HerpesHealth.ca:How genital herpes is transmitted

No One Wants to "Give" Genital Herpes to Anyone Else

How genital herpes is transmitted

This much you probably already know: the risk of transmitting genital herpes is greatest during an outbreak when the virus is most active. If a blister or sore rubs against your partner’s skin, the virus can be spread even if sexual penetration does not take place and so it’s important to abstain from all sexual activity until the outbreak is over and the sores have completely healed.^2,3

What you may not know is that although the use of condoms and other barrier methods can reduce the risk of transmission, they are not enough to prevent the transmission of genital herpes because they do not cover all areas of skin where the virus can be present and active.

You may also be unaware of asymptomatic viral shedding [?] : when the virus becomes active, travels to the surface of the skin, “sheds” without causing any noticeable signs or symptoms – and is contagious. Viral shedding (with or without symptoms) can occur anywhere from just below the waistline down to the upper thighs including the buttocks, not just the genitals. Asymptomatic viral shedding is now recognized as a major cause of new infections.^1,4 Transmission of genital herpes in 70% of patients results from sexual contact during periods of asymptomatic viral shedding.¹

Unfortunately, no-one can predict when viral shedding will occur.^4,5
The only way to know for sure would be through lab testing, which is not always an option. The point is, you just don’t know when the virus may be active – and contagious.

The transmission of HSV-1 through oral sex is becoming increasingly common.⁶ It is important to practice safer sex during all sexual activity with all partners.

Finally, although it is rare, herpes can be spread to other parts of your body – for example, by touching a blister or sore and then rubbing or scratching another part of your body. This is known as autoinoculation [?] and is best avoided by washing your hands after touching any area infected with the herpes virus.²

How genital herpes is not transmitted
Some people may tell you that herpes can be passed on through blood transfusions, swimming pools and bath water, toilet seats and even by hand shaking. Don’t be fooled. There is only one way you or anyone can become infected with genital herpes and that’s through direct skin-to-skin contact with an infected individual. The herpes virus can be transmitted when an area of skin that is shedding the active virus comes into contact with uninfected skin in the genital, anal or mouth areas of another individual. This means direct oral-oral, genital-genital, oral-genital, genital-anal or oral-anal contact.^2,3

References

1. Mertz GJ, Benedetti J, Ashley R, et al. Risk Factors for the Sexual Transmission of Genital Herpes. Annals of Internal Medicine 1992;116:197-202.

2. Sacks SL. The Truth About Herpes. 4th ed. West Vancouver, BC: Gordon Soules Book Publishers Ltd.;1997.

3. Ebel C, Wald A. Managing Herpes: How to Live and Love With a Chronic STD. Research Triangle Park, NC: American Social Health Association;2002.

4. Wald A, Zeh J, Selke S, et al. Genital Shedding of Herpes Simplex Virus Among Men. JID 2002;186(Suppl1):S34-S39.

5. Wald A, Zeh J, Selke S, et al. Virologic Characteristics of Subclinical and Symptomatic Genital Herpes Infections. NEJM 1995; 333(12):770-775.

6. Aoki, FY. Canadian Guidelines on Sexually Transmitted Infections 2006 Edition: Genital Herpes Simplex Virus (HSV) Infections. Public Health Agency of Canada. http://www.phac-aspc.gc.ca/std-mts/sti_2006/pdf/sti2006_e.pdf. Accessed May 15, 2006.

7. Wald A, Krantz E. Selke S, et al. Knowledge of partner’s genital herpes protects against herpes simplex virus type 2 acquisition. J Infect Dis 2006;194:42-52.

8. Green J, Ferrier S, Kocsis A, et al. Determinants of disclosure of genital herpes to partners. Sex Transm Infect 2003;79:42-44.

9. Health Canada. What You Need to Know About Sexually Transmitted Infections. Ottawa, ON: Health Canada; 2002. Available at http://www.phac-aspc.gc.ca/publicat/std-mts/sti_s.html and http://www.hc-sc.gc.ca/iyh-vsv/diseases-maladies/gonorrh_e.html.