anonymous on September 19, 2011

I have genital herpes...will my boyfriend ever be able to give me oral sex without protection?

I’m a 22-year-old woman with genital herpes. Recently, I met a wonderful guy and we’ve been dating. Our sex life is fun and we always use condoms, but I miss receiving oral sex and I don’t think using a dental dam will feel as good. I read an article that said it was very unlikely (but not impossible) to pass herpes through oral sex. What do you think?

answered by Terri Warren, MS, RN, ANP on September 19, 2011

You brought up a good question, and I’m happy to offer you my perspective. 

First, do you know which type of herpes is causing your genital herpes infection? Genital herpes can be caused by two different types of herpes simplex virus and they behave differently. HSV-1 is the main cause of oral herpes (cold sores), but it can also cause genital herpes if someone who has oral HSV-1 passes it to the genitals during oral sex. HSV-2 is another herpes virus and it’s often responsible for genital herpes infections...but not always.

To begin, I would encourage both of you to get tested for herpes with a “type-specific” blood test...which looks for both HSV-1 and HSV-2 antibodies. Once you know what type of herpes you have, and whether your boyfriend also has a herpes infection, you can better assess your risk of unprotected oral sex. 

What’s the difference between HSV-1 and HSV-2 in the genital area? HSV-1 is shed less frequently from the genital area than, if you have HSV-1 genitally, your partner’s risk of catching it from you through unprotected oral sex is low. 

Also, just so you know...if your partner has ever had a cold sore at any time in his life, and you have genital HSV-1, then he can safely give you oral sex. That’s because if he’s ever had a cold sore, he already has HSV-1...and he can’t be re-infected with a virus that he already has. Of course, it’s also possible that he has HSV-1 and doesn’t know it...some people don’t have symptoms. 

If you have HSV-2 genitally, transmission of the virus through oral sex to your partner’s mouth is also relatively unlikely. HSV-2 doesn't like to live in the oral area, but that's not to say it couldn't be transmitted to his mouth. If it was, it would probably come back only infrequently and look just like a cold sore. 

In fact, if your partner gets HSV-2 orally, it may actually serve the same function as a vaccine to prevent an HSV-2 genital herpes infection. Why? Because once a person has herpes in one location on the body, it’s highly unlikely to get it in a new place on the body.

Bottom line: if your partner doesn’t have herpes, there’s a risk of passing your infection to him if he gives you unprotected oral sex. However, the risk of transmission is low...especially if you’re on a daily antiviral treatment.  

To learn more about herpes risks, transmission, prevention, testing and treatment, you might want to read through our Expert Guide to Herpes 1 + 2

Thanks again for writing. I’m sure that you and your partner will make the best decision for your individual situation.

Related info:

Terri Warren, MS, RN, ANP

Warren is a Nurse Practitioner and owner of Westover Heights Clinic in Oregon. She is a renown expert and author in the field of genital herpes research, diagnosis and treatment. Warren was educated at Oregon Health and Sciences University and the University of Portland.

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