We both have herpes 1 & 2 — will having sex cause more outbreaks?

Originally Published: September 18, 2009
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Dear Alice,

I have tested positive for herpes 1 and herpes 2. My boyfriend has also tested positive for herpes 1 and herpes 2. This a a long-term stable relationship. Neither of us has outbreaks very often.

Since this is a monogamous relationship, do we need to use any protection for genital or oral sex? I understand that we both have antibodies for 1 and 2 so I don't believe we can reinfect each other. However, when I consulted some doctors and sites, they suggested refraining from any sexual intimacy whenever one of us has an outbreak or feels an outbreak is about to happen.

My question is: if we both already have herpes 1 & 2 can we a) re-infect each other or b) cause either of us to have more outbreaks? Also, can we spread the virus to other locations on our own bodies?

Thanks, Alice. I hope you can help us.

Dear Reader,

Living with herpes can be challenging, so your boyfriend is lucky to have such a caring and savvy partner. You're correct that after being infected, your body develops antibodies to both strains of the virus. In practical terms, this means that since both of you already have HSV-1 and HSV-2 you cannot be "re-infected" nor will you cause each other to have more outbreaks.

After your first or "primary" herpes outbreak, future flare-ups are determined by the status of your immune system — not exposure to an infected partner. Outbreaks usually become less frequent and less severe over time. The average number of outbreaks is about four to five a year for people with genital herpes and one a year for oral herpes. Since you already have both kinds of herpes, having sex while your partner has an active sore or is going through viral shedding will not trigger an outbreak.

As long as the relationship is monogamous, both partners have the same type of herpes infection(s) (known as a seroconcordant couple),  and both partners are free of other sexually transmitted infections, it's not necessary to use barrier methods like condoms or dental dams. Friction can aggravate herpes sores and slow healing, so you may want to avoid getting it on when one of you has an outbreak for comfort reasons. On a related note, some folks with herpes actually seek a partner who has the same strain(s) of herpes, that way there's no risk of passing on the virus.

As you mentioned, there is a very small possibility of spreading the herpes infection to other parts of your body. For more background, take a look at Possible herpes outbreak on shoulders and legs? in the Go Ask Alice! archive for Sexual Health.

To find out more about herpes, you may want to talk with a health care provider. Unfortunately, it sounds like you received some less-than-accurate information in the past, so you may want to seek out a provider who specializes in sexual and reproductive health care and/or has experience treating patients with herpes. Students at Columbia can make an appointment with a clinician at Primary Care Medical Services (PCMS) by calling x4-2448 or logging on to Open Communicator. You may also be interested in these resources:

Herpes Resource Center: This website run by the American Social Health Association provides a variety of information and support for people concerned with herpes.

Managing Herpes: Living and Loving with HSV: This book by Charles Ebel and Anna Wald explores herpes issues ranging from transmission to telling a partner, sexuality, and long-term relationships.

Dealing with herpes isn't always easy, but good information can benefit your health and your relationship. Since you and your boyfriend share the same diagnoses, you can focus on each other instead of worrying that herpes will get between you!
Alice