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Ghsv1 newly dx'd, married over 20 years ... questions

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Many questions for me. Just experienced my first (that I know of ob) pretty painful. Lesion swabbed and tested positive. Currently awaiting further testing and trying to find a lab willing to draw for western blot. Husband is awaiting results as well. My ob came after genital sex only and the last oral was almost 4 mos earlier. Seems odd to have first ob after genital only. Neither of us have had cold sores in our lives. Soooo, I'm trying to determine if he was faithful? Btw, I've never rec'd oral from anyone else and I have been faithful. Ideas? Advice? Seems like options are, new ghsv1 for him transferred to me, late ob for me from oral months earlier which could have been new or old, or longstanding non symptomatic ghsv1 for me originating from him?

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While oral-to-genital transmission is more common with HSV1, genital-to-genital transmission does happen. HSV1 sheds less often from the genitals than from the mouth. It is estimated to shed roughly 1/3 as often as genital HSV2. Data does not yet exist to pinpoint transmission rates, but Terri Warren has suggested using HSV2 transmission rates as a reference starting point, then dividing by 3 to take lesser shedding into account. So if male-to-female HSV2 transmission rates without condoms and antivirals = 10% annually, this would equate to 3% annually for HSV1. So yes, it is possibly you could have been married for 20 years and only now have contracted it, and contracted it through genital-to-genital contact, without infidelity being a factor.


"However, among 48 source partners of people with documented newly acquired genital HSV‐1, HSV‐1 was isolated from the genital area in seven and from the oral area in three (unpublished data). This suggests that genital to genital HSV‐1 transmission is potentially not uncommon." Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564733/

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