Unprotected intercourse with HSV2 positive person on antivirals

Hello,

Thank you for asking your query at DoctorSpring .

Since your partner has no active lesion and since he is taking anti-viral the chance for transmission is pretty less. If you choose to discontinue using condoms, yes your risk increases. But unfortunately there is nothing more you can do. No, there is no point in you taking the anti-viral.

But if there is an outbreak and there is active lesion – do use condoms till it resolves. In that case condom use is also recommended in case if there is oral sex, as genital herpes can also cause cold sores.

Is it possible for some people to be exposed and never contract the disease? – With no active lesion, chances are that your partner is not shedding virus at all. With antiviral treatment probability is even less. And then there is the possibility (more than 70% chance !) that even if contract HSV you might never manifest the disease. So, Yes it is possible. But when the duration of contact increases the risk increases.

So bottom line – Do not be bothered about partners HSV as he is on antivirals. Condoms are generally recommended. Un protected sex is acceptable in your case. But if it is not for reason (pleasure reasons, planning a baby etc) better go for condoms.

Hope this helps
Please feel free to ask follow-up questions
Thank you.

Thank you very much for your reply and for the helpful information. A few follow up questions.

1. How often should I get tested to determine if I have contracted the disease? As this is a monogamous relationship, I am not concerned about passing the disease to someone else. But if I were to contract the disease, I would need to go onto antivirals myself so I'm not sure how frequently to be tested. Each 6 months? If I were to see a lesion, I would immediately go see my doctor and be tested but if that never happens, how frequently should I be tested?

2. Can you confirm I am understanding the bottom line?
-As long as my partner is on antivirals and no lesions, my risk is as low as is possible by using condoms
-But if we decide to discontinue use (pleasure or desired pregnancy) then my risk is increased but not enough that I should be overly concerned

3. Does oral or anal sex increase my risk in any way? Or is the risk level the same regardless of method of sex?

4. My risk for infection increases over time of contact. Meaning the longer we are together, the higher my risk becomes. (But it sounds like my risk is actually fairly low as long as he continues on antivirals and we dont see any lesions.)

Thank you!

1. I would not recommend testing. Test only if there are symptoms. Because a positive test will not change anything. If just found positive without symptoms you NEED NOT take medications. Paradoxically if you test positive and if you both are in a monogamous relationship your partner can stop antivirals (provided no active lesions). I would recommend no testing, or at max once during yearly Physical.

2.
a – Yes risk low. But with condom risk is much lower
b - yes

3. Oral sex carries less risk. As only 10% of the cold sores (oral manifestation of HSV) is caused by the type of genital HSV - that is HSV 2. Anal sex, more or less same risk.

4. Well this is just technical. As in if I say, “ If you live more the chance of getting struck by lightning is more” is technically right, but does not change anything. So no reason to be concerned.

Hope this helps
Thank you

This was a huge help. Thank you very much!