He gets coldsores, I don't, how soon can he perform oral sex

[Zannnalee]

He gets coldsores. I have never had them(I realize I could be infected without an outbreak). I wanted to know how soon after one he could perform oral sex? How soon before is he infected? Is it contagious when there is no outbreak(I was reading about shedding)? If I give him head while he has a coldsore on his mouth is there a chance of me getting infected? When we have sex while he has one on his mouth(he has never had a genital one)his there a possibility of me getting one?

I don't have insurance right now and can't talk to my Dr.

Thanks for you help

[Guest Anonymous]

1. TRANSMISSION DURING SEX

a. There's a chance he might transmit the virus while performing oral sex on you even when he has absolutely no symptoms - due to asymptomatic viral shedding (which according to some studies takes place on the surface of the skin at the infected site for up to 1/3 of the time between active outbreaks). That said, if you both are careful the chance is greatly reduced (more on precautions below).

b. You can only get herpes from coming in direct contact with the affected area of your parner's body during viral shedding, or with an object (such as a glass) that he's touched with the affected area just before. While there are minute quantities of the virus in saliva (relevant in case you want to kiss a partner who has genital herpes) and body secretions (relevant in case you want to go down on a partner who has oral herpes), it's not enough for transmission, and no cases have been recorded to date. Unlike HIV, this is an illness that it transmitted I'd say entirely through skin-to-skin contact.

So feel free to give oral even when he has a cold sore. Just remember that you might be asymptomatically carrying the virus on your lips, whether from having kissed him or just because you have it anyway (a very high % of people in the US have oral herpes since early childhood and never know about it).

c. This applies to HV2 as well. I have genital herpes and my partner was concerned about kissing me during my outbreaks. I researched exhaustively and was happy to learn the danger to him is nil to zero.

d. You may have intercourse with a partner who has a cold sore without fear of infection. See above - herpes is not transmittable through blood, saliva, or bodily fluids that come from a site that's not directly affected. Herpes is only transmittable through direct skin/skin contact with your partner's affected skin. That said, remember, if he has an outbreak in/on his mouth, don't use his saliva for lubrication during intercourse - it will carry his skin cells with live virus in them.

e. A note on urine and genital herpes: while urine is sterile, during an outbreak it will carry affected skin cells with live virus and could trigger infection.

2a. WHAT TO WATCH FOR:

-- prodrome: if he starts to feel a faint tingling/itching/pulsing sensation at the site where he usually gets the sores, the possibility of transmission is greater. He shouldn't kiss you or perform oral sex on you until the sensation disappears & for a few days of "quarantine" - since studies have shown there's greater concentration of the virus on the skin surface during & following prodrome. It's advisable to not eat/drink from the same glass/fork/plate as well.

2b. USING SUPPRESSIVE THERAPY TO LOWER TRANSMISSION CHANCES:

-- acyclovir, famvir, valtrex: you need a prescription to obtain any one of these antiviral drugs. Acyclovir is the least expensive b/c it's generic. The other two are often more effective & require less pills per day, but they could run you $300+ for 60 pills if you don't have insurance (I should know!). However, it's frequently the best investment you could make, for yourself and your partner. Reason: these antivirals help lower the viral count and may therefore lower the risk of transmission.

-- episodic suppressive therapy: effective for many. Consists of taking an intensive course of the antiviral meds for 3-5 or 5-7 days as soon as he feels that tingling. Typically up to 1500 mg acyclovir, 1000-1500 mg valtrex or famvir/day.

--continuous suppressive therapy: in some cases where the outbreaks or prodrome periods are frequent and/or severe (the virus seems to operate in cycles, & each person is different... people with lower immunity will have more outbreaks/prodrome periods per year). The patient takes 500 mg Valtrex or Famvir, or 1000-1250 mg acyclovir daily. Acyclovir is indicated for years-long suppressive therapy. No studies have been done on Famvir's safety when used for over a year.

All the above antivirals have relatively few side effects but are contraindicated for certain med. conditions such as renal insufficiency, and should not be taken in combination with certain antidepressive & antipsychotic medications.

3. There are some programs out there that cover just meds, no doctors' visits. You might consider purchasing this cheaper alternative to health insurance.

Good luck!

[Zannnalee]

Thank you for your replies

We are careful about not kissing and him not giving me oral sex while he has a sore. The other questions I just thought I would ask since there seem to be so much information on here. He only gets them about once a year. He did give me oral sex about 2 days before he saw it and I am worried.

It sucks that you never know. He are going to get married and we have been in a monogamous relationship the whole time we have dated. The thought of having to use a dental dam with him every time just drives me crazy...

Next time he goes to the Dr. he is going to say that he gets them a few times a year so they will prescribe him one those drugs(he used abreva this time and it is almost gone-after 6 days). If he doesn't get them frequently and he uses those drugs are there any chances of something bad happening-more breakouts or anything?

[ardent]

OPINIONS ON USING ANTIVIRAL MEDICATION

Opinion is divided on this subject.

On the one hand there are medical studies indicating that daily suppressive therapy with Valtrex or Famvir reduced chance of transmission during asymptomatic shedding by up to 50%. Hard facts are hard to top.

On the other hand, there's the school of thought that advocates letting nature take its course because our bodies' immune systems would supposedly be better able to fight and maybe even eradicate the illness by itself if the full effects of the virus were not consistently dampened by the antiviral drugs. Advocates of this viewpoint usually add that strategic marketing by large, wealthy, profit-driven corporations is responsible for the widespread popularity of the antiviral medications with the doctors who treat us. These advocates point, not unreasonably, to the abusive over-prescription of antibiotics by doctors as a result of intensive marketing, and the resulting wave of antibiotic-resistant bacterial strains.

I think the reasoning in both camps has some merit but is also faulty.

_Whatever the pharmaceutical companies claim today about safety and no evidence of building drug resistance, it's likely that one can't take the antiviral drugs forever. I'm 26 now, I was 21 when I was infected. No way can I be taking Famvir or Valtrex every day for the rest of my life without incurring some undesirable effects on my kidneys or liver. In my case I've gone off antivirals entirely because none of them worked and after years of religious use of Valtrex and Famvir, with little or no improvement in my OBs, I've decided I simply can't afford to keep feeding myself pills that cost about $10 a pill (yes I don't have health insurance).

_As for the holistic "sufferer heal thyself" crowd, there are just too many false claims of triumph over deadly diseases with the power of positive thinking. Thinking positive and doing yoga/quigong/accupuncture/ reflexology/visualization may help maintain a healthier immune system by lowering stress, but I doubt it'll cure a brain tumor, send cancer into remission, or eradicate the HSV virus in your body.

Choose what you think is best. Good luck.

[Palomita]

I got it that way

Hi

I have HSV-1 (generally called oral herpes) genitally. Now it is always possible that I got it from a guy who had genital HSV-1, but my best guess is no. The best I can come up with is that I got it from a bf going down on me who was shedding the virus, since I was with a guy who I saw a few months later had a big cold sore on his lip. Or from my bf after that who had cold sores like once or twice in 3 years we were together (but nothing genitally) but who never an open ob when he gave me oral. So it is my guess that yes, you are at risk. You may want to risk it, you may not, but this has been my experience. Hope that helps.