What’s your Risk of Spreading Herpes? Herpes Transmission Probability

One of the most common questions for newly diagnosed people is about herpes transmission. What are the odds of passing herpes? The transmission of HSV-2 to an uninfected partner depends on many different factors. The question of transmissibility is more complicated that what you may expect.

What’s your Risk of Spreading Herpes?

Know how is herpes transmitted

How does herpes transmission occur? Herpes is primarily transmitted through direct skin-to-skin contact. Not bodily fluids, blood, surfaces, towels, bedding, toilets, or otherwise, just skin-to-skin contact.

The virus is passed to a sexual partner when there is a high concentration of the herpes virus present in a blister sore or intact skin during silent virus shedding, and this comes into contact with their skin. Once the herpes virus enters the body, it lodges itself in a local sensory nerve root and remains dormant until triggered by certain factors, which may or may not lead to an outbreak.

Herpes viruses tend to enter the body through areas with thin, moist, damaged skin or mucosal surfaces, making the oral and genital areas more susceptible. In contrast, the thicker skin on the arms and torso is less penetrable and less commonly affected.

What is asymptomatic herpes? After contracting herpes, the virus remains in the body in a latent or suppressed state. Unlike some other viruses that are completely cleared by the immune system, the herpes virus is only suppressed by the immune system.
When does asymptomatic shedding occur? The exact timing of asymptomatic shedding remains unclear, but it is believed to be triggered by the same factors that cause visible flare-ups, such as fatigue, illness, sun exposure, or stress. Triggers activate the herpes virus, causing it to travel from the nerve ganglion where it resides in its suppressed state to the skin surface. However, this shedding doesn't typically result in visible skin symptoms, but the virus concentration on the skin is still high, increasing the risk of transmission.

Systematic herpes transmission: Genital herpes is highly contagious, especially when symptoms and signs are present. The risk of herpes transmission by an infected individual who is symptomatic can reach as high as 20.1%. Importantly, a person with herpes can be infectious even before visible skin lesions appear. The initial symptoms of systemic prodrome include fatigue, fever, chills, and local symptoms such as skin tingling, burning, and itching. However, a person with herpes is most contagious when they have visible signs such as fluid-filled blisters. Even after the sores have healed and the crusts have fallen off, the person can still transmit the virus. The risk of transmission is highest during the first outbreak due to the higher concentration of the virus in the sores.
Asymptomatic herpes transmission: Surprisingly, 75% of herpes transmission occurs when the infected partner is asymptomatic, showing no visible signs of an outbreak. The chance of asymptomatic herpes transmission is approximately 10.2% over time, compared to 20.1% when symptoms are present.

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What are the odds of transmitting herpes?

What are the chances of getting herpes from infected partner? The odds of transmitting herpes can vary depending on several factors, including whether the person with herpes is symptomatic or asymptomatic, the location of the infection, and the precautions taken.

Symptomatic Transmission: When a person with herpes is experiencing visible symptoms such as blisters or sores, they are highly contagious. The chance of transmission during this time can be as high as 20.1%.
What are the odds of spreading herpes without an outbreak: Surprisingly, most herpes transmission occurs when the infected person does not have visible symptoms. Asymptomatic shedding happens in about 75% of cases, with a transmission rate of around 10.2% over time.
First Outbreak: The initial outbreak of herpes tends to be the most contagious, as the concentration of the virus in the sores is typically much greater. This increases the chances of transmission.
Shedding Frequency: Shedding, both symptomatic and asymptomatic, is more common in the first few years after contracting the virus and becomes less frequent over time. On average, it is believed to occur on about 4% of days annually.
Direct Skin-to-Skin Contact: Herpes is primarily transmitted through direct skin-to-skin contact with a lesion. Avoiding such contact can significantly reduce the risk of transmission.
Precautions: Taking precautions, such as using antiviral medications, using barrier methods like condoms or dental dams during sexual activity, and practicing good hand hygiene, can further reduce the risk of transmission.

It's important to note that while these statistics provide a general idea of transmission probabilities, individual experiences may vary. If you have herpes or are concerned about transmission, it's advisable to consult with a healthcare professional for personalized guidance and to discuss effective preventive measures.

Percentage of HSV Risk: Hsv 2 transmission probability

How likely is it to pass HSV-2? The likelihood of passing HSV-2 (genital herpes) to a sexual partner can vary depending on several factors, including whether the infected individual is symptomatic or asymptomatic, the precautions taken, and individual circumstances.

What is the hsv-2 transmission probability? Overall, the risk is about 10% per year that an infected male would transmit HSV2 to an uninfected female. That is, if 100 infected men were having one-on-one sex with 100 uninfected women, about 10 women would get infected per year. If the situation were reversed, about 4 uninfected men would get herpes in a year from infected women.

The studies that gave us those numbers were based on the following criteria:

1) No sex during outbreaks
2) No daily antiviral medication
3) No regular use of condoms.
4) The people involved know that one of the people has genital herpes.

An infected male and an uninfected female

If they avoid sex during outbreaks, don’t use condoms regularly, and he doesn’t take an antiviral therapy every day, the risk of transmission is about 10% per year, though there is a large range — from 7 percent to 31 percent — in different studies.

HSV 2 transmission female to male

HSV-12 is most contagious during an outbreak. If they avoid sex during outbreaks, don’t use condoms regularly, and she doesn’t take an antiviral therapy every day, the risk of transmission is about 4% per year.

Those percentages represent what studies consider an ‘average’ sex life incorporating vaginal penetration over the course of one year’s duration, which, of course, is highly subjective.

A study completed in the summer of 2002 evaluated whether antiviral therapy, taken daily, could reduce the risk of transmission of HSV 2 in healthy, heterosexual adults over the age of 18, from an infected partner to an uninfected one. The person with herpes took either valacyclcovir 500 mg daily or placebo. The study followed the couples for a total of 8 months, drawing the blood of the uninfected partner monthly to look for infection. The study found that the taking of valacyclovir daily reduced transmission by 48% over placebo (or sugar pill).

Condoms also reduce the risk of transmission. When men use condoms with every single intercourse, transmission is reduced by 96% to an uninfected female. Condoms used by uninfected men while having sex with infected women reduce the risk of transmission by 30-50%.

When both condoms and antiviral therapy are used, transmission rates can be greatly reduced. Even then, there is a small chance that transmission can occur. Taking antiviral therapy and using condoms does not alleviate the need to tell prospective partners about genital herpes.

Asymptomatic Shedding

Up to 70% of new cases of herpes are transmitted from someone showing no apparent symptoms at the time they infect their partner.

One of the hardest pieces of news to hear about herpes is that there is a chance that the virus can be transmitted when there are no apparent lesions. Women can have virus on their cervix with no sores on the outside of their body. Men can have the virus present inside of the urethra with no external sores.

Virus can be given off from the genital skin of both men and women with no sores, through microscopic breaks in the skin. This is called asymptomatic shedding of the virus; giving off the virus from the body with no apparent symptoms. The more sensitive our virus detection methods become, the more viral shedding we can identify. Shedding rates vary, based on location of virus and type of virus.

Once infected with HSV1 or HSV2, a person is capable of transmitting the virus forever, even when there are no symptoms present. Transmission that occurs when there are no visible symptoms is a result of asymptomatic viral shedding:

Viral shedding means the virus is active on the skin. HSV can shed before an active outbreak (the prodromal period), during an outbreak<, during the healing process following an outbreak, and also at random when there are no noticeable symptoms, and that is called asymptomatic viral shedding, or simply, asymptomatic shedding.

Both HSV1 and HSV2 are easily transmitted to their site of preference, and can also be spread to other sites. Both are most contagious during active outbreaks, but are often spread through viral shedding when there are no recognizable symptoms.

In general, people with HSV1 asymptomatically shed the virus about 5% of the time.
In the first year of infection, people with HSV2 asymptomatically shed the virus about 6-10% of the time.

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Does the risk of spreading herpes decrease over time?

Yes. Over time, though, the percentage someone sheds the virus asymptomatically is said to decrease. Studies involving discordant couples, in which one partner has HSV-2 and the other does not, introduce various biases. Discordant couples, for example, have not transmitted the virus between them and are encouraged to use condoms and take other preventive measures.

Most people get HSV1 as a child

Oral HSV-1 is often the most easily acquired herpes infection. Usually the first herpes simplex virus that people encounter, oral HSV-1, is typically spread simply by the kind of social kiss that a relative gives a child. Because children have no prior infection with any HSV type, they have no immune defense against the virus.

By the time they’re teenagers or young adults, about 50% of Americans have HSV-1 antibodies in their blood. By the time they are over age 50, some 80-90% of Americans have HSV-1 antibodies.

Almost all HSV-2 is encountered after childhood

Almost all HSV-2 is encountered after childhood, when people become sexually active. Those who have a prior infection with HSV-1 have an acquired immune response that lowers – though certainly doesn’t eliminate-the risk of acquiring HSV-2. According to one study (Mertz, Annals of Internal Medicine,1992), previous oral HSV-1 infection reduces the acquisition of subsequent HSV-2 infection by 40%.

Women are more likely to acquire HSV-2 from an infected male partner then men are from women.

In general, females are more likely to contract an HSV infection than males, because the majority of the vagina is comprised of mucous membranes. And while there are mucous membranes on the male genitalia (the head of the penis, the foreskin, and the urethra), there is less exposed surface area on the male genitalia that is made of mucous membranes than compared to the vagina.

On average, the risk for women acquiring HSV-2 sexually from an infected partner is about 10 percent per year, though there is a large range — from 7 percent to 31 percent — in different studies.
For uninfected men, the risk of sexually acquiring HSV-2 from an infected woman is about 4 percent per year.

The greatest risk of transmission occurs anywhere there is contact by an infected area with a mucosa: the nostrils, the mouth, the lips, the eyelids, the ears, the anus, the vagina, the glans penis (head of the penis), the glans clitoris, the urethra, the inside of the prepuce (foreskin), and the clitoral hood.

Having HSV-1 infection may lower the risk of acquiring HSV-2 sexually, but studies on this provide conflicting results.
Condoms reduce the risk of transmission by about 30 percent, and daily suppressive therapy reduces the risk of transmission by about 48 percent, studies show. Using condoms and taking daily suppressive therapy reduces the risk even further than either measure alone, though studies were not large enough to provide reliable numbers.
Unfortunately, there is no available data on the rate of transmission for same-sex couples.

HSV-2 transmission is more dependent on genitals than gender. HSV transmission is actually most dependent upon the location of the body in contact with the virus rather than the gender of the person, because of exposure to mucous membranes themselves. Oral sex is more of an issue for HSV-1 transmission — from mouth to genitals, and indeed, HSV-1 is a fast-growing cause of genital herpes. Oral sex, though, is not much of a risk for HSV-2, since HSV-2 oral infection is rare and shedding of HSV-2 from the mouth is extremely low.

Asymptomatic shedding

Even if they don't show any sign of infection, people carrying the genital herpes virus can infect a sex partner 10% of the time. Up to 70% of new infections can be attributed to asymptomatic shedding. Read more facts about asymptomatic shedding.

Sex when both partners are HSV positive

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.

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How Can I Protect My Sex Partners?

You can take steps to protect others from herpes. Keep in mind that you can spread it even when you don’t have symptoms. Use some practices, your risk of transmitting the virus to your partner(s) might be much much lower. Read more about how do I stop my partner from catching herpes.

Know more facts about herpes outbreak:

What’s your Risk of Spreading Herpes? Herpes Transmission Probability

Know how is herpes transmitted

Worry about herpes transmission? Meet nearby people with herpes

What are the odds of transmitting herpes?

Percentage of HSV Risk: Hsv 2 transmission probability

An infected male and an uninfected female

HSV 2 transmission female to male

Asymptomatic Shedding

Have herpes & feel alone? Meet nearby people with herpes

Does the risk of spreading herpes decrease over time?

Most people get HSV1 as a child

Almost all HSV-2 is encountered after childhood

Women are more likely to acquire HSV-2 from an infected male partner then men are from women.

Asymptomatic shedding

Sex when both partners are HSV positive

Have herpes & feel alone? Meet nearby people with herpes

How Can I Protect My Sex Partners?

Know more facts about herpes outbreak:

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