Partner's last herpes episode was more than 3 years ago — Am I at risk?

Dear Not-so-sure,

Although your partner hasn’t had an outbreak of genital herpes in three years, the virus never completely goes away or stops being contagious. While the first outbreak of herpes is usually the most severe, outbreaks after that may be mild or go completely unnoticed — sometimes they can even be totally asymptomatic. However, it’s still possible to transmit Herpes Simplex Virus (HSV) and other STIs even when no symptoms are present due to viral shedding. For more information about how HSV-1 (oral) and HSV-2 (genital) can be spread, you can check out the Go Ask Alice! herpes archives.

Since you have already had unprotected sex with your partner, it’s possible to  have contracted genital herpes without knowing it. Some people don’t have symptoms for years after getting infected, so you may want to consult with a health care provider about your recent exposure.

As you and your partner look into the future, there are a number of ways to lower the risk of transmission during future sexual contact between you and your partner:

• Abstaining from sexual activity during an outbreak (when your partner has herpes lesions), including all oral-genital and genital-genital contact, is one way to prevent transmission.
• Using barrier methods like male or female condoms, even when it doesn’t seem like she has symptoms, is advisable due to outbreaks that go unnoticed and viral shedding. However, it’s good to note that condoms may not cover all contagious areas.
• Using antiviral medications, including acyclovir, valacyclovir, and famciclovir, to manage a genital herpes infection. These types of medications can shorten the length and severity of an outbreak (this type of treatment is called episodic therapy). They can also be taken on a regular basis to reduce the number of outbreaks a person experiences (referred to as suppressive therapy). Viral shedding can be reduced by up to 94 percent in those who take suppressive therapy. This means you’d likely have a much lower risk of getting herpes from an asymptomatic partner who is taking this medication.

Rest assured that many couples are able to have emotionally and sexually fulfilling relationships when one of the partners has herpes. Communicating openly and honestly about STIs, though potentially uncomfortable, is essential to a healthy sexual relationship. So, it’s great that you and your partner have started a dialogue about her herpes status and the associated risks. Being better informed about HSV will allow you and your partner to have safer sex in this and in any future relationship.