Fact checking

I'm confused. My boyfriend recently asked his doctor questions about my HSV2 and his HSV1 and the responses don't align with what my dr told me about 8 years ago when I contracted. If anyone has definitive answers to these questions, would you please share / clarify?

1. We were told that HSV1 (oral) can only be spread to genitals during oral sex when there is an actual blister on his lip, but that I could give him HSV2 on his genitals, or mouth even when I am not having an outbreak. Is this true?

2. If he contracts my HSV2 on his genitals, can he give it to me again on a different location of my vagina, in other words can we reinfect each other during sex? I read that once you have HSV1 on one part of the body, it acts as an immunity and you can't catch it again. Is that true, and if so is it true about both HSV1 & HSV2?

Is herpes research inconclusive at this time? I feel like there are contradictions among doctors.

Thank you for reading / providing informative responses!

None of the medical professionals I've spoken with (PCP, gynecologist, nurse practitioner) have had an awareness of asymptomatic shedding being a potential factor in transmission. I think it used to be that doctors advised people HSV could only be spread when there's an active outbreak, and some doctors still advise this, though research indicates otherwise, whether it's HSV1, HSV2, oral or genital.

Average shedding rates do differ depending on type and location. Genital HSV2 typically sheds most frequently with oral HSV1 close behind. Then genital HSV1 (about 1/3 as often as genital HSV2), then oral HSV2 (hardly ever sheds). If you have genital HSV2 and take daily antivirals, your shedding rates would like be comparable to someone who has genital HSV1. IIRC, on average, daily antivirals cut shedding rates by 70-80% and lower risk of transmission by 50%.

Terri Warren (who you quoted in your link) has also stated that people infected with HSV2 are highly unlikely to contract HSV1. The opposite is not true (having HSV1 does not provide protection against contracting HSV1), but she has also pointed out that someone with an existing HSV1 infection is less likely to have noticeable symptoms upon contracting HSV2. 80-90% of people don't notice when they contract HSV2 and she believes this is partially due to many of these people already having HSV1.

I have a more recent quote from Terri Warren on the topic of oral sex and HSV2 which I will PM (private message) you. It's a link to a Q&A with someone so I don't feel right positing it in a forum but will PM.

As for your specific questions, #1 is incorrect in that it ignores the reality of asymptomatic shedding. However, if you've had HSV2 more than a few months now, that supposedly provides a significant degree of protection against HSV1. #2 - Spreading the virus to other parts of the body is rare once someone has been infected long enough to build sufficient antibodies. And yes, there is ongoing research on HSV. For instance, there is a lack of sufficient research on genital HSV1 transmission and same sex couples in particular. There is more existing research on HSV2 rates and transmission among heterosexual couples.

Thank you very much, optimist! I read both articles and they were very helpful. I guess the bottom line is that we both need to be careful because we could possibly reinfect each other. Hopefully we both have built up antibodies over the years. Thanks again for your thoughts!

@PrettyLady That was not my takeaway from those articles, but we all have to do what is most comfortable for ourselves. It generally takes a few months for antibodies to build to a sufficient level to prevent autoinoculation. There are rare exceptions, particularly in people who have highly compromised immune systems.

My current health care provider also told me I could be infected with a different strain of HSV1 or 2 from a new partner (I already have both). I asked Terri Warren (an HSV expert) about this and this was her reply:

"While that is conceptually true, experts agree that there is no clinical implication to this theory and we do not discourage this kind of contact nor do we suggest that you be careful about transmission with someone who has your same type (1 or 2)."

FWIW. I've had both types for 20+ years, so I've decided I'm just not going to waste time worrying about it. I'd happily trade some awesome sex for the remote chance of a new strain. :)

Thank you hikinggirl! I've had HSV2 for 8 years and my bf has had HSV1 orally for as long as he can remember. We both seem to have healthy immune systems. I take daily antivirals as well as Lysine. He hasn't had a breakout in 5 years. To both our knowledge, we have never given it to any of our partners. Even if the chance of infecting each other is remote, which appears to be the case, I come from the school of anything can happen, so proceed with caution. These comments give me a lot to think about. Thank you both!