild ride since my last post. I did my first real disclosure on Friday night - third date, girl takes me back to her place and jumps on me. Thanks to @hippyherpy and his ladies man's posts, I assumed it would go fine. I stated things in total confidence, and was in an Uber, crushed, within the hour. I've been pretty depressed ever since. I shall rise again, but not yet.

 

But that is a post for a different forum.

 

I have also been chewed out by an epidemiologist I work with, after a few-hours long conversation that recapitulates much of what is on this thread. It was dangerous for me to do the per-exposure calculation because people will just take that with them (even though I warn them not to), and use it as an excuse to not disclose.

 

On the other hand, I saw it as a chance to try to answer a question everyone was asking, and maybe teach people some probability theory along the way.

 

The take away from this post and my other conversation is, however, that the per-exposure risk can swing drastically. It can be orders of magnitude more or less depending on the person - their diet, immune system, random chance, etc. I thought the "much less than 1%" number balanced those things, and I stand by that, but we should all realize that for any given particular act the odds can be much higher than 1%.

 

So why am I still comfortable telling a girl the chances are much lower than 1% (if I ever have the chance again :( )? Because life is probabilistic. Whenever you do anything you run the risk of getting hurt, and in our minds we call make the calculation of risk vs. reward. But we should know that those aggregate risks (e.g. 0.04% of transmission, or 0.01% chance of dying in a car crash) are indeed aggregate. There will be times when the risks are much greater and you just don't know. All we can do is disclose as much of the known risk as we can, hope that others understand the risks and how they are aggregate, and go about living our lives. In this case, by saying the risk is "much less than 1%" (maybe we should take out "much"), we are actually multiplying the aggregate risk by 25. So I think that is safe and cautious to our partners, but would love to hear others' thoughts.

 

I think everyone has struggled with the disclosure question. Goodness knows, all I need is a rebound right now so I can move on instead of thinking about how my cheating ex-GF is doing fine and in a relationship, and that has proven difficult. If I had just not disclosed Friday night my life would be so much better and the girl would probably never have known. But at the end of the day I want to be able to call myself a good person, an honest, open, and moral person. And that oftentimes requires courage, perseverance, and sacrifice. @hippyherpy's successes hearten me that the sacrifice will not be too severe, that one can have his cake (sex) and eat it too (the peace that comes with disclosure). We shall see.

[aep001]

What about even longer term than a year. Two years? Three, five, ten, etc.? Does the risk of transmitting to your partner increase as you add more years? Does it bottom out at some point to a percent and not get bigger from there?

 

To answer this let's stay away from the per-act conversation and rely on the more reputable annual numbers. If there is a 10% chance of giving someone herpes in a year, what's the chance of not giving it to them in a year? 90%. In two years what's the chance of not giving it to them? 0.9 * 0.9 = 0.81. Thus the chances of giving someone herpes in two years is 19%, again assuming sex twice a week.

 

To get geeky, the % transmission is:

 

T = 1-(Q^N)

 

Where Q is the chance of *not* transmitting in a year (1-the annual chance of transmission), and T is the overall chance of transmission in N years. If you were to draw that it would be a curve that is always increasing ("monotonic upward"), but with the slope decreasing ("negative concavity"). It "asymptotically" reaches 100%, that is, there is never a 100% chance of giving your partner herpes, unless you live (and have sex with them) forever. However, there is a 99% chance you will give it to them in 44 years (N = log(1-T)/log(Q), Q=90%).

 

Yes, I am not using the continuous distribution calculations, but I don't think there will be a large difference here. I'm happy to re-work all the numbers if people can tell what distribution they used (Poisson?).

 

So, using the numbers in my original post here are the 1-year, 2-year, 5-year, 10-year, and 30-year probabilities:

 

Male-to-female:

Avoid outbreaks only: 10%, 19%, 41%, 65%

Suppressive therapy: 5%, 10%, 23%, 41%

Suppressive therapy + condoms: 3-4%, 5-7%, 12-17%, 23-31%

 

Female-to-male:

Avoid outbreaks only: 4%, 8%, 18%, 34%

Suppressive therapy: 2%, 4%, 10%, 18%

Suppressive therapy + condoms: 1%, 2-3%, 5-7%, 10-13%

[Bambina3]

I'm just reading this and shaking my head....for me personally, when I leave work, that's where I like to leave my brain (lol)

 

So to chime in and simplify, the transmission risk is so minimal that I sit here and think "why me??"

 

I'm on to read next thread

[hippyherpy]

Yeah but Bambina I also know people who have been married for

over thirty years with HSV2 in one partner, having unprotected sex with the spouse and not transmitting.

 

I'm curious about the stats on thus forum membership. Shouldn't a place like this have many more members if herpes was such a common and debilitating virus? Wouldn't there be many more Ella Dawsons jumping in the herpes as identity politics bandwagon?

 

Or do we represent the worst of the worst with regards to symptoms? I haven't had bad symptoms yet, but some people on here give horror stories.

 

 

 

[hippyherpy]

aep001-

 

you got to just move on to the next opportunity and yes there will be rejection and I had that feeling of "it could be so easy to not disclose" when I've gotten rejected, but my success rate dwarfs my rejection rate.

 

The thing is, if you are talking to a lot of women simultaneously, any kind of rejection that one gives you won't matter at as much because there are others to mingle with. That's the closest I'm getting to math here with the physics genius posting hahah

 

 

Having herpes will probably force you to improve your game even more, which can only be a good thing for you. Also, to keep things in perspective, there are so many other reasons why people get rejected that I don't consider herpes some special reason.

 

 

This week I slept with two new sexy girls, and I also had two other previous lovers contact me to hang. All were disclosed to.

 

What I'm saying is that is definitely possible to live the life. You have to

make some mental adjustments at first, but it is definitely possible.

 

I can tell you that when I started that thread, I didn't know what to expect. I did have a boost of confidence when I first got diagnosed because I had two of

my lovers at the time who I told about it still sleep with me. One of them even went raw.

 

That plus the mindset that I'm not going to let some fucking cold sores get in the way of me doing my thing, and that I saw it as a point of pride to prove to

myself and to the world that it can be done- casual sex and disclosure are a very real and possible.

 

I still get rejected but I want you to use and piggy back off my successes to keep your confidence.

 

The self improvement opportunity that herpes presents is tremendous. I suggest everyone on this forum who is interested in having sex and disclosing do what they can to do to present the best possible versions of themselves to potential lovers.

 

 

[janedoe]

@hippyherpy I don't think people here represent the worst case scenerio. I figured so many people are ashamed and afraid abt this. That is why there are people here who don't post. Also, people in long term committed relationships may not have the urge to post here. So, this leaves us with newbies and the people who still trying to figure out this stuff.

 

I'd like to do what Ella did but sadly, my days here are limited and my country is not some place that you can have STI talk openly without getting murdered or else... Maybe later in my life, when I finish my PhD, I will try that.