My boyfriend was diagnosed with genital herpes. What should I do?

Q: My boyfriend was diagnosed with genital herpes and I have some questions.  I hope you can answer or direct me to the correct source.  I can never get a live person with the herpes hotline.

1.  What are the chances that I could get herpes from him if he uses a condom? He has no symptoms and has never had an outbreak. He only found out he had it after being tested for it.

Could he “shed” the virus in the area surrounding the penis where its not covered by the condom?  Could I get it this way if he has no symptoms and no sores/blisters?

2.  If he has no outbreaks should he take valtrex or any other antiviral medication to reduce risk of transmission. His doctor told him no need because he doesn’t have outbreaks.

3.  After intercourse when he takes off his condom, if i accidentally touch his semen (on my leg or hand or genital area) could I also get herpes.?  How long does the virus “live” out of the body?

Signed,  Trying to Make Things Work

******

A:  From your message, we can already tell you that your boyfriend’s doctor is way “out-of-date” about how herpes is spread because he told your BF that he didn’t have to worry about spreading it to you if he wasn’t having an active outbreak.  That’s totally incorrect.  Most new herpes infections are the result of skin-to-skin contact with someone who has herpes when they are not having any noticeable symptoms.  Most people who have herpes occasionally shed the virus on the surface of their skin even when they have no noticeable symptoms.  This is called asymptomatic shedding.

Taking Suppressive Therapy such as Valtrex can reduce the number of days of shedding the virus by 50%.  Using condoms can also reduce the risk of spreading the herpes virus by 50% – but only if the condom covers the area where there might be shedding.  Shedding can occur anywhere in the boxer region (on or around the genitals), and it’s possible that the condom does not cover the are where shedding may occur.  Still, condoms can be extremely helpful.  They just don’t protect 100%. Please read our page about How to Reduce Your Risk (of getting or spreading herpes).

Does your boyfriend know if he has HSV-1 or HSV-2?  Does he know the method by which he was diagnosed with genital herpes? (See How to Get Tested for Herpes).  Not all herpes tests are reliable.  Hopefully he took a type-specific IgG herpes blood test for both HSV-1 and HSV-2 or a PCR test from an active infection.  Get a copy of his test results and check to see that the doctor used one of the better herpes tests from our list of herpes tests.

Do you know if YOU have been tested for herpes recently? Please check with your doctor and ask for a copy of your latest STD test results to make sure that it included a herpes blood test for both HSV-1 and HSV-2.  Even if you have never had any symptoms, you should immediately ask your doctor to give you a type-specific IgG herpes blood test for both HSV-1 and HSV-2.  Most doctors do NOT include a herpes blood test when they are testing their patients for other common STD’s, so most people have never been tested for herpes (and think they were).  So it’s possible that you may already have HSV-1 and/or HSV-2 or both, but don’t know it (like most people).  Most people don’t have noticeable symptoms, and most doctors do not test for herpes – unless you specifically ask them to.

If you get a type specific herpes blood test for both HSV-1 and HSV-2 and your boyfriend does the same, you may learn that both of you already carry both HSV-1 and HSV-2. Either of these types of herpes can cause genital herpes. If you both have the same test results, then you probably don’t have to take any particular precautions because you already have what the other person has.  However, if  you don’t test positive for the same things, then you may still want to use condoms, dental dams or other protections, including supressive therapy such as Acyclovir or Valtrex.  If this seems like “over-kill” – that may be true. But remember – everyone’s immune system is different and just because you don’t have any herpes symptoms – doesn’t mean that your next partner will have the same response to the herpes virus.

If you are NOT in a monogamous relationship, then whomever has herpes may want to take Suppressive Therapy such as daily Acyclovir or Valtrex, and also use condoms and dental dams etc.  And remember – herpes is not the only STD or STI that can be spread from partner to partner, so you should probably take all of the precautions you can to prevent spreading STD’s.  Unless you have both been tested recently for all STDs or STIs including herpes between each of your last partners, then you may have something new that you didn’t have before.  You may have a new STD/STI but never have any noticeable symptoms. And you can still spread any STD/STI to a partner even when you are not having any noticeable symptoms.

If your BF’s doctor thinks that just because he doesn’t have noticeable symptoms, then he cannot spread the virus, then his doctor is one of the very many doctors who are way totally out-of-date about genital herpes transmission and prevention.  Daily antiviral therapy has been shown to dramatically reduce the number of days of “shedding” the virus, including asymptomatic shedding, and is extremely effective. However, this is not a 100% guarantee by any means.  There is always a small chance that with or without treatment, your BF may be shedding the virus and potentially spread it to you. However, if you are using both condoms and daily antivirals, then the risk of transmission is pretty small. Still, there is no 100% way to prevent herpes transmission because it also depends on your own immune system.

The Herpes virus is spread via skin to skin contact.  Semen does NOT contain the herpes virus.  Also, the herpes virus cannot live long outside the body and there are no known cases of anyone getting herpes from a toilet seat or a towel or anything like that.  If it makes you feel better, go ahead and take a shower after sex.  But you’re not going to be able to catch herpes from dirty sheets, towels, or toilet seats.

Bottom line:  Even though your boyfriend has genital herpes, it is possible to have safer sex and reduce your risk of getting herpes from him by following certain precautions listed on our webpage at How to Reduce Your Risk.

Your boyfriend, like the majority of people with genital herpes, doesn’t experience any noticeable symptoms and only found out about it via a blood test. You might also have genital herpes and not know it.  And it’s possible that you already had herpes before you started dating him – but had no symptoms.

The stigma of genital herpes is really more of a problem than the virus itself.  For most people, genital herpes is a minor nuisance if at all, except for the “stigma”, which seems way out of proportion in relation to other STDs and medical conditions.  If he is using condoms and taking daily antiviral suppressive therapy, you are unlikely to get herpes from him, but there are no guarantees.  In the meantime, you should also take a blood test for genital herpes as a baseline for today – so you know your current herpes status – positive or negative – with or without any symptoms.  If you already have the same strain of herpes as your boyfriend (HSV-1 or HSV-2), then you and your boyfriend can forget about taking daily antiviral therapy or using condoms – except as a contraceptive.