Shredding vs. Transmission

[Roja]

Hey everyone, 

I am just checking out this very interesting pdf: https://herpesopportunity.com/downloads/herpes-opportunity-disclosure-handout.pdf and I am wondering if someone might help me with the difference between shredding and transmission (I am not an english native speaker). 

If I (female, HSV2) have sex with a man without protection but without OB, the risk of transmission is 4%.

The risk of shredding (= transmitting it without OB) for HSV-2 genital is 15-30%. 

What is the difference? 

Thanks everyone!

 

 

[Dutchy]

Hi!

You can also transmit the virus through shedding. IT means you have virus in your vaginal fluids. But IT takes a sertain rate of shedding for Transmission. Nobody knows when we shed and how much. So really there is always a Risk. By taking Anti virals you lower the Risk..

 

 

[Roja]

Thanks Dutchy. 

So I don't really understand the numbers. How high is the risk of giving the virus (2) to a men while having sex then? 4 % or 15 % - 30 %?

[Dutchy]

Hi! I think without shedding and ob 4% and with shedding 15-30%

But nummers do not mean that much. Because you never know. 

For me... With An ob its a no go.

With no ob...the risk is always the same. I never gave It to my partner. But hé needs to be willing to take the risk. 

What is your situation. Are you scared of sexual contact? Of in a relationship?

[Roja]

Hi Dutchy, 

thanks for your reply again. 

I am in a stable, good relationship. I just wanted to know the exact risk to deal with it better. I always have the feeling of being "dangerous" to my bf, even though without an OB (I also NEVER have any sexual contact with an OB). I know that there is always the risk of giving it to others, however knowing it is somewhere around x % helps me to relax a little bit more. 

[Dutchy]

Yess i do Understand! IT freaks me out sometimes too not knowing when we are at Risk..but i do know now that there are things we do without Transmission. That relaxes me a bit. I do believe the risks are not that high as we feel Them to be..

 

[Roja]

@WilsoInAus Could you maybe help me with the difference please? I see that you have a lot of knowledge about it.

What is the "overall" risk - 4 %? Even tough we are shedding like 20 % of the time?

[Roja]

2 hours ago, Dutchy said:

Yess i do Understand! IT freaks me out sometimes too not knowing when we are at Risk..but i do know now that there are things we do without Transmission. That relaxes me a bit. I do believe the risks are not that high as we feel Them to be..

 

Thanks! :-)

[WilsoInAus]

2 hours ago, Roja said:

@WilsoInAus Could you maybe help me with the difference please? I see that you have a lot of knowledge about it.

What is the "overall" risk - 4 %? Even tough we are shedding like 20 % of the time?

I'll have a go at making things perhaps clearer from my perspective.

What we know by observation and clinical trials is that couples where the male is negative and female positive for genital HSV-2, there is a 4% chance in a year a sex that transmission to the male will occur. This involves unprotected sex without condoms or antivirals. In the end that is all that matters. The measurement of shedding and its explanation might be useful, but it does not change these odds which are the observed outcomes allowing for all factors. The definition and understanding of shedding is evolving, but it simply doesn't matter in the context of transmission chances.

My understanding of what we now know about shedding may be summarised as follows:

• The virus appears quite suddenly on the skin's surface during a shedding episode. Some liken it to a field of flowers blooming when the sun hits. Some liken it to a lava flow from the nerve endings. It does not last long and is gone inside 2-6 hours and probably deactivated considerably quicker.
• It takes a lot of virus for a chance of infection. For example some models suggest that at least 1 million copies of the virus need to be present for even a low probability of infection. At 10 million viral copies, it seems infection is closing in on near certain.
• Most shedding episodes are well below 1 million copies. Shedding episodes with more than 10 million copies of the virus appear to occur in about 2% of shedding episodes.

So in summary, for a shedding related transmission to occur and only a chance for it to occur, the following conditions are required::

• There must be 1-10 million viral copies as part of the shedding episode; and
• Sex must occur in a small window of time within the shedding period, probably within 1-3 hours of the shedding 'bloom' with strong rubbing from that particular point of viral eruption.

[Roja]

12 hours ago, WilsoInAus said:

I'll have a go at making things perhaps clearer from my perspective.

What we know by observation and clinical trials is that couples where the male is negative and female positive for genital HSV-2, there is a 4% chance in a year a sex that transmission to the male will occur. This involves unprotected sex without condoms or antivirals. In the end that is all that matters. The measurement of shedding and its explanation might be useful, but it does not change these odds which are the observed outcomes allowing for all factors. The definition and understanding of shedding is evolving, but it simply doesn't matter in the context of transmission chances.

My understanding of what we now know about shedding may be summarised as follows:

• The virus appears quite suddenly on the skin's surface during a shedding episode. Some liken it to a field of flowers blooming when the sun hits. Some liken it to a lava flow from the nerve endings. It does not last long and is gone inside 2-6 hours and probably deactivated considerably quicker.
• It takes a lot of virus for a chance of infection. For example some models suggest that at least 1 million copies of the virus need to be present for even a low probability of infection. At 10 million viral copies, it seems infection is closing in on near certain.
• Most shedding episodes are well below 1 million copies. Shedding episodes with more than 10 million copies of the virus appear to occur in about 2% of shedding episodes.

So in summary, for a shedding related transmission to occur and only a chance for it to occur, the following conditions are required::

• There must be 1-10 million viral copies as part of the shedding episode; and
• Sex must occur in a small window of time within the shedding period, probably within 1-3 hours of the shedding 'bloom' with strong rubbing from that particular point of viral eruption.

Thank you so much Wilson!! I knew you could help, hehe 

It seems quite hard to infect someone else then... However, I do not get the high number of new infections per year then. 

[Scooby2112]

Many people that pass it do so because they don't know they have it.  Not that people who have don't transmit but are more likely to take precautions (anti-virals, condoms) and avoid sex during symptoms. 

 

 

[Roja]

6 hours ago, Scooby2112 said:

Many people that pass it do so because they don't know they have it.  Not that people who have don't transmit but are more likely to take precautions (anti-virals, condoms) and avoid sex during symptoms. 

 

 

That's a good point, thanks!

[22Newbie]

Reading those stats makes me feel that much worse about the fact that I got it...like there was that little of a chance and I had to get it? Great. Lol. (GHSV1 from oral)

Edited November 7, 2018 by 22Newbie

[Scooby2112]

There really isn't a study that I am aware of regarding oral to genitally transmission rates.  

Although oral shedding is high so it may be close to the same type of transmission.  

[Roja]

20 hours ago, 22Newbie said:

Reading those stats makes me feel that much worse about the fact that I got it...like there was that little of a chance and I had to get it? Great. Lol. (GHSV1 from oral)

I recently read that about 50% of all new genital herpes infections are from HSV-1. Yes, the chance of transmission is not very high, but as Scooby said: Probably a lot of people have intercourse with an outbreak (or recently after it) because they are not aware of the risk.  Also a lot of doctors still tell the lie that herpes is only dangerous if you have blisters with the "liquid" in it (one doctor told me once!).

[a1mbt]

I found similar figures, however i have seen as high as 30% risk. they say shedding is about 31-50% active in the first year and reduces to 5-20% after. However i dont know if this means throughtout the year or around outbreak timescales which are typically 7-14 days

ive done a bit of looking up this morning and i found a couple interesting stats. Seems results are all over the place for transmitting whilst shedding. but ultimately based on 'testing positive' for herpes. My understanding is that 'testing positive' rtefers to both shedding and having an outbreak because both mean the virus is active and transmittable regardless of whether you use protection - however protection with further reduce this to a degree as we all know.

The result: Swabs were 95% less likely to test positive for HSV-2 when a person was taking acyclovir. But even during treatment, people tested positive 3% of the time.

This was based off of 400mg only once per week which i find very inrteresting

links:

https://academic.oup.com/jid/article/190/8/1374/878164

https://www.webmd.com/genital-herpes/news/20120112/herpes-drugs-dont-stop-herpes-spread#1

Ive had herpes for 20 years now and lived a very safe, active and happy life (apart from the first year or so which sucked but). I still cant figure out the safest way to try for children though given the risks of transmitting during shedding, even from pubic area friction (unprotected parts), 3-4% is still 3-4% and if you are having to have regular sex to conceive?? even if your partner accepts the risk, they can still give this to the child during birth and breast feeding. I feel there is a safer solution somewhere out there. There must be a way to understand shedding more clearly.

On another note i will point out another treatment not written alot about but was in a formula around years ago called dymaniclear. Copper sulphate alone (purchased very cheaply online but be careful! in pure form is quite strong!) when diluted and applied to sores (they must be burst and completely cleaned of fluid) will instantly heal the sores into scab and did show reduced frequency of outbreaks. It was dtermined that is also killed the virus from the surface. I used this if i have a severe outbreak, it does sting ALOT, imagine putting vinegar on a wound, but will instantly turn the outbreak into a scab and heal. You can also apply over the surface without bursting the sores and it helps with itching and reducing the sores faster. Again not alot of research, it is a bit painful (doesnt bother me) but my point is if it kills the virus from the surface it may help reduce transmitting the virus? Then again you would have to have physical symptoms to know where to apply, so doesnt really help with shedding i guess. Thought is was worth mentioning however as many people get very depressed with the constant outbreak and blisters. Link below

https://www.ncbi.nlm.nih.gov/pubmed/22270204

Edited November 8, 2018 by a1mbt

[Roja]

 

Hi a1mbt, 

as far as I know it is NOT possible to transmit the virus to a baby through breastfeeding (at least if you don't have an OB on your breast). It is not transmitted trough liquid!

If you are planning to get your wife pregnant, it is recommendable to use medication during that time. When she is pregnant already, it is safe to use condoms. 

However, as a woman who wants to have a healthy baby soon, I read a lot of studies and transmitting herpes to a baby during birth is dangerous, but very, very rare. If women are aware of the virus and talk to their doctors, usually it is not a problem at all, because they know their body and are aware of outbreaks. Some women like to take medication during the last weeks, in order to have a normal birth. 

Look, even if there is some risk left: Everything in life is risky. Think about driving, going out, sports... Whenever you take your partner with you in your car there is a risk both or one of you might be killed. Of course we need to be careful and try to keep the risk as low as possible, but I don't think we should actually go crazy about it.