Insight into genital herpes type 1?

October 22, 2009 8:49 AM

Herpes filter: Just found out that I have Type 1 Herpes, genitally. What the heck?

I went to Planned Parenthood after major pain during sex. The doctor found a small sore, and I just found out that it tested positive for Herpes Type 1 but negative for Herpes Type II. I have never had a cold sore but my boyfriend of 2 years has (although not since we've been together). My doctor says I probably got it from oral sex with him when he didn't have a sore.

I'm having a hard time understanding the gravity of the situation. On the one hand, the majority of people have Herpes Type I, and genital Type I sores are increasingly common. On the other hand, is this an end to condomless sex with my boyfriend? Obviously sex right now is a no-no, but my doctor prescribed Acyclovir to clear up this outbreak for good. After that, what are my chances of spreading it to him, even though he already has it (but not on his genitals, I guess)?

And now that I have it, is it confined to my genitals? And the single sore is so, so small. Is the initial outbreak the worst?

Throwaway e-mail: [e-mail]

posted by anonymous to health & fitness (9 comments total)

Answers to some basic questions can be found here at http://www.webmd.com/genital-herpes/guide/genital-herpes-faq.

I don't know how to make those fancy links. Good luck!
posted by 3dd at 9:24 AM on October 22

Please consult your doctor, and take a look at the American Social Health Association website on herpes, it's excellent and renowned in the world of STD for factual, up to date info:

www.ashastd.org
posted by tristeza at 9:28 AM on October 22

Check your throwaway email--I just sent you some stuff.
posted by pullayup at 9:34 AM on October 22

If your boyfriend has oral HSV-1, he already has antibodies conferring protection against that strain of virus. This makes it unlikely -- though not impossible -- that you will pass herpes to him genitally. (Similarly, it is unlikely that you will ever contract oral HSV-1, because you too now have antibodies to that strain.) Condomless sex with your boyfriend is probably not a huge risk, but it isn't risk-free, either. Whether you comfortable with it is something only the two of you can decide (after talking it over with your doctor, obviously!).

Some good news: you are correct that the first outbreak is usually the worst. Not only that, but most people with genital HSV-1 have fewer, less severe outbreaks because it isn't the virus's "preferred" area of infection.
posted by purplemonkie at 9:35 AM on October 22

What are my chances of spreading it to him, even though he already has it (but not on his genitals, I guess)?

Pretty high, over a long enough time period. You two will need to talk about this and decide what to do in the future. Together.

That was the easy part. Now comes the controversial part of my answer....

I'm having a hard time understanding the gravity of the situation... is this an end to condomless sex with my boyfriend?

Probably not, but of course he gets a vote in that too. Ask him.

Visible cold sores are a bigger stigma than genital herpes... especially if your partner already has the same genital virus too... so he might simply not care at this point, and choose to continue with no condom, understanding that he may recontract "his own" virus back again genitally sooner or later. He's resistant to it, but it could happen. Since he was the likely source of your infection in the first place, he may realize that it'll be simpler for your future together to just get it over with, like chicken pox. Once you're both resigned to being infected equally, there's no more to worry about. Your carefree life together can continue, though you may have to treat symptoms sometimes. Hey, maybe it's romantic to share your viruses? Okay, maybe not, but it doesn't have to be a relationship-shattering weight, either.

If either of you have future partners, you're bound to deal with it at that time already anyway, so that's moot now, I think.

(I realize this is poor advice from a community health standpoint, and I expect flak for that... but within the context of your relationship, it's more important that the two of you be happy, I think.)
posted by rokusan at 9:39 AM on October 22

An enormous amount of the population has a form a form of herpes. I think something like 25% of women over the age of 18 have SIMPLEX 2 worldwide. (That's genital herpes).

Simplex 1 is supposed to be pretty mild, particularly if it's on the genitals. Keep it in perspective.
posted by mdpatrick at 9:44 AM on October 22

Pretty high, over a long enough time period. You two will need to talk about this and decide what to do in the future. Together.

This may not be true if he is already infected with HSV-1, which is likely if he has had a cold sore at any point in his life. Generally, once you've got herpes, you've got herpes for life--but it's probably just hanging out in his trigeminal nerve, doing nothing.

If either of you have future partners, you're bound to deal with it at that time already anyway, so that's moot now, I think.

As others have noted, HSV-1's prevalence is somewhere between 50% and 90%. It's very, very common.
posted by pullayup at 9:52 AM on October 22

I am not a medical doctor, but I do research viruses.

Type 1 herpes being limited to oral and type 2 to genital is a myth.
Type 1 herpes has a prevalence rate of about 90% of the population. It tends to be less severe and is more often limited to the oral mucal membranes.
Type 2 has a prevalence rate of about 25%. It tends to be more severe and is more often on the genitals. But - there is a fair bit of overlap.

In terms of the gravity of the situation - not too grave. The outbreaks of type 1 tend to be mild and tend to be worst during the first outbreak. In terms of communicating it to others, well, almost all others already have type 1. As a further precaution you may wish to abstain from sex if you have a flare up.

Long term consequences are not often that severe or else uncommon. An ocular infection is a possibility or a severe infection if you become immunocompromised.
posted by dances_with_sneetches at 11:06 AM on October 22

The most awkward thing about this will probably be disclosing it to future partners. Even if you aren't having a visible outbreak, you could still be shedding the virus.
posted by sindark at 12:08 PM on October 22