Things are going well with someone and they disclose to you that they have GHSV-1. What’s next?
Above all, keep in mind that despite the stigma around herpes, it’s not a big deal! Over half the people on the planet are carriers of HSV-1. There are literally more people on planet Earth with herpes than without it.
For GHSV-1, the risk of transmission is so low that some doctors do not even recommend disclosure. The fact that this person shared their diagnosis with you demonstrates that they care about your right to make informed decisions about your sexual health and that they are willing to be honest and open about potentially awkward issues. Those are good signs!
What is HSV-1?
HSV-1 is a strain of herpes that typically affects people orally (OHSV-1) and can produce blisters known as cold sores. Over 50% of adults in the U.S. carry the HSV-1 virus. If you’ve ever had a cold sore, you already carry the HSV-1 virus and have built up a sufficient store of antibodies to where you won’t catch it in another location. If you’ve never had a cold sore, there’s still a chance you carry HSV-1. Around 80% of folks with the virus are asymptomatic, meaning they never show symptoms.
Absent an outbreak, the only way to know if you carry HSV-1 is to ask specifically for a blood test (Western Blot or IGG). Since these tests are not part of the standard battery of STI tests, the simple truth is that most people out there have no idea whether or not they have herpes.
If you are considering dating someone with HSV-1 and have not been tested yourself, it might be worth getting tested to know your status. If you already have HSV-1, you have nothing to worry about because you cannot get it again in a different location.
What is GHSV-1?
When HSV-1 appears on the genitals, it’s called GHSV-1. It’s the exact same virus, just in a different location on the body. GHSV-1 is almost always the result of receiving oral sex from someone with OHSV-1.
Although it might seem like it would be worse to have GHSV-1 than OHSV-1, it’s actually a more benign version of the virus because it sheds much less frequently (more on that later) and because outbreaks are less frequent. Many people with GHSV-1 have only one initial outbreak or an outbreak for a couple days every few years.
Basically, HSV-1 prefers the mouth to the genitals, so when it sets up camp below the belt it’s much less active.
How is HSV-1 transmitted?
HSV-1 is transmitted only through direct skin-to-skin contact with an affected area. It cannot be transmitted through saliva, semen, or touching with parts of the body that are not affected.
So – sharing a cocktail, hot tub, bong hit, towel…none of these things are going to put you at risk of getting herpes.
HSV-1 is most likely to be transmitted during an active outbreak (when there are blisters) or during a prodrome period, which is the time right before an outbreak. People with HSV1 can often recognize the prodrome period because they will get a tingling sensation in the affected area.
In the absence of an active outbreak, HSV-1 still sheds through a process called viral shedding. Basically, the virus travels through the nerves to the edge of the skin and is able to be transmitted to others through skin-to-skin contact.
Transmission during these times is possible, but far less likely than during an active outbreak.
As mentioned above, viral shedding rates for GHSV-1 are significantly lower than those for OHSV-1. This means you are more likely to get HSV-1 from someone with oral HSV-1 than genital HSV-1.
How can I prevent getting HSV-1?
Condoms decrease risk of transmission by around 50% (some studies suggest that male-to-female risk reduction is closer to 96%).
In addition, your partner can take a daily antiviral pill (e.g. Valtrex). This is called suppressive therapy. Suppressive therapy keeps active outbreaks from occurring and also reduces the frequency of viral shedding by around 50%.
Because GHSV-1 transmits so infrequently, suppressive therapy is not typically recommended for folks with GHSV-1. If your partner is using suppressive therapy, they’re really going the extra mile to be safe!
Isn’t there still a risk?
Yes. Dig this, though.
Roughly 1 in 2 people have HSV-1 and 1 in 6 have HSV-2 (a different, more active strain of the virus not discussed here).
80% of these people are asymptomatic, meaning that while they can still transmit the virus, they are not aware that they have it, so they don’t know to take extra precautions. They might also have very mild prodrome symptoms or outbreaks and – since they don’t think they have herpes – not understand the importance of refraining from sexual contact during these periods.
Frankly, you’re much more likely to get HSV-1 orally or genitally from someone unaware of their status than someone who has been diagnosed with GHSV-1, understands their body, and is taking the right precautions to be safe and responsible.