The herpes virus can be spread by direct skin-to-skin contact, especially during intimate sexual contact. This includes kissing, oral sex and contact with the genitals or anus. The herpes virus may sometimes be transmitted through a cut to the skin.
The herpes virus is most often spread during an outbreak of symptoms as the virus is contained in the blisters and sores on the skin. However, even when there are no symptoms, the herpes virus can still be present on the skin and be transmitted to other people who come into close contact.
The medical terminology for the virus being released from the surface of the skin is called viral shedding. Viral shedding can occur with symptoms (symptomatic herpes) and without symptoms (asymptomatic herpes). You may (if you have classic herpes lesions) or may not be aware that viral shedding is occurring. The virus cannot be spread when it is inactive (in the nerve cell). There is no simple way to know if the herpes virus is active when there are no symptoms.
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.
Did I get herpes from my current partner?
A current episode of herpes may not be from a current relationship. Some people with herpes for the first time may think that they have acquired their herpes from a recent partner. However, because herpes can recur, a current episode may have been passed on by a sexual contact in the recent or distant past. For example, you may have contracted herpes from a previous partner and passed it on to subsequent partners (including your current partner) through viral shedding.
It is often difficult to identify the person from whom one acquired the infection. The person who did give it to you may not even be aware they are infected, as they may never have experienced an outbreak. Research suggests that it is possible to transmit herpes type 2 to a partner, even when you are not experiencing an outbreak.
Can I pass herpes on to my baby during pregnancy?
Herpes can be passed on to the baby either via the placenta when the baby is still in the womb (this only occurs if the mother is having her first ever infection with herpes), 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). However, the vast majority of women with genital herpes have normal pregnancies and deliver healthy babies.
Fortunately, women who have genital herpes before falling pregnant 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.
If a first ever episode of herpes infection occurs during pregnancy, the mother is usually given antiviral medications. Additionally, if this infection occurs in late pregnancy, it is recommended that the baby is delivered by Caesarean section.
Recurrent episodes of genital herpes in pregnancy present a smaller risk of transmission. Caesarean section is only recommended if the woman has sores at the time of delivery. Antiviral medications may also be given to women with recurrent genital herpes. Babies are always monitored closely after birth to check for infection.
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 through asymptomatic viral shedding.
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. When you have symptoms, choose sexual activities that do not include skin-to-skin contact with the affected area. Remember that sores in areas such as the buttocks and thighs can be just as contagious as those in the genital area.
- Use condoms. Condoms offer you and your partner good protection against a wide range of STDs. 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.
- Use dental dams. Dental dams are a thin latex sheet available from chemists that can be used when giving oral sex. They will reduce exposure to oral herpes and minimise exposure to genital herpes.
- Stay informed about the antiviral medications available. Taking daily antiviral medication can reduce the frequency of episodes of viral shedding. This may be particularly helpful when you first get the herpes virus, as viral shedding is more frequent in the earlier days. If your partner is pregnant and has never had herpes, it may be advisable to use antiviral medication for the duration of the pregnancy to prevent transmission to the mother and baby. You may wish to discuss this matter with your doctor.
- Ask your partner if s/he has herpes. If they carry the same type of herpes as you, it is highly unlikely that you can transmit the virus. This knowledge may be especially useful if you are in a long-term relationship.
- Therapeutic Guidelines (eTG). Genital herpes simplex virus infection. In: Dermatology guidelines [updated 2009, Feb; accessed 2009, Jun 19]. Available from: http://www.tg.org.au
- Australian Herpes Management Forum. Herpes simplex in pregnancy [updated 2009, May; accessed 2009, Jun 19]. Available from: http://www.ahmf.com.au/guidelines/genital-herpes/herpes-and-pregnancy
- Australian Herpes Management Forum. Suppressive therapy for genital herpes [updated 2009, May; accessed 2009, June 22]. Available from: http://www.ahmf.com.au/guidelines/genital-herpes/suppressive-therapy-for-genital-herpes