Genital herpes transmission

How do you get genital herpes?

Genital herpes is a sexually transmitted infection (STI) that causes blisters or sores on the skin on or around the genitals. Genital herpes is caused by the herpes simplex virus (HSV) – type 1 and type 2. Once you have been infected with herpes simplex virus, it stays in your body forever.

The herpes virus can be spread from person to person by direct skin-to-skin contact, especially during intimate sexual contact with an infected person. This includes kissing, oral sex and contact with the genitals or anus.

You can’t catch genital herpes by sharing cups, towels or from toilet seats. You can still share a bed, kiss or cuddle your partner and not risk infecting them with herpes.

Catching the herpes virus

The herpes virus is most often spread from person to person when someone is having an outbreak of genital herpes, as the virus is contained in the blisters and sores on the skin. However, even when a person has no symptoms, the herpes virus can still be present on the skin and be transmitted (passed on) to other people who come into close contact.

The medical term for the herpes simplex virus being released from the surface of the skin is called viral shedding.

How do you know if someone has genital herpes?

Some people with genital herpes have outbreaks of genital sores, while other people have no symptoms at all and don’t even know they have the virus in their body. So it’s possible to transmit the virus to sexual partners even if you don’t have symptoms (although this is less likely than when you have active lesions).

Mostly, you won’t know whether or not your sexual partner is infected with one of the viruses that cause genital herpes. In fact, many people don’t know themselves whether or not they are infected. So, when having sex with a new partner, it’s always best to follow safe sex tips (see below).

Did I get herpes from my current partner?

It is often difficult to identify the person who infected you with genital herpes. Because it’s possible to have the genital herpes virus but never experience any symptoms, some people are not aware they are infected, and can unknowingly transmit the herpes virus to a partner.

A current episode of herpes may not be from a current relationship. People who experience herpes for the first time may think that they have acquired their herpes from their current partner. However, a current episode may have been passed on by a sexual contact in the recent or distant past.

If you always use a condom or a dental dam during sexual contact, you significantly reduce your risk of catching or passing on genital herpes. However, a slight risk remains because the area of infected skin may not always be covered by the condom or dental dam.

Can I pass herpes on to my baby during pregnancy?

During pregnancy, it is possible for the herpes virus to be passed on to the baby. However, the vast majority of women with genital herpes have normal pregnancies and deliver healthy babies.

The virus can be transmitted via:

  • the placenta, when the baby is still in the womb (this usually only occurs if the mother is having her first ever infection with herpes in the third trimester);
  • during delivery (if the mother is shedding the virus from the genital region, either via sores or asymptomatically); or
  • after the birth (through skin-to-skin contact).

Fortunately, women who have genital herpes before falling pregnant and those infected early in pregnancy have a low risk of passing the virus on to their babies, because their body has built up antibodies to the virus. These antibodies cross the placenta to protect the baby.

How to protect yourself against genital herpes during pregnancy

If you are pregnant and your partner has genital herpes, it is important to avoid contracting the virus during pregnancy. Avoid skin-to-skin contact when herpes sores are present and remember to use condoms, even when there are no obvious genital herpes lesions, to reduce the risk of possible transmission.

Becoming infected with genital herpes during the third trimester of pregnancy increases the risk of the baby becoming infected with the virus. Abstaining from sex with an infected partner is usually recommended during the third trimester of pregnancy.

If a first ever episode of herpes infection occurs during pregnancy, the mother is usually given antiviral medicines. Additionally, if this infection occurs in late pregnancy, it is recommended that the baby is delivered by Caesarean section.

There is less risk of infecting the baby if you have a recurrent episode of genital herpes during pregnancy. Caesarean section is only recommended if the woman has genital herpes sores at the time of delivery. Antiviral medicines may also be given in the last few weeks of pregnancy to women with recurrent genital herpes to reduce the risk of an outbreak at the time of delivery.

Babies are always monitored closely after birth to check for infection.

How can I reduce my risk of transmitting herpes?

You can reduce your risk of transmitting herpes by adhering to the following steps.

  • Discuss genital herpes with your partner so that you can take the necessary precautions together.
  • Avoid all sexual contact when you have an outbreak of genital herpes. Remember that sores in areas such as the buttocks and thighs can be just as contagious as those in the genital area.
  • Always follow safe sex practices between outbreaks, as the virus can be passed on even when no sores are visible.
  • Use condoms. Condoms offer you and your partner good protection against a wide range of STIs. Although condoms do not cover all of the potential sites of viral shedding, they do offer useful protection against asymptomatic shedding, by protecting parts of the body that are the most likely sites of transmission. It is essential to slide a condom on as soon as a complete erection occurs, not just at penetration. During oral sex, always use a condom to avoid direct mouth to penis contact.
  • Use dental dams. Dental dams are a thin latex sheet available from chemists that can be used when giving oral sex. The dental dam is held over the entrance to the vagina or anus as a protective barrier during oral sex to avoid direct mouth to vagina or mouth to anus contact. Keep only one side of the dam next to the genital area, remember to keep your mouth on the other side of the dam (don’t turn it over) and don’t reuse it. The dental dam will reduce exposure to oral herpes and minimise exposure to genital herpes.
  • Avoid touching other parts of your body, especially your eyes, after touching affected areas since the herpes virus can be transferred from one part of the body to another during an outbreak. Wash your hands often during an outbreak.
  • Talk to your doctor about treatment options such as antiviral medicines, which can reduce the number of outbreaks and help make them less severe and of shorter duration. Antiviral medicines can be taken intermittently to treat specific outbreaks, or regularly as suppressive therapy to reduce the frequency of outbreaks. Suppressive therapy, along with condom use during sex, can help reduce the risk of transmitting the virus to a non-infected partner.
  • If your partner is pregnant and has never had herpes, it may be advisable for you to use antiviral medication for the duration of the pregnancy to prevent transmission to the mother and baby.

Talk to your doctor or visit your local sexual health clinic for further advice on preventing the spread of genital herpes.

Last Reviewed: 30 November 2016
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References

1. Genital ulcer disease (revised November 2014). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2016 Jul.http://online.tg.org.au/complete/ (accessed Nov 2016).
2. Australian STI Management Guidelines for use in primary care. Herpes (updated 20 May 2016). http://www.sti.guidelines.org.au/sexually-transmissible-infections/herpes (accessed Nov 2016).
3. Centers for Disease Control and Prevention (CDC). Genital herpes – CDC fact sheet (reviewed 23 Jan 2014). http://www.cdc.gov/std/herpes/stdfact-herpes.htm (accessed Nov 2016).
4. BMJ Group. Patient information from the BMJ Group: Genital herpes (published 27 Oct 2016). http://bestpractice.bmj.com/best-practice/pdf/patient-summaries/532420.pdf (accessed Nov 2016).
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