The realities of herpes

Dear Dr Ren:

As a lesbian in the poly and BDSM communities, I have multiple sex partners. I practice safer sex, but recently became fluid bonded with one lover. We were tested for STIs at intervals and discussed our histories. She had genital herpes long ago but hasn’t had an outbreak in many years. Her doctor assured her that her immune system has suppressed the virus.

Now great stress in her life has resulted in a herpes outbreak after all these years. I am concerned. We have returned to safer sex practices, but what else does her outbreak mean? Could I be infected with the herpes virus? Could I transfer it to other partners I kiss? Is it true I can transmit the virus even though there are no herpes lesions on my body? How should we treat the outbreak my lover’s having now? With her history, can she ever be fluid bonded with anyone?

Concerned For Us Both.

Dear Concerned:

Although this is a bad scene for you and your girlfriends, it is a good example of how safer sex considerations apply in real life situations.

Herpes is common in the lesbian population because women’s sexual behaviour patterns make transmission so easy.

You may indeed have contracted the virus from your girlfriend, but only if you came in contact with infected cells from her skin during her outbreak or during her prodromal, or sloughing, period–the time just prior to an outbreak when the virus is active and contagious but not yet causing full symptoms.

It is possible to transmit the herpes virus when there are no apparent lesions through a process called silent shedding, but it is unlikely to have affected you given your girlfriend’s history. Because she has such strong immunity, her prodromal period was likely short, her outbreak minor and, unless her immune system becomes compromised or she experiences another uncharacteristically stressful event, she is not likely to experience another outbreak again for many years.

Nevertheless, I trust she recognized her symptoms early, alerted you immediately, and got treatment with antiviral drugs. The drugs will have minimized the chances that you were exposed to any infected skin cells she may have cast off.

If you went down on your lover while she was actively sloughing cells infected with type II herpes, you may have taken the virus into your mouth. If so, you would have probably developed a cold sore or noticeable lesion at the point of infection and, as long as that lesion is present, it is possible to infect others through kissing.

If you haven’t developed a lesion, you are probably home free, though there is no 100-percent guarantee.

Regarding fluid bonding–choosing to have unprotected sex with a trusted partner–herpes is not fluid borne; it’s transmitted through skin-to-skin contact. Avoiding fluid exchange, although well intentioned, will not protect you from contracting herpes. This is one aspect of this virus that makes it so frustrating.

While some would call it unwise to have unprotected oral sex with someone carrying the type II herpes virus, after long symptom-free periods, it is reasonable to relax and reconsider fluid bonding, as you and your girlfriend did.

You can get tested to see if you harbour the virus, but you may have to pay for the test from your own pocket, and it can take up to four months for the virus to reach detectable levels in your body.

If you did become infected during your lover’s outbreak, keep in mind that herpes itself causes no long-term health hazards. It is annoying, inconvenient, and painful at times, but it is also treatable. New research shows that people compromised by the herpes virus are more susceptible to HIV infection, so you are wise to be vigilant, but herpes infection is not the end of the world. Try to keep this in perspective.

Given the benefits of pleasure, connection, and physical release that come with sex, most of us would walk through fire to get some. HIV sero-discordant couples, for example, can live indefinitely without infecting the negative partner by sticking to scrupulous safer sex behaviours.

We weigh the benefits and risks of our actions and make decisions based on the best information we have. But sex is for adults, the risks are real and the consequences can be life changing. No matter how careful we are, sometimes our best efforts fail.

With that perspective, doesn’t sticking to safer sex practices seem a reasonable price?

I applaud your attempt to protect everyone’s physical health, but keep in mind that your lover needs your emotional support now, too.

It sounds like her life is in upheaval, and she may be feeling guilty and blamed, as well as uncommonly stressed. Perhaps giving her lots of strokes and additional time will help. Although this is no one’s fault, you may be feeling some anger and resentment. While you may be cognitively aware of her innocence, you may still feel angry that she put you at risk for catching herpes. You are entitled to a human reaction and your relationship may need a bit of extra care to recover from this.

You have a special bond with your girlfriend that may now be strained by fear. I hope this information helps you to embrace each other again as freely and lovingly as you once did.