Preventing the Transmission of Herpes
It is certainly possible to have a sexual relationship and not spread the herpes virus, particularly if some simple precautions are followed.
This article talks about the possibilities of passing herpes onto another person and what you or your loved one can do to help address the problem.
What needs to be considered in a relationship
Herpes often brings about some changes in a couple’s sex life, such as abstaining from oral sex or intercourse during outbreaks. For most people with herpes this occurs only a few times a year. There is a small risk of spreading the virus in between outbreaks but condoms and certain treatments can help to minimize this risk significantly.
What is the chance of spreading herpes to my partner?
It varies whether you are a man or a woman. In either case, the risk of spreading herpes to a partner is very, very small if you abstain from contact with the affected area during outbreaks.
For a woman with HSV-2 genital herpes, the chance of spreading the virus to a man if they abstain from having sex during outbreaks is approximately 3% in a year. This is without the use of condoms or suppressive drugs which would reduce this risk even further.
For a man with HSV-2 genital herpes, the chance of passing the virus onto a female partner if they abstain from sex during outbreaks is close to 8% in a year.
This is still only a very small chance which could be reduced by a further 40% or more with the use of condoms, a suppressive therapy or antiviral herbs.
The risk is even lower for those individuals who have HSV Type 2 in the mouth area, or HSV Type 1 in the genital area. For more information please read this article Herpes Simplex 1 and 2, which explains the two different types of Herpes simplex and the rates of recurrence.
How the herpes virus can be spread
Herpes is most easily spread when a sore is present, but, it is also often spread at other times too. Some people notice itching, tingling or other sensations before they see anything on their skin. These are called “Prodromal Symptoms” and they warn that the virus may be present on the skin.
Herpes is most likely to be spread from the time these first symptoms are noticed until the area is completely healed and the skin looks normal again. Contact with the infected area (including oral, vaginal, or anal sex) is very risky during this time.
In the few days just before and after an outbreak there may be a small chance of spreading the virus, even when no symptoms are present. This is scientifically referred to as asymptomatic or Viral Shedding.
Although it is hard to predict when viral shedding is occurring it is estimated that it only occurs approximately 5% of days during the year (possibly even less after having the virus for a long period of time) and this is usually during the few days just before, during and after an outbreak.
It is a good idea to use latex condoms or latex barrier protection in-between outbreaks for additional protection (please see your doctor for alternative barrier methods if you are allergic to latex). The herpes virus does not pass through latex condoms, and when properly used latex condoms are likely to reduce your risk of spreading or getting herpes, however even the best condoms do not guarantee total safety.
When herpes sores occur in places not covered by a condom the condom is of little help, if any. Condoms and foams should not be relied upon when herpes sores or symptoms are present. Condoms do not guarantee 100% protection because a lesion may be found which the condom did not cover. Used consistently, however, condoms are one of the best available forms of prevention.
Can the virus be spread to other body areas?
Yes, you can spread herpes to other areas of your own body but it is unlikely.
One kind of complication involves spreading the virus from the location of an outbreak to other places on the body by touching the infection and then transferring the virus particles via the finger and forming herpes whitlow or ocular herpes, and other body areas can accidentally become infected in this way.
This type of scenario is rare and is more likely to happen only in cases where:
- The immune system is highly compromised (such as in patients with HIV)
- There is a tear or break in the skin allowing easier access for the virus to transmit
- During the first primary outbreak (the body may not have had time to build up sufficient antibodies)
Preventing self-infection is simple. Be mindful of transmitting the virus to other skin areas, especially where there is broken skin, avoid touching the infected area altogether during an outbreak. If you do, immediately wash your hands and the area that you have touched with soap and water thoroughly, this will help to stop spreading it further.
Just remember, self re-infection to other body areas (also called auto-inoculation) is unlikely during a recurrent outbreak and fairly uncommon in general. So, be sensible and don’t let paranoia rule your thoughts.
How can a person contract genital herpes?
Genital herpes can be transmitted through direct contact with a herpes infection (such as an infected blister or sore), usually through sexual contact such as oral, vaginal or anal intercourse. Herpes can also be transmitted when there are no symptoms present and be dormant for a long period of time before you recognize any signs or symptoms.
It is also possible to contract genital herpes from a cold sore on a partner’s mouth or face through oral sex. It is possible to pass the virus on even if they did not have a cold sore present at the time of contact.
To help prevent transmission it is important not to engage in any activities that involve touching the affected area while there are sign or symptoms, this includes itching, tingling or irritation on the skin.
How can a person contract Cold Sores?
Cold sores are generally contracted from skin to skin contact with an infected area. For example, if someone has a cold sore on their lip they can pass on the virus to another person’s mouth through kissing.
The usual incubation period of the virus (time before any symptoms show) is approximately two to twelve days after the first exposure to the virus. As most people contract cold sores before the age of seven, it is common for a person not to remember their first or ‘primary’ cold sore outbreak.
Once infected with cold sores, the virus remains inside the body in a latent (sleeping) state. Throughout a person’s life the virus can then become “activated” causing a cold sore recurrence.
Is it possible to prevent herpes infection?
Yes, definitely. Many couples have been in a relationship for years without ever transmitting herpes. Some simply avoid having sexual contact when signs or symptoms are present, while others use condoms or other protection in between outbreaks to help guard against asymptomatic viral shedding.
If you take the necessary precautions, the chances of getting the virus from your partner are small. Genital herpes does not necessarily mean complete abstinence from sex or a reduced enjoyment of sex. If you both know the facts and keep the issue in perspective, it can be only a minor inconvenience.
In some cases, the risk of transmitting the virus can be reduced by up to 40% if you with the use of condoms. However, the continued use of condoms in a long-term relationship is a personal decision that only the couple can make. Most couples find that as the importance of the HSV infection in their relationship is seen in perspective, condom use can become less relevant if this is the only reason condoms are being used.
At all costs couples should try to avoid sexual intercourse during an active episode of herpes, because this is when the virus is most likely to be transmitted. This period includes from the time when your partner first has warning signs of an outbreak, such as a tingling or burning in the genitals, until the last of the sores has healed. If you or your partner has an active cold sore, it is advisable to avoid oral sex as this can spread the virus to the genitals.
Sexual activity can prolong the healing of the episode and the risk can be increased if there are any breaks or cuts in the skin, such as if you have thrush or small abrasions from sexual intercourse (often due to insufficient lubrication). It can be helpful to use a lubricant specifically for sexual intercourse and avoid sex if you have thrush. Sexual lubrication is helpful right at the start of sexual activity. If interested, the Female Herpes Issues section has more information about thrush.
Sores in other areas, such as the buttocks and thighs, can be just as contagious as those in the genital area, and care should be taken to avoid direct contact with such sores during sex. At other times, there is still a small risk of transmitting the infection, even if there are no signs of genital herpes.
Read the Herpes Supplements and Herpes Medications sections for more information about treatments that can help to reduce the chance of transmission when there are no symptoms.
Is genital herpes spread via a toilet seat, or from sharing drinks, towels, etc?
The fact is it would be virtually impossible to catch genital herpes by sharing cups, towels or bath water, or from toilet seats. Even during an outbreak, it is only skin to skin contact with the parts of your partner’s body which have the sores which you need to avoid. If you or your partner has genital herpes, you can still cuddle, share a bed, or kiss.
What steps can I take to help prevent transmission?
In a sexual relationship with a person who has herpes, the risk of contracting the infection will never be zero. However, these steps can greatly reduce the risk:
Tell Your Partner
It is important that both you and your partner understand what herpes is, what this condition involves and the precautions that should be followed to help prevent transmission. Telling a partner is often the hardest step, but once you have done this you can be honest with each other and work together to safe-guard against HSV.
Avoid contact during the “high risk” periods
Avoid contact with the affected area in the few days before, during and just after an outbreak because herpes is most contagious during this time. Cold sores are a form of the Herpes simplex virus so the same rules apply.
Some couples have had successful relationships for years without ever transmitting herpes, sometimes this is done just by avoiding sexual contact when symptoms are present (this includes any sign of itching, tingling or burning in the affected area, as these can be an indication that the virus is active).
Limit the number of sexual partners
By having sex with a non-infected partner who has sex only with you (mutual monogamy) you are greatly decreasing the chance of spreading the herpes virus to other people.
This does not mean that you have to be with the same person for the rest of your life, it simply means that by being faithful to the one person while you are with them, you are making a responsible choice which can reduce transmission.
Use Latex Condoms and Dental Dams in between outbreaks
Condoms offer useful protection against herpes, protecting or covering the mucous membranes which are the most likely sites of infection. Although they can nearly halve the risk in some cases, condoms do not guarantee safety. This is because the herpes infection is not always located in an area that can be covered by a condom.
Both the prescription drug Valtrex and some medicinal herbs have been proven to reduce herpes viral shedding in clinical studies, so incorporating one or both of these options may help to minimize the risk of transmitting the virus to your partner when there are no symptoms.
If you are in a relationship or just beginning one, you may want to consider talking with your Doctor about daily Valtrex or consulting a Naturopath about herbs and nutrients which have been proven to help reduce herpes virus activity.
Certain medicinal herbs may also be beneficial in creating a strong immune resistance against HSV in non-infected partners. You can learn more about some of these herbs in the Boosting the Immune System section. This is a sensible approach which could help to reduce the chance of transmission even further.
Is there or will there ever be a drug to stop the virus from being transmitted?
Some experts believe that developing an effective HSV vaccine is the only practical way to control the disease and the spread of infection, and if such a vaccine becomes available then universal immunization may be the best approach.
Various vaccines are in clinical trials or pre-clinical development, including mutated strains of herpes virus that cannot replicate, inactivated herpes virus, and DNA vaccines that use genetic fragments of the virus to trigger an immune response. Creating such a vaccine, however, is complex and difficult.
There are often new trials commencing in all areas of treatment and participants are always in high demand. The websites below should be able to point you in the right direction if you are interested in following the progress of these:
There are treatments which have been proven to reduce viral shedding and the growth rate of the virus, which can in turn help to reduce the risk of transmission. If you are interested in learning more about these you can read through the Herpes Supplements and Herpes Medications sections for details.
Warren, Terri J. “Counseling Patients With Genital Herpes” Medscape June 22, 2002.