There are two types of herpes simplex virus: HSV-1 and HSV-2. Herpes which occurs around the mouth and on the lips is usually, but not always, caused by HSV-1. Around 70-80% of the population carry HSV-1 inside their bodies, but only about one third of carriers will ever experience an oral herpes outbreak.
HSV-2, on the other hand, is most often associated with genital herpes. However, in recent years, there has been an increase in genital herpes caused by HSV-1, which can spread through oral sex. The scientific consensus holds that around 15% of U.S. adults have genital herpes, but within these 15%, only about 10-20% of carriers will experience a genital herpes outbreak (painful, itchy bumps or blisters on or around the genitalia). In fact, most people with genital herpes aren’t even aware that they have it.
Whether an HSV carrier experiences a herpes outbreak in large part depends on the immune system. The stronger it is, the less the likelihood of experiencing an outbreak. Conversely, sickness or certain drugs or chemotherapy agents, can weaken the immune system and give the herpes virus the opportunity to replicate.
Whether you contract herpes at all, depends on your sex life and choice of partner(s).To avoid contracting the virus, it is recommended that you avoid sexual intercourse or oral sex with people who have more than seven visible outbreaks per year. Individuals with frequent outbreaks may also have “quiet” outbreaks with either mild symptoms or no symptoms. They can remain contagious during quiet outbreaks but would not necessarily be aware. Studies show that by having sex with a partner who has frequent outbreaks the risk of contracting the virus is approximately 30%. If you have sex with a partner who is having a visible outbreak, the rate of trasmission is far higher than 30%. Lastly, having sex with a partner who carries HSV but does not experience outbreaks still leads to a 10% transmisssion rate.
Valacyclovir (also known by the trade name Valtrex) is an oft-prescribed treatment for both oral and genital herpes. It can also treats chickenpox, which is another herpes virus strain. Valacyclovir, when prescribed to prevent herpes outbreaks or lower their frequency, also reduces the rate of transmission.
Research has found that using valacyclovir will reduce the risk of transmission by about 50%. If in addition, you use condoms, the risk of contagion drops by another 50%. So, the total risk reduction is about 75% of whatever the initial risk was. It’s not 100% safe, but a significant odds improvement. Studies have found that daily valacyclovir therapy for the duration of one year did not cause any significant adverse health effects. If you suffer from recurring genital herpes outbreaks, talk to your doctor about whether valacyclovir may be right for you.
If you aren’t a herpes carrier yourself but your partner is, to be safer yet, just avoid having sex when your partner has an active outbreak, even if he does take valacyclovir. The same goes for oral sex. If your partner has cold sores (which are an oral herpes outbreak), don’t let him or her give you oral sex, and avoid skin-to-skin contact with the affected area on his or her mouth.
If you know that you have genital herpes (you either had an outbreak in the past or were positively tested for it), you need to take extra care in order to prevent the virus spreading to your partner(s). Be frank and tell your partner, practice safer sex, and avoid sex completely when you notice signs of an outbreak, however mild.