worried about condoms and transmission

[Joperty]

https://www.guttmacher.org/pubs/journals/2721301b.html

 

so today i found this.... and it makes it sound like actually condoms aren't much use against protecting guys from herpes? 

does anyone have any thoughts? my partner is HSV free and i would like to keep him that way and am now even more worried!

[Acesheart]

Hey Joperty, they actually don't cover the entire area just the  staff of the penis and when frictions from sexy times are happening , the flat skin area can become irritated by the females outter vagina area and cause frictions which if you have a sore spot, can rub it raw and expose the partner to your genitals virus. If your taking antivirals during the sexy times, they reduce the chance of transmission. Hugs Aces xo 

My husband is still negative for herpes  !

[Joperty]

But they do help protect women?? 

I'm assuming women do she'd the virus from their vaginas too?

I always thought it was harder to pass this virus onto men than it is women but how can that be the case if condoms don't even do anything! 

I really didn't wanna be taking antivirals for the rest of my life because of this  

Urgh this fucking sucks all over again  everything I thought I knew I am doubting! 

[ST]

Aceheart, does it matter how many days before sex that you take the antivirals? I've been dating someone for 4 months and I've disclosed to him. He would like for us to be together in a few weeks. I don't want to take antivirals daily but I am willing to for that occasion. Should I take them a few days before or will they work if I take them the day of? I'm seeing a doc this week to fill the prescription.

Joperty, sorry for jumping in, I was curious about the condom situation myself. I have ohsv and ghsv 1. I don't want to spread this either.

Edited December 12, 2015 by ST

[Acesheart]

5 hours ago, ST said:

Aceheart, does it matter how many days before sex that you take the antivirals? I've been dating someone for 4 months and I've disclosed to him. He would like for us to be together in a few weeks. I don't want to take antivirals daily but I am willing to for that occasion. Should I take them a few days before or will they work if I take them the day of? I'm seeing a doc this week to fill the prescription.

Joperty, sorry for jumping in, I was curious about the condom situation myself. I have ohsv and ghsv 1. I don't want to spread this either.

I took them everyday for 25yrs sexy times and no sexy times, but some I've heard take them when they know they will be sexually active about two days before. User JBnAtl, he can explain how he takes his before sexy times. I knew my guy was the one. Like after two years of nursing my wounds and broken body and shattered heart, I knew this man was mine for the taking, all I had to do was ask. I hope this helps some honey. Hugs Aces xo 

[Acesheart]

6 hours ago, Joperty said:

But they do help protect women?? 

I'm assuming women do she'd the virus from their vaginas too?

I always thought it was harder to pass this virus onto men than it is women but how can that be the case if condoms don't even do anything! 

I really didn't wanna be taking antivirals for the rest of my life because of this  

Urgh this fucking sucks all over again  everything I thought I knew I am doubting! 

It helps against other sexual transmitted diseases, but NOT fully for herpes simplex virus. The virus is passed from skin to skin, frictions weaken the membranes and can allow the virus to enter if the person is in active outbreak or possible shedding. The antivirals reduce shedding, lessen the chances of transmission, and lessen the frequency of outbreaks. It did all that for me without condom usage. 

It is harder for females to pass the virus, but add antivirals to this and condom use and your chances are really low. I'm sorry it's NOT a 100% guarantee but in my years of dealing with life and marriage, nothing in life is a guarantee. If he knows what you have and what you do to protect him, let the decisions be his too. Truly, Aces xo 

[november13]

What the study shows is that there is evidence that condom use lowers the risk of transmission for women, but there is not evidence of the same for men. This is not necessarily proof that condoms are not effective for protecting men. That is an important distinction to remember when looking at statistics. We have evidence to reject the null hypothesis (that condoms are not effective in reducing transmission) for women but not for men. 

And this may be the case because so few men acquired HSV2 in the study. Only 5/261 men in the study acquired HSV2 at all, whereas 26/267 women acquired HSV2. The authors note: "Because few incident cases were in men, the analyses of risk factors are weighted toward women, and the estimates are less reliable for men." Because your boyfriend is a male (I know, duh), the risk is already pretty low. 

The researchers also note that men take more risks during sex, so this may have affected the results: "Men may be more likely to limit condom use to situations with higher risk of acquisition, such as lesions in the source partner. This practice may obscure any benefit of condoms." Also, keep in mind that these are participants who are self reporting their condom usage, so there should be some concern there too. 

Here is the full article if you are interested: http://jama.jamanetwork.com/article.aspx?articleid=193953#COMMENT

There is no way to 100% protect your boyfriend. You can only do your best. Talk to him about what he wants to do to protect himself. If he isn't worried, try not to worry for him. He's an adult who can make his own decisions about his health. If he thinks you are 'worth the risk', just try to be happy and enjoy it!

Edited December 15, 2015 by november13

[Joperty]

Thanks November,  I found this on bad day and stressed myself out before even really thinking it over. I spose it's a bit of a relief that so few men get herpes anyway! I just feel almost less in control now thou,  never felt especially in control in the first place. I get that it's his choice etc but I can't help feeling like it's just too bigger risk and it would suck more than he realises if he caught it. He's always stressed about other stuff, adding to that  might break him or summet

[solidsnake007]

Synthetic condoms are the way to go I believe.

 

[Cantbetrue]

I have a good friend who has been married 21 yrs to a woman with ghs2. He uses condoms every time they have sex (his choice) and he is H- to this day. He gets tested yearly. She just started anti viral so this was mostly just with condom use keeping him H-.

[HerpedUpOne]

Depending on activity and care involved with handling the barrier once done, the barrier can help, but not fully.  A risk is still there. 

But HSV will travel through saliva and sweat, rendering the condom entirely worthless for preventing transmission of HSV. 

Let's say the guy is wearing a condom and you want to do oral.  Okay, oral is done.  Keep in mind the one performing oral has HSV1.  Now remove the condom with the hand since I can't think of anything else to use, and if HSV is present it is clinging in the liquid you now have on your hand.  Now you decided to use your hand on where the mouth had just been.  Guess what went from condom to hand to genitals?  Yup, the HSV virus, since it can live in saliva and sweat.  The hand makes an adequate transit mechanism IF the virus survives long enough to find a place to survive in -- and these days the genitals are compatible:  Cold sore HSV (type 1) has mutated over the years and decades to survive on the genitals.  gHSV or gHSV1.  And what I described can all happen subconsciously, even if one knows the technical processes involved.  The risk is slight, but absolutely present.  And the activity needn't be oral.  Anywhere where Willie and H'andy go, the risk is still there.  It's admittedly depressing... 

Ditto for the gal wearing a dental dam, the usual fluids, procedures, and risks involved still apply.

Also note, HSV2 (not as common as HSV1) has also mutated over the years where it, though less likely, can live on the mouth as well.  HSV1 is still the more prevalent version, and the one that surprised more when it finally managed to build a club med on one's junk to prosper in.

Technically, the risk of spreading when no outbreak exists is extremely low.  Something like 2 to 4%.  That didn't stop me from getting it, though had I been told about Herpes beforehand and risks involved I might have acquiesced.  2 to 4% is indeed very low.  But people who have it also can assume "2 to 4%" means 0%, which is often why people don't mention it (along with many other and mostly understandable reasons).  But the risk is still there.

[Joperty]

Just a little update. My boyfriend decided he didn't want to continue using condoms a few months after I made my original post, I usually take antivirals around the time I'm spending time with him and so far it's all good, as far as we know he hasn't caught it. 

[Luvnlife]

I got herpes the first time I slept with my giver and he used a condom, which means his sore was above where the condom ended and his sore came in contact with me. He also didn't disclose to me either. 

[Blahdittilyblah]

I got it somewhere between the 1-3 time of sex with my partner as a male writhin a weeks time. So it really to me is a 50/50 shot because according to research and statistics I had a 4% chance yearly and it essentially happened right away.  Just be cautious if he's ok with it that's his choice don't deny someone the ability to love you because of something you fear. 

[Joperty]

I think that when it happens right away it must be because it's a recent infection in the giver. I found out my ex was sleeping with other people while we were getting to know each other (after the herpes obviously) and I then caught it also within the first three times we slept together. He didn't have symptoms. 

It took me a long time in my current relationship to feel comfortable being intimate in any way with my partner. And longer before I could have sex. And it look pretty much a full year before I actually relaxed enough to enjoy sex knowing I'm putting someone at risk. He knows everything and has from the start. Potentially Putting someone else in my position is terrifying but he loves me. He thinks I'm worth the risk and living life in fear is not how to have a happy life. It took years before I was able to stop letting herpes control me. Like aces I've now found someone who loves me for me and am able to not stress every single day.

[Lisajd]

Hsv2 is the boxer short area.  You can catch it from shedding on the thigh if a person has it there.  

[moosehorn]

Do you shed everywhere, or only where the outbreak occurred?

[wildman]

There are no "gold standard" studies on the effectiveness of condoms. This is because it is considered unethical to have a control group not using condoms. People cite the 50% risk reduction stat becasue it is a round number - it includes people not using condoms every time, and using them incorrectly (not the entire time), etc. The studies are based on self-reported data to research questionnaires (people are known to exaggerate past condom use becasue they think it is the "correct" thing to say to the researcher). The 50% risk reduction "estimate" is likely to be incorrect - understating the effectiveness of condoms.

The best meta-study on condoms was a case-crossover analysis done by some of the foremost researchers in 2012: Case-crossover analysis of condom use and HSV-2 acquisition,  Jeffrey D. Stanaway, MPH1, Anna Wald, MD, MPH1,2,3,4, Emily T. Martin, MPH, PhD6, Sami L. Gottlieb, MD, MSPH7, and Amalia S. Magaret, PhD2,5   

https://www.fredhutch.org/en/news/spotlight/imports/case-crossover-analysis-of-condom-use-and-hsv-2-acquisition.html

And https://www.ncbi.nlm.nih.gov/pubmed/22504606

This study corrects for the lack of a control group by measuring risk of acquisition per individual per protected or not-protected sex act over time (the individual is their own control group).

The results of this study showed that condom use is consistent with VERY HIGH levels of protection against HSV transmission, with the results indicating that a protected sex act had "no significant increase in risk [of HSV acquisition for individuals in the study] when condoms were always used."

"We found a 3.6% increase in the odds of HSV-2 acquisition with each unprotected act
(OR=1.036; 95% CI: 1.021, 1.052). No significant increase in the odds of acquisition was
detected for protected acts (OR=1.008; 95% CI: 0.987, 1.030). Thus, the estimated odds of
acquiring HSV-2 were significantly lower with a protected act than with an unprotected act(Wald test P=0.029) (Table 3a). Similarly, the model based on the categorized condom use estimated a 3.6% increase in the odds of HSV-2 acquisition with every act when condoms were never used (OR=1.036; 95% CI: 1.021, 1.052), a 2.7% increase in the odds of acquisition with each act when condoms were sometimes used (OR=1.027; 95% CI: 1.010, 1.044), and no significant increase in risk when condoms were always used (OR=0.989; 95% CI: 0.957, 1.023) (Table 3b). Neither HSV-1 status, nor the number of partners, nor the number of new partners were explanatory or altered other associations in multivariate analyses."

"The case-crossover design is a strength of our study. Relative to the full cohort analysis, the case-crossover design yielded larger odds ratios for the effect of unprotected acts on
acquisition risk (3.6% versus 1.3% increase per unprotected act). In either analytical
approach, the confidence interval surrounding the OR for the risk of acquisition with
protected acts included 1.0, ; as an OR of 1.0 corresponds to 100% efficacy, these findings
are consistent with but do not demonstrate complete protection. Other strengths of our study include the use of laboratory confirmation of acquisitions, prospective data collection, and the large number of acquisitions observed."

It would likely be more accurate to say that condoms, when used properly and consistently, reduce risk of transmission by 80% to 90% (and some study results have been consistent with complete protection).

This study corrects some of the flaws in earlier research and shows that condoms are more effective at reducing risk than the standard advice of "50%" . . .

 

[wildman]

I believe Anna Wald, MD was an author on both studies - presumably she believes in the 2012 study I linked more than the old 2001 study that was the initial topic of this conversation . . . I would view the 2001 study as outdated . . .

[WilsoInAus]

@wildman awesome post!

The simple message is... condoms work. Perfectly, no but as Dirty Harry says " it sure beats whatever is in second place."

There is also a similar comment to be made with antivirals. Consistent use of appropriate dosage also probably enhances reduced chances of transmission beyond 50%.

In fact, there are numerous studies that have involved appropriate condom usage and antivirals and they ended up with zero transmissions after thousands of sexual episodes.

[wildman]

Yes, the Valtrex study showed 50% risk reduction, but it also included real-world factors such as missed doses and imperfect compliance with other study directives. The 50% risk reduction should be regarded as the minimum risk reduction that the original study parameters allowed them to claim as statistically significant, to secure FDA approval. Most experts believe ideal compliance with Valtrex is more effective than 50% at reducing transmission (perhaps 75% effective). It is true that many studies using condoms and Valtrex together have resulted in zero transmissions (which would be expected if the risk reduction for Valtrex was 50-75% and condoms were 80-90% effective - but such a result would be highly unlikely if each level of protection offered only 50% risk reduction).

Personally, I think it is important not to overstate the risk, but many "official" guidelines still use the 50% numbers - mainly because 50% is a round number and people don't want to change the guidelines every time new studies come out, and since the "exact number" is not conclusively known.

To me, saying 50% for condoms is very misleading though, becasue someone might think "well what's the point then" . . . but if condoms are widely known to be 90% effective against HSV, people would probably be more conscientious about using them correctly every time . . .

[moialbalushi]

On Sunday, December 13, 2015 at 5:23 AM, Acesheart said:

I took them everyday for 25yrs sexy times and no sexy times, but some I've heard take them when they know they will be sexually active about two days before. User JBnAtl, he can explain how he takes his before sexy times. I knew my guy was the one. Like after two years of nursing my wounds and broken body and shattered heart, I knew this man was mine for the taking, all I had to do was ask. I hope this helps some honey. Hugs Aces xo 

Im sorry if this is private. But with your husband. Did u have sex without a condom for few times ? 

[Alicia123]

@Acesheart why is it harder for women to pass on the herpes virus to men?

[Morpheo]

On 2/15/2019 at 6:51 PM, Alicia123 said:

@Acesheart why is it harder for women to pass on the herpes virus to men?

the amount of mucosa men have vs the amount of mucosa women have...they have more mucose, therefore, more risk..

[IloveCoco]

On 12/12/2015 at 3:17 PM, Acesheart said:

Hey Joperty, they actually don't cover the entire area just the  staff of the penis and when frictions from sexy times are happening , the flat skin area can become irritated by the females outter vagina area and cause frictions which if you have a sore spot, can rub it raw and expose the partner to your genitals virus. If your taking antivirals during the sexy times, they reduce the chance of transmission. Hugs Aces xo 

My husband is still negative for herpes  !

Do you take antivirals everyday? What HSV you have?