Dr. H. has responded to many questions on this subject, and we post summaries of some of them here along with the answers he gave. If you are faced with this situation, and with giving "the talk" (i.e. having to tell a potential partner that you have herpes) then you may also want to review the other suggestions given in the Top Ten Questions area (it's question #2).

A potential partner has herpes
Dr. H.,
Someone I am considering a relationship with has discovered he has herpes. He said he is asymptomatic, and mentioned shedding. My question: is herpes avoidable when having sex (like aids safe sex) or should I just forget this guy and avoid any contact. I have HSV-1 oral, which flares up only infrequently throughout the year (1 - 3 times/year at most).
Dr. H. writes:
You know, I would ask you, how do you feel about this person? Is this love or just an attraction? Being pretty old fashioned, I would say, avoid sex until, if not marriage for you, at least until a firm sense of a monogamous relationship has been established. It is the right thing to do. Old fashioned, yes, but a much safer way to sort through feelings and STD issues. Everything else is dangerous and simplistic, in my opinion. This is what I think.

Let me respond specifically to your question. Generally, herpes is avoidable. You must avoid anyone having acute symptoms, including burning, blisters, irritation, or any other sign of inflammation including referred pain, pain going into the legs or groin, or similar symptoms.

If you friend has a diagnosis of herpes, he joins 1 of 5 people in America, meaning that it is very, very common. People with herpes commonly shed virus, as much as 40% of the time when not on medication. Regularly taken acyclovir really decreases virus shedding, if the person is taking it, maybe as much as 95% decrease of shedding.

Is HSV infection avoidable if careful? Definitely. Your consort should be on medication, acyclovir unless allergic to it, once or twice a day and, if you are female and he is male, he should wear a condom, preferably with a virucidal cream in the condom. He should be free of symptoms of any sort, which usually only he would know. Meeting these criteria, the chance is probably between one in several hundred to one in several thousand that you will contract the virus.

You might transmit oral HSV to him, either genitally or orally. How does that make you and him feel? You should be free of symptoms, and he should be aware of your condition also, just as you are of his.

Personally, since herpes is almost only dangerous only to newborn babies, I would say that you should weigh the above information, decide how you feel about this guy, and think about it from a "love" standpoint. Yes, there is risk to you. You have to weigh the potential consequences.

Partner with herpes
Dr. H.,
My girlfriend has herpes, but hasn't had an outbreak in 20 years, I have had sex with her numerous times. She claims she hasn't had any problems with boyfriends in the meantime...am i at risk?
Dr. H. writes:
Absolutely you're at risk, if it was in fact herpes that she was diagnosed with 20 years ago. That's a long time ago in medicine, in the late 70's. I don't recall that viral cultures were readily obtainable then, so the diagnosis MAY be somewhat suspect. A blood test for Herpes simplex Type 2 using the POCkit Test or the Western Blot test would be helpful on her, and on you too for that matter since one in 5 people are carriers.

Wear spermacidal condoms, latex preferred. Don't have sexual relations if she's having symptoms. Encourage her to take acyclovir 400 mg twice daily if you're going to be having sexual relations. And, relax. That should give you a very high protection factor.

(Editor's note: Please make sure that you go to visit your primary health care practitioner before taking prescription medication, and remember that giving your partner your medication, if it has not been prescribed for them, is illegal. They need their own supply. Thanks.)

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