I was thinking about Nonoxynol 9 while writing the post, actually, but I’d thought its only approved use was as a spermicide. (More likely than not I’m wrong; I’m working in AIDS-related research but have only been in it a couple years.) Like you said, it’s not recommended for use any longer either. I was also trying to think about various antibacterial preparations that I know of but many of them are irritating or drying, it seems.
Actually, there are hard numbers on transmission per exposure, especially for HIV. Generally, these numbers aren’t publicized because they aren’t well understood by the public and, therefore hinder public health missions. I don’t know the numbers for HSV or HPV, but HIV is somewhere in the neighborhood of once every 1000 sex acts in a stable couple. Of course, many things can skew this number and those factors (and the resulting rates) are also known.
Somebody asked about oral sex spreading Herpes Type 2 (genital herpes) to the mouth/throat and/or Type 1 (oral herpes) to the genitals. You can get cross-infection and have an outbreak, but the outbreaks don’t usually recur. HSV I prefers to live around the lips and HSV II likes the genital area. So in seroprevalence studies, sometimes the strains are found in the opposite locations, but not as often and they don’t seem to stay there long. That’s probably way too simplified an explanation, but I think that’s the general idea.
Oh, and this hasn’t been relevant so far, but since we’re also talking about risks associated with Human Papilloma Virus (HPV), this virus doesn’t only cause cervical cancer in women, although that’s the most common one. Men CAN get penile cancer from it (not common, I don’t think) and women or men who have sex with men and engage in receptive anal sex can get rectal or anal cancer from HPV. Especially those with HIV/AIDS are more likely to have HPV progressing to cancer. Nobody knows why it does in certain healthy people, but it’s why women are advised to get pap smears every year or two.
For anyone who is tempted to write HSV off as a non-issue, let me point out that while there are many people who are asymptomatic, there are others for whom an outbreak is a frequently occurring event.
There are many triggers that can cause an outbreak, including eating foods that are high in argonine and low in lysine (such as peanuts.) Some women experience outbreaks with every menstrual period. You can get one if you get too tired or too drunk and your immune system is supressed as a result. You can get one if you get a cold (cold sores, anyone?) or anything else that affects your immune system.
Lesions are painful, yes, but even if you have NO sores or lesions, you may still experience unexplained flu-like symptoms such as fever, aching and fatigue (mimics mononucleosis, apparently. Some doctors will test for mono and never think to test for herpes if there are no lesions.) Areas of your skin may become painful to touch, as if you have sunburn, with no outward sign of a problem. With genital herpes, the sensitive patches can be anywhere from your waist to your knees.
If you experience more than one or two outbreaks a year, your doctor may very well prescribe 1 GRAM tablet of Valtrex daily (or two 500mg twice daily).
Standup Karmic, I applaud your friend for being honest with you. I wish everyone was as honest. I also applaud your caution in doing the research before making a decision.
Yeah, I’ve seen all those studies. I even gave some of that info. to Cecil for a Straight Dope article he wrote about this some time ago (check in the archives… my computer is too slow to pull it up right now). But the FACT is that what is most important re. HIV is: What are the Chances that your Sex Partner is Infected with HIV to begin With? The pool from which you draw your partners, and how many partners you have is more important than what kind of sex you have. And if you Know your partner IS infected and you use condoms every time you have intercourse, the studies show a far lower rate of spread of infection to the steady partner. I always am a little dubious about applying mathematical formulas to human behavior. And, although there are a lot of theories (viral load, other diseases present, number of exposures, type of sex act, etc.), we really don’t know why someone gets HIV from a sexual act with an infected person and someone else doesn’t. Gonorrhea is VERY infectious and you are very likely to get it if you have sex with somebody who has it. Even if you have sex with them one time. HIV is much harder to catch, but treating risk of disease as a Game of Chance like this isn’t that helpful, I don’t think. Get yourself and your partner tested. Limit the number of partners you have sex with. Use condoms or have non-penetrative sex. This makes more sense than treating it all like Russian Roulette, I think.
The Straight Dope article: What are the Odds of Getting HIV during Heterosexual Sex?
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I can accept that. Thank you for the apology.
Those hard numbers are important to me. Of course, I’m well aware that applying predictive statistics on a case-by-case basis is stupid. What are the chances that I caught “X” by having sex last night. Well, I suppose it’s either 100% or 0%, depending on if you caught it. Of course, I’m not concerned about whether I’m at risk tomorrow night, the first week in December, or any given Thursday. However, given the statistics that I was able to find, it seems that over the course of a year, with frequent enough contact, statistically speaking I am quite likely to become infected. It is that fact that is very important to me and guided me in my decision that we should remain abstinent if we’re going to remain together (the other option I gave her was that, if abstinence was not an acceptable solution for her, we would need to go our separate ways).
One of the reasons that she was angry with me for a time was that she now felt “dirty”; like she was some kind of untouchable. Of course, I assured her that she means no less to me than before I knew, and probably even means more given that she was honest and brave enough to share the info with me. It still doesn’t sit well with her, and I guess we’ll see how we deal with that. Over the course of an hour or two, she came to accept that I wasn’t saying “ew, why would I even think of being with someone dirty”, but only, “because I must protect myself first, until I have - we both have - a better idea of where this relationship is going, I’d rather we be cautious.”
What shook her most is that this is not 100% her problem. She figured that so long as she didn’t have sexual contact during breakouts, anyone else was completely safe. Since there’s no way to tell if a person is shedding viruses, it should I guess be assumed that during any six to twelve days during any given year, her partner will be at risk of contracting HSV. That scared her.
I think we’ve got a road ahead of us, but I don’t see it as a very hard nor a very steep path to follow. She has some of her own stuff to work on with respect to accepting it, and we have our own burdens between us, as I suppose should could become bitter and/or feel maligned about my not wanting to have genital contact with her right now.
Like I told her last night, I hope we end up going down the path that I’d like to see us on - a committed, long-term, monogamous couple eventually married with family - but until we both know better where our respective heads are at, I prefer to err on the side of caution. Then again, I’m going to continue my research. I’ll get tested for the virus to see if the whole thing is a non-issue. I want to find out if there’s been any studies determining the …uhh…I don’t know the right word here…catch-ability of HSV during viral shedding as opposed to during outbreak periods. The 75% number I’d mentioned did not make a distinction between the two, so I have no idea if its the right number. If shedding is only 2 to 4% of the days in any given year, and the catch-ability of it because of viral shedding (as opposed to outbreak) is only 10%, well those are numbers I’m far less worried about. Yes, I know I can still get it the very first time, but that’s not and never has been the point. The degree of liklihood of catching it is the point (for me).
But it appears I’m now rambling with little forethought and little added value. Good God, let’s hope she doesn’t catch this from me. It’s been plaguing me my whole life.
Again, anti-viral medication significantly reduces asymptomatic shedding of HSV.
Sorry, I should have said earlier, she’s very much an anti-pill person.
I’m not surprised that she feels ‘dirty’ what with the paranoia that’s about, up to and including this board. Cold’s are virus’s that you pass on just as easily and make you feel just as bad, but you’re not taking anti virals for that? If I avoided people every time I had a cold, I would never see anyone.
Ok, one of my friends had HSP 1 so badly that he had lesions all down arms (now all sorted as far as I know), but you can also die from catching cold and (particularly) flu.
As far as I understand it, here in the UK, the NHS is mostly spending money on educating people about herpes and showing people what a small thing it is and spending the vast majority trying to slow down the spread of syphilis, which is also on the increase.
Standup
Not to beat a dead horse here, but again: unless you have decided to be completely abstinate for the foreseeable future - forego sex all together with anybody until they are blood-tested for subtypes of Herpes Simplex virus, you are not decreasing your risks for contracting Herpes. Many of the recent sources I’ve seen say that 25% of adults are infected with genital Herpes. 90% of them are unaware of their infection. Of the ones who DO know they have it, less than 18% of these potential partners will tell you. So avoiding sex with only people who know they have the infection AND tell you is not going to protect you much, if at all. That’s why I say the emotional risks - heartbreak, losing a potentially important person in your life - are the bigger risks here than herpes. I am NOT saying you should not do everything you can to protect yourself. I’m just saying.
Again, not to say it’s trivial to worry about getting herpes, but the scary pictures you have seen on websites are not representative of typical genital herpes outbreaks. A few people, especially those who do not have Subtype 1 and have recently contracted Subtype 2, have severe first outbreaks. They can be extremely painful with visible lesions, sometimes fever and other flu-like symptoms. That’s because the body has no antibodies to herpes. Once the body develops antibodies, the outbreaks generally diminish in frequency and severity to the point where they are very infrequent and often unnoticeable. A slight itching or sensitive spot with no visible lesions. That’s why so many people don’t know they have it - many don’t even have that severe primary outbreak.
Yes, the STIGMA is still there - an incurable STD that you might pass to someone else - but as another poster said, genital herpes is almost always an inconvenience more than a serious risk to your health or life. Now if you are immunocompromised - have HIV, for example - herpes can cause some real suffering. But the fact is that everyone who has had Chicken Pox as a child still carries that herpes subtype in their bodies that can flare up later in life as shingles. That can be really painful. So almost all of us are contaminated with at least one or two herpes-type viruses.
I’m just trying to give some balance to this discussion, not trying to discount your efforts to prevent the spread of herpes.
I think you are smart to recommend that she take suppressive treatment to prevent infecting you. If she is not willing to do that, well, that’s another story.
Abstinate = abstinent. Jeez.
Condoms every time you have sex will decrease the risk of transmission (transmittal?).
Not having sex when she has an outbreak decreases the risk of transmission.
A good friend of mine has been in several committed relationships since she contracted herpes years ago. She has been honest with each partner, and they jointly made the decision to be reasonably cautious and not use condoms due to personal preference. When she felt she was at risk of an outbreak (she said it was very easy to tell, because of an itchy, tingly feeling in the same spot starting a few days before any lesions showed up), they just satisfied each other in alternate ways. NONE OF HER PARTNERS have gotten herpes. In 15 years.
YMMV of course, but I’m just sayin’ … it seems quite easy to NOT get it, once you have the facts.
And as another poster said, outbreaks can be brought on by stress, poor diet, lack of sleep, hormonal imbalance (like right before her period) … so if she takes good care of herself, that helps reduce the risk as well.
JillGat-
I would like to say “Thank you” for your informative posts.
I have done some serious research on the subject of Herpes and have still learned new things from you.
You don’t need my approval…but I consider you a Stand up Lady.