Advice needed for someone in a relationship where only one person has the virus

[Josephine W]

Since my second outbreak started we haven’t had sex in 2 months. There was a period where I was in the clear for a couple weeks but we didn’t have sex. At first he claimed he was tired but upon talking about it I found out he was skeptical because when we tried to have sex a few weeks back I found a new blister immediately after. He became frustrated and now I’m afraid I’ve permanently damaged our sexual relationship. I totally understand where he is coming from, if I were him I would be skeptical/ scared about contracting it genitally too. But I just don’t know how to help the situation or what to say to him if anything. He’s not a huge talker and I can tell this subject is hard for him to talk about. 

Anyone have golden advice for navigating a relationship where only one person has the virus?

[WilsoInAus]

@Josephine WA couple of suggestions to start with:

For you: Originally, where were the sores and what did they consist of? What swab test did you have and how was it typed? Did you have a blood test as well?

For your partner.. does he get oral cold sores? Has he had a blood test for HSV?

[Josephine W]

@WilsoInAus I was diagnosed with genital HSV 1. The doctor swabbed it and told me three days later it was positive. I was with the same boyfriend at the time and they believe that i contracted it from a recent exposure during oral sex. So essentially saying I contracted it from my boyfriend. So I think that makes it harder for him because he’s never had a cold sore. He hasn’t had a blood test for it recently, my doctor said those aren’t always very reliable. 

[WilsoInAus]

That's what I guessed. Then there really are no concerns on his part about being reinfected as it were. Sex without an outbreak means that there is a zero to negligible chance he can be reinfected.

Sadly this is his issue. He needs to get over himself and man up a bit. (Sorry to say).

[Josephine W]

@WilsoInAus Yeah..so when you say sex without an outbreak means that there is zero to negligible chance he can be reinfected..what do you mean. Our assumption was that he must have oral HSV1 and I have genital HSV 1 so there is still a risk I could pass it on to him genitally? Does that make sense? 

[WilsoInAus]

No that is not a pragmatic risk. The immune response to HSV-1 is very, very effective at protecting males in particular from reinfection. There is no documented case of it happening!

[ThatGurl]

The chances of him getting on his genitals are incredibly slim.  Assuming you got it from him, he already has the antibodies to fight it and it's harder to pass to men because it needs a mucosal surface which is a limited area on the penis.

I would try to encourage him to get tested, although chances are that if he had it for a long time, he would test negative because there won't be enough active virus to detect.

He could potentially have given it to you unknowingly if he was asymptomatic and shedding the virus.

If this is putting a damper on the relationship, it would be a good time for the both of you to learn a little more about it and have him tested. Knowledge is power.

I hope you are able to resolve this with him, good luck!

[Josephine W]

@ThatGurl Thank you so much! That information is a huge help.

[Alicia123]

Guys, can someone please clarify: "the chances of him getting on his genitals are slim"? So if a woman is shedding down there (or has an OB), doesn't she pass it onto a man? 

[WilsoInAus]

4 minutes ago, Alicia123 said:

Guys, can someone please clarify: "the chances of him getting on his genitals are slim"? So if a woman is shedding down there (or has an OB), doesn't she pass it onto a man? 

Not all shedding results in infection, no. The following article is the best I know of (for HSV-2) that looks into this issue: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006256/

It shows that you need more than 10^5 copies of the virus for there to be any pragmatic chance of infection. Only about 15% of shedding episodes are estimated to involve more than 10^5 copies of the virus. At 10^6 copies, infection chances are 25% roughly, 10^7 its 75% and 10^8 or more its 100%. This is all a model and I wouldn't read more into it than answering the fundamental question that not all shedding leads to infection - and that 10^5 is a magic number at which infection chances commence their climb from negligible.

We know that for a female in the know about their HSV-2 infection, then there is about a 4% chance of infecting an uninfected male in a year. For HSV-1, this figure is <1% per annum. 

For a male already with oral HSV-1 then the chances reduce a lot, lot more. Perhaps some where between 0-0.01% per annum.