Unprotected sex and transmission of HSV2 with no symptoms

[nik77]

Newly diagnosed with hsv-2, after one year with boyfriend who says has zero symptoms.  If we’ve had unprotected sex for a year, and I had no symptoms of herpes during this year.. what is the probability of me giving him the virus? Should we assume he more than likely has it now, or he himself brought it into the relationship and infected me?  

[mr_hopp]

This question is one that goes down in history as one of the unanswerable questions. It's hard to tell timeline, even based on the best of blood tests. Only way to answer that is if both of you have been getting consistent and reliable STD tests over time. Also, it's hard to say whether he has herpes or not, even if you've been having unprotected sex for a year. Technically, for herpes to be passed to a man without signs or symptoms, without meds, without protection, the risk is 4% per year (10% for women because of more mucous membrane). So the chances are actually pretty low. Has he been tested? He should either get an IgG test or Western Blot (WB costs more out of pocket, but is the best and most comprehensive).  

[nik77]

Thanks for your response. I know you stay busy answering everyone’s questions on here. I will suggest that to him.. looking online you see so much information you don’t know what to do.  The different tests available and if they are accurate or not is straight up confusing!

[lali]

On ‎2018‎/‎08‎/‎13 at 10:57 AM, mr_hopp said:

This question is one that goes down in history as one of the unanswerable questions. It's hard to tell timeline, even based on the best of blood tests. Only way to answer that is if both of you have been getting consistent and reliable STD tests over time. Also, it's hard to say whether he has herpes or not, even if you've been having unprotected sex for a year. Technically, for herpes to be passed to a man without signs or symptoms, without meds, without protection, the risk is 4% per year (10% for women because of more mucous membrane). So the chances are actually pretty low. Has he been tested? He should either get an IgG test or Western Blot (WB costs more out of pocket, but is the best and most comprehensive).  

Just read somewhere on the forum that people can shed between 5 to 45% of the time so how is it 4%? Doesn't seem like those numbers are for everybody.

[mr_hopp]

@lali Great question! Here is a screenshot from the disclosure handout showing the shedding rates based on which HSV strain you have and whether it's oral or genital: 

Shedding rates aren't in lock step with transmission rates since just because the virus is shedding doesn't mean it will be passed. (For example, if there is a 5% shedding rate of HSV-1 genital, then it doesn't mean that there will be a 5% transmission rate.) 

Does that help?

[lali]

@mr_hopp

Yes that makes sense, thank you. But theres something i don't understand. If i shed the virus more often doesn't that mean I'm more contagious?

[mr_hopp]

Yes, the 4% transmission rate is an overall average. I don't believe that transmission rates themselves have been broken down by strain/location on the body.  

Edit: The 4% transmission rate to males (10% to females) are referring to genital HSV-2 only. 

[lali]

18 minutes ago, mr_hopp said:

Yes, the 4% transmission rate is an overall average. I don't believe that transmission rates themselves have been broken down by strain/location on the body.  

Uhm that's scary then. Hsv2 is more contagious than hsv1. I shouldn't be using those numbers than when i disclose.

[mr_hopp]

Ah, sorry, I misspoke. Those transmission rates (4% transmission risk to male, 10% to female, etc.) are for genital HSV-2 only, so it's safe to say, for example, that if someone only has genital HSV-1, then the transmission rate is less than 4% or 10%, respectively.