Genital Herpes Transmission and
FAQ About Genital Herpes
Herpes can be spread through skin-to-skin contact at any
time the virus is in its active phase: Viral shedding
deposits HSV on the skin or a mucous membrane. Contact
with another individual's skin allows virus to spread and
begin the job of situating itself in the nervous system
of a new host.
How Many People Have Genital Herpes?
At least half of the population is infected with oral
herpes, an illness often passed during childhood. And
approximately one-quarter of Americans over the age of 15
are infected with genital herpes -- an estimated 40 to 50
These numbers may seem hard to believe. To put them in
proper perspective, remember: HSV is usually a very
subtle infection. In research studies, less than a third
of those infected could easily recognize herpes symptoms
The remainder -- the vast majority -- could not. Most
people simply don't know they are carriers. ( In some
cases, this is because they have failed to identify some
of the milder symptoms of herpes. In others, it's because
they apparently have suffered from no symptoms at all.)
How Can I Find Out If I Have Herpes?
If you have genital symptoms now, it's important to see a
medical professional as soon as possible to be examined
If you've had genital symptoms in the past or believe you
were exposed to genital herpes and want to know whether
you now have it now, there are new blood tests available
that detect can herpes even without symptoms present.
How Did I Get Herpes?
Herpes can be so subtle that even the active phases are
sometimes hard to identify. As a result, herpes is often
spread during periods when people simply don't recognize
the virus has become active. In addition, a person can
acquire herpes without recognizing the "first
For these reasons, it's often difficult to trace the
source of infection or know exactly when transmission
How Does Transmission Occur During Symptomatic
If a person has a herpes sore on the lips, for example,
he or she can spread herpes to the lips of another person
through kissing. Infection can also be spread from the
lips to the genitals during oral sex. This is why so many
cases of genital herpes are caused today by herpes type
If one has a herpes sore on the genitals, coitus or other
unprotected sexual activity gives the virus a chance to
How Does Transmission Occur During Sub clinical
The same principles and same scenarios hold. Unrecognized
or "sub clinical" shedding has been documented
in or around the mouth as well as in various genital
sites such as the vagina, penis, and anus. Thus, if HSV
is active, oral, anal or vaginal intercourse can cause
transmission -- even when one has no visible sores or
other signs and symptoms.
How Can I Reduce The Risk Of Giving This To My
Because it's hard to pinpoint herpes' active phases,
preventing transmission is not a simple matter. But there
are a number of measures you can take to lower the risk
of transmitting herpes:
Refrain from sexual
contact when symptoms are present - including prodrome. Following outbreaks, it's best to wait
for a day or two after the skin heals up, since sub
clinical viral shedding is more likely at this time.
Consider using condoms: Because of the risk of
transmission from sub clinical shedding, it may be
helpful to use condoms for penetrative sex in between
outbreaks. Condoms restrict contact between the penis and
the mucosal surfaces of the vagina, mouth or anus, where
sub clinical shedding is known to occur. Be advised:
Condoms may not cover all sites of viral shedding, and
they don't provide a 100% guarantee against herpes
transmission. For example, herpes sores may be present on
the scrotum or upper thigh, or virus may be shed into
vaginal secretions that would reach places not covered.
On the other hand, condoms are the best all-around form
of protection against HIV and other sexually transmitted
Consider medication: Some research shows that the
use of daily antiviral therapy dramatically lessens the
rate of asymptomatic viral shedding as well as reducing
the frequency of outbreaks. The
effect of daily therapy on transmission rates is still
Consider outercourse: Touching, cuddling, kissing,
sensual massage and many other ways of giving sexual
pleasure carry less risk than penetrative intercourse.
Contact with a herpes lesion, however, is never
Which Combination Of These Precautions Is Right
It's best to talk these over and make decisions with your
partner. In doing so, note that your partner's medical
history may be an important consideration. If he or she
has already acquired herpes, for example, it may be
important to know the type and discuss which precautions
you still want to take. The best way to find this out is
to get a type-specific blood test. For more information
about these tests, including
the new rapid, finger prick test for herpes, search google.com for 'herpes
What Are the Odds of Infecting a Partner?
Unfortunately, no single precaution listed above can
guarantee protection for a sexual partner. And because
it's difficult to organize scientific studies of sexual
behavior, there's no easy way to rate the effectiveness
of each risk reduction strategy. Your sexual partner's
risk of acquiring herpes will vary according to a number
of factors. For couples in whom one partner has genital
herpes and the other does not, it appears the average
rate of transmission is about 10% per year when the
couples simply refrain from intercourse during outbreaks.
But this average obscures two important factors:
1) The risk to uninfected women is roughly three times
greater than the risk to men.
2) the risk of acquiring herpes type 2 is higher in those
who have not previously been infected with herpes type 1.
A potentially important variable in risk may be the use
of suppressive antiviral therapy. One study showed a 95%
reduction in sub clinical shedding in people taking daily
antiviral therapy, a result that could indicate lowered
risk of transmission as well. Follow-up studies are
addressing this question.