HSV 2 or herpes simplex virus 2 is a viral infection. HSV can come in 2 forms: HSV-1 and HSV-2. The World Health Organisation estimates that 3.7 billion people under 50 have HSV-1 globally, while 491 million people aged 15-49 have HSV-2.
HSV-2 usually results in genital herpes but can also present with cold sores. HSV-2 is exclusively contracted during sex and is a sexually transmitted disease, while HSV-1 is not considered a sexually transmitted disease and is acquired through oral-to-oral contact.
Order safe and effective treatment for genital herpesView all treatments
After contracting HSV-2, individuals might not experience any symptoms initially. During an outbreak, individuals can expect to find small, painful blisters around the genitals, rectum, cervix, thighs, and or buttocks. These blisters can burst, leaving open sores, but they will not leave scars. Individuals could also experience pain during urination and flu-like symptoms. Some women might even notice unusual vaginal discharge.
These symptoms usually last three weeks, and the sore should scab and heal on its own. However, these outbreaks do not occur in isolation. After experiencing one outbreak, individuals can expect more outbreaks in the future.
The outbreaks tend to be less severe and unpleasant over time.
When you have your first HSV-2 outbreak, you should take a break from sex. However, having HSV-2 does not limit or end your romantic and sexual life. The initial primary outbreak usually occurs after two to three weeks of infection. However, this might not always be the case, and some people might not have their first outbreak for weeks, months, or even years after their initial exposure.
In your initial outbreak, you may notice the HSV-2 symptoms outlined above along with flu-like symptoms like fatigue and muscle aches. You will also see the classic herpes infection of cold sores around the genitals, buttocks, thighs, and legs. There might be some cold sores on your lips, but this is not that common.
It is imperative not to have sex during a herpes outbreak. This is because the virus is the most contagious at this stage and can be spread very easily. Usually, the first outbreak is the worst and most unpleasant, so you will probably not feel like you are in a sexual mood.
Antiviral medications are the most effective medications used for HSV. These antivirals include acyclovir, famciclovir, and valacyclovir, which reduce the frequency and severity of the outbreak symptoms. Sadly, HSV is a lifelong infection. There is currently no cure for it, just a treatment regimen to suppress the virus's symptoms.
Once the outbreak has cleared and you have no more cold sores, you can go back to planning your sexual rendezvous.
Transmission can occur from female-to-male or from male-to-female. As long as one sexual partner has an active HSV-2 infection and is partaking in unprotected sex, there is a high chance of transmitting it. The cold sores contain high amounts of the virus and hence increases the chances of spread significantly.
Using condoms is very important. It is the only form of contraception that can offer protection from sexually transmitted diseases. Condoms do not entirely remove the risk of transmission, but it does make a significant difference. A study showed that using a condom reduces the risk of transmission of HSV-2 from female to male by 65% and male to female by 96%.
Antiviral medications also stop the spread of the herpes infection within the body. This, in turn, reduces the risk of viral shedding. A study conducted concluded that taking valacyclovir antiviral therapy makes a person 48% less likely to transmit the infection to their partner.
Telling your partner
Herpes simplex 2 is a lifelong infection that can result in multiple outbreaks throughout your lifetime. Even though the chances of spreading HSV-2 is extremely high during an active outbreak, there is still a transmission risk without an active infection. It is important to tell your sexual partner about your HSV-2 as they are also at risk of contracting the virus. It can be a difficult conversation, but it does not have to be a negative experience. Make sure you have the conversation when you feel comfortable and take it at your own pace.
- Magaret AS, Mujugira A, Hughes JP, Lingappa J, Bukusi EA, DeBruyn G, et al. Effect of Condom Use on Per-act HSV-2 Transmission Risk in HIV-1, HSV-2-discordant Couples. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. [Online] 2016;62(4): 456–461. Available from: doi:10.1093/cid/civ908 [Accessed: 30th October 2020]
- Bonnar PE. Suppressive valacyclovir therapy to reduce genital herpes transmission: Good public health policy? McGill Journal of Medicine?: MJM. [Online] 2009;12(1): 39–46. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687913/ [Accessed: 30th October 2020]
- Schiffer JT, Mayer BT, Fong Y, Swan DA, Wald A. Herpes simplex virus-2 transmission probability estimates based on quantity of viral shedding. Journal of the Royal Society Interface. [Online] 2014;11(95). Available from: doi:10.1098/rsif.2014.0160