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HSV-1 vs HSV-2 questions


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Hi everyone, you may have seen me around lately and I was diagnosed July 24 with HSV2 at an urgent care facility... except today when I went to my doctor and she read me and provided a copy of the results, I have HSV1 genitally and they gave me the results wrong (or perhaps the rude lab tech who gave me the information had no idea HSV1 could occur genitally and assumed). I had really coped with the idea of HSV2 and even begun to be optimistic because it wasn't likely to be contagious orally (with the small risk, and if it were transmitted HSV2 orally is usually a one-time or very uncommon thing) and was fairly mild for me... but now I am reeling from the idea that having HSV1 means I am likely to give someone this orally OR genitally. It feels like the risks are higher and although I know most people have HSV1 already (about 60% I recently read) I feel like it's a higher risk of transmitting it than HSV2 even if it's more mild because it occurs more commonly in both places than HSV2, kind of like a double whammy. Is that true? Am I making sense? Somehow, I felt better about HSV2 knowing it was mostly going to be genital and I wouldn't have to worry (as much) about oral sex as HSV1 and after convincing myself of that, I have to now do the reverse and I'm a little stressed about it and need some guidance around the differences.

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Hey Lulu!

 

This brings up an oft-discussed topic on these forums: With oral HSV-1 being so prevalent (no, not 60% — 80% of Americans have oral herpes/cold sores!), then where does the responsibility lie? Also, to your question about possibly spreading HSV-1 to their mouth if someone gives you oral sex, consider this: Since 80% of people have cold sores, then KISSING someone else who carries HSV-1 orally has the same possibility of spreading oral HSV-1 as having oral sex with someone who has genital HSV-1. It's the same virus, only in a different place. See how this is a direct representation of our sexual shame? If I contracted oral HSV-1 from oral sex or kissing someone, it ends up affecting me in exactly the same way; only difference is from which part of the other person's body I got it from. Ultimately, who cares? But for some reason, our minds make it mean something vastly different.

 

So, to your question specifically, if the overwhelming majority of people have something, does the responsibility lie in those who have it (when the chances of the person you're telling has it, too) or does it lie in those who don't have it (and know that the majority of people do, so if they want to protect themselves, they need to bring it up)? It's an open question, and I've heard plenty of people who are on both sides of this topic. It's a fascinating one to consider because it really opens up a lot around our sexual shame as a culture.

 

And about your worry that HSV-1 is more transmissible than HSV-2 genitally, that's simply not true. Genital HSV-1 only asymptomatically sheds 3-5% of the time while genital HSV-2 sheds 15-30% of the time. Check out all the facts here:

http://bit.ly/h-opp-disclosure-handout

 

... and here are some blog articles about HSV1 and HSV2:

http://herpeslife.com/genital-hsv-1-herpes-and-oral-sex

http://herpeslife.com/spreading-genital-herpes-hsv2-from-oral-sex

http://herpeslife.com/hsv-1-hsv-2-types-of-herpes

 

See how getting the facts and putting it in the proper perspective can help ease a lot of unnecessary worry and shame? Allow yourself to see the truth of this instead of a shameful imagination of it. :)

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Good point Adrial! I think some days for me are harder than others. I accept it and most days I'm fine, others I am beating myself up about this and bringing it upon myself... and that is definitely the sexual stigma. So many people have sex but nobody is supposed to talk about it, so an STD is a double stigma: you are not only admitting you had sex, but you got something from it. Anyway, it's hard. Your point about whether or not to disclose is a good point too.. of course, I would choose to even knowing it's type 1. It just seems like it'll be more complicated to explain that there's two types and I have this type and you probably do too but don't know it or it's in a different place, blah blah blah. The safest road is to tell them, ask them to get the antibody test and then if they're part of that 20% that doesn't carry it already, then they can decide about the risks.

 

My only question left is: if someone has HSV1 orally and don't know it, is there a risk they can get it genitally still? Or do their antibodies protect them from that?

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I want to be clear about what I was specifically referring to in the whole disclosing piece: What I was referring to was a conversation about whether to disclose ORAL HSV-1 to a partner or not since 80% of people have it. That was where the question of reverse-disclosure came in. Interestingly, since a majority of people don't have HSV-1 genitally, then disclosure is the way to go. But when more people have it than don't have it, where does the responsibility lie? For example, in the population of African American women in America, 48% have genital herpes. If one out of two black women have herpes, then those who date black women should know the risks. It's a fascinating discussion across the board, regardless.

 

And to your question, antibodies certainly protect a lot against spreading HSV-1 to other parts of the body, but there is still a chance of spreading it to the genitals, especially if you have an actual visible outbreak happening (but you would definitely avoid sex during these periods anyway). Most likely with the small amount that the virus sheds during asymptomatic viral shedding, their antibodies for HSV-1 would probably protect against them getting it genitally from you. Make sense? (Disclaimer: And I'm no doctor, but from all I've heard and read it seems to be a fair assumption to make.) ;)

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:) Same thing applies to you, you, YOU! Your body immediately started building antibodies to protect it from HSV-1 the second you got it. Just don't touch an outbreak and then pick a zit on your lip and you're golden. It's really hard to autoinoculate (the magic phrase meaning spreading herpes to other parts of your body), so just use common sense and you'll be fine and keep it corraled to one spot.

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Kuro, from my understanding they are quite similar viruses but tend to stay towards their preferred group of nerves (1 prefers the base of the spine, 2 prefers the pelvic region). In cases like mine, they can also swap places and this just means they're in the less common area and may not occur as often or as intensely as they would in their "home" base. So you can have HSV1 (oral herpes) genitally, like me, you can have HSV2 (genital) orally, you could have both, you could have neither, etc etc etc ;)

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