How To Lower Transmission Risk To Partners

There are a few ways to help lower your transmission to your herpes negative partners. Nothing is 100% this is why it is important to disclose to partners prior to engaging in any activity that can potentially transmit. (I.e Physical contact, kissing/ oral sex if you have oral herpes, or sex if you have genital herpes). For help with disclosures see The Disclosure Guide here: https://sites.google.com/view/herpesdisclosureguide/disclosure-guide 

Also to note that most people who have herpes have no idea they have it so there is a good chance the person you are sleeping with may already have a form of herpes. Most people are asymptomatic and standard STI panels do not test for herpes. Your best bet is to have a date at a clinic to see what you are working with. You may be stressed about transmission for no reason. Reminder that around 80% of the earth's population has some form of herpes.  

Source:

This is a How To Reduce Herpes Transmission Risk To A Partner pamphlet to print/send to a partner! https://drive.google.com/file/d/1iVftCN-oEWEf5pdNNLlyYk1PVp1wxaru/view?usp=sharing 

Herpes Transmission AI Tool: This site you can use as a herpes coach you can ask it questions and it will pull answers based on this document and the cited sources.   https://notebooklm.google.com/notebook/52e283a8-e133-4254-963e-b8891a56db05 

Table of Contents

Transmission Guide AI Podcast Overview:

Steps to Prevent Transmission:

Preventative Methods That Are Controversial:

What Will Not Reduce Transmission:

Can A Herpes Negative Partner Do Anything To Help Reduce The Risk?

Transmission Facts:

Transmission / Dating Myths:

Transmission Rates Between Sexual Partners:

Transmission Guide AI Podcast Overview:

This is an AI generated podcast that analyzes this document to make a comprehensive audio overview. Unfortunately I cannot upload audio alone so I made it into a video.  https://youtu.be/QDD7OsU4Dps?si=2mjEMGj2XX0hN6in 

Steps to Prevent Transmission:

  1. Take antivirals, Study data shows that people with symptomatic herpes who take valacyclovir are almost 50% less likely to transmit the virus to others than non-medicated people with herpes. In one study, the HSV-2 acquisition rate was reduced from 3.6% to 1.9% using valacyclovir treatment.
  1. Reduce the amount of outbreaks: you are most contagious when having an outbreak so to protect your partner take supplements to lower the amount of outbreaks you have. Supplement list:
  1. Condoms. While condoms are not 100% effective at protecting against herpes they do offer some protection over the covered area. For oral sex you can also use things like dental dams for added protection from giving or getting herpes.
  1. Avoid having sex when you or your partner is sick or immunocompromised. Herpes is a virus and like most viruses they attack the immune system if your partner is under the weather already they are more likely to catch other viruses. Same vice versus, if you are not feeling well you are more likely to have an outbreak.
  2. Listen to body cues. Viral shedding sometimes comes with warning signs called prodrome symptoms. Most commonly tingling or itchiness in the skin area you get outbreaks and lower back and leg pain nerve pain. Nerve pain can range from feeling of needles in the skin to a dull ache or soreness. You are contagious during these times. Also look for bumps and cuts that appear in the are herpes outbreaks aren’t always obvious it’s better to play it safe.
  1. Having open communication with your partner. If you are feeling off, or something doesn’t feel right, tell your partner and do not engage in sexual activity. It’s better to have a false alarm then have sex when you aren’t sure about a bump or tingle. Always disclose your herpes status prior to sexual activity.
  2. Testing: in many cases the person who has herpes discloses their status to a partner but the partner has no idea if they actually have it. Herpes testing is not included on a standard STI panel and the CDC does not even recommend testing with no symptoms or outbreak present. Many people with herpes are asymptomatic (meaning never having symptoms or outbreaks) so many people walk around with herpes and have no idea that they even have it. Testing is important to not only protect the person who knows they have herpes from getting a different strain but to also see if there is even a need to worry about transmission at all. (Once you have a strain of herpes it is very unlikely to get it again in a different location especially after the first year.) This is all the information on herpes testing, where and how to get tested and which test would be right for your situation: https://docs.google.com/document/d/12WNIb6LT4uzTTIqp07vtfWjm5oclHav3ZyED_U0mI8o/edit?usp=sharing 

Preventative Methods That Are Controversial:

The following list are methods that work for some people but can make others feel gross or like a walking biohazard. This is why having open and honest conversations with your partner is ALWAYS important. Everyone has different boundaries and likes and dislikes and sex is only fun if all parties involved are informed, consenting, and enthusiastically involved. A partner should not pressure you to do anything you are uncomfortable with or make you feel dirty or like a walking biohazard.

  1. Having Sex Through Boxers / With Clothing on: some people try having sex with a penis sticking out of boxers while wearing a condom. Or any type of combination where the least amount of skin-to-skin contact is happening. This is definitely something that will reduce (and even eliminate transmission risk depending on where you or your partner gets outbreaks) however this may make your partner feel icky or like a hazmat. For others this may give them peace of mind and they may be able to relax knowing that there is little to no risk of transmission. Be sure to discuss this option with your partner.
  2. Mutual Masterbation / Use of Toys: for some individuals the thought of having any type of sex can cause anxiety or is not something they are interested in doing. The use of toys can offer a sexual experience without any risk of transmission (as long as there is no skin-to-skin contact with the area potentially virally shedding or having an outbreak). Be sure to not put the toy on any open herpes outbreak sores and then use it on the herpes negative partner without cleaning and for sanitary purposes be sure to always clean your toys between use.
  3. Different Positions: though this is not a fail safe way to prevent transmission it can be helpful. For instance if your partner gets their outbreaks on the front pubic area having sex from behind can be a safer method (not 100% effective but may make you and your partner feel safer and more relaxed). Same with if your partner only has outbreaks in the anal region only having sex in missionary can be an option for a safer sex approach. This can potentially lower the chance of transmission especially in addition to antiviral and condom usage.
  4. Avoiding Sex Acts That Risk Transmission: this is also something that will need to be discussed with a partner as everyone's boundaries are different. But avoiding skin-to-skin contact with the area that gets the outbreak entirely is a great way to eliminate transmission risk. If you have anal herpes, never have anal sex. If you have oral herpes, never kissing or having oral sex. However for some people (myself included) avoiding sex acts is not something they are comfortable with and they will want to be with their partner fully or they want a different partner. This is okay too. Some people are just not compatible sexually and instead of compromising your sexual desires it would be better for both parties to find a different partner that better suits your needs. It is also important with an avoidance method of prevention to be sure that this isn’t masking toxic behavior. For example if you have genital herpes and your partner is okay with having genital to genital sex (especially without a condom) but they refuse to give you oral out of “fear of transmission” that  is a red flag.
  5. Antiviral Creams to Prevent Transmission: There are limited studies on the effectiveness of using antiviral topical creams as a prevention barrier during sex. Some people feel that the antiviral creams will inactivate the virus on contact making the skin “herpes free”. There is limited clinical evidence; mainly experimental or anecdotal. While this method cannot increase the chances of transmission there is no concrete evidence in it eliminating the risk entirely. There is also limitations to the reduction of the risk:
  • Coverage: HSV can be transmitted from skin outside the treated area, so applying cream only to visible lesions doesn’t protect completely. There is also a risk of not applying the cream equally to the entire area, or missing areas that are invisibly shedding the virus.
  • Practicality: Requires frequent, proper application over the entire area.
  • Longevity: depending on how long the sex act goes on for the skin can absorb the topical cream, or skin-to-skin friction/position changes can wipe away the topical cream leaving areas exposed.
  • Not Suitable For Certain Sex Acts: topical antivirals should not be consumed and are not for internal use. Therefore it will not be an effective prevention method for oral sex or if the individual gets outbreaks on the tip of the penis or inside the vagina.

What Will Not Reduce Transmission:

There are many rumors of things that will prevent transmission online that can have you going crazy that are either overkill, do not reduce transmission or can make you or your partner uncomfortable. This is why open communication and education is so important for both you and your partners to ensure that not only you are both safe but also comfortable. Sex is only fun if ALL parties are comfortable, enthusiastically consenting and informed.

  1. If the herpes negative partner takes antivirals: unlike STIs like HIV there is no medication that your partner can take to help prevent contracting herpes. It may seem like a good idea to have your partner take antivirals as a preventative measure however this is not how antivirals work and not only would this waste the antivirals it can potentially give your partner side effects from the medication for no reason. HSV makes an enzyme called thymidine kinase that activates acyclovir. Without HSV in the body, that enzyme isn’t there, so the drug just stays inactive and does nothing. Acyclovir doesn’t sit in your body and block herpes from entering cells.

Sources:

  1. Taking a Shower / Washing Directly After Sex / Exposure: This may seem like an option as you are “washing away the herpes” but there is no evidence that showering or wiping the area with a wipe will reduce the risk of transmission. HSV is transmitted through skin-to-skin contact with the area having the outbreak or virally shedding and the transmission happens very quickly. The virus can start infecting skin or mucous membranes (genitals, anus, mouth, nose, or eyes) as soon as contact happens.Even tiny invisible breaks in the skin or mucosa give HSV a way in, washing won’t undo that once the virus has crossed the skin barrier. Showering after sex is good for general hygiene and may help lower the risk of some other infections (like bacterial UTIs or yeast infections), but it does not stop herpes transmission.

Sources:

  1. Using Harsh Chemicals to clean up after sex: not only does this not prevent the spread of herpes this is very dangerous and can cause irritation of the skin, drying out of the skin, allergic reactions, and even chemical burns. NEVER use household cleaners or disinfectants anywhere on or inside your body. Even cleaners like hand sanitisers that are safe to use on places like your hands are not safe to use in, on or around your genitals. As stated above, cleaning the area that came in contact with an area of your partner's body that has herpes is not a preventative measure.

Sources:

  1. Having sex in a shower or body of water: there is no evidence to suggest that having sexual intercourse in a body of water reduces the chance of transmission. Even though herpes does not transmit through a body of water (i.e. if you are swimming with an active outbreak the water will not transmit it to the people you are swimming with) and when cleaning objects water and soap kills the herpes virus on the objects, the skin-to-skin contact of having sex is still a transmission risk. Shower water can’t remove or neutralize the virus quickly enough to prevent infection.
  2. Pubic Hair: having it clean shaven or having a bush doesn’t matter for herpes transmission. Some individuals feel that having hair acts as a protective barrier from skin-to-skin contact however this is not true. Hair is thin and in some cases patchy so it offers little to no protection from skin-to-skin contact. Pubic hair also does not cover the entrance to the vagina, anal area, penis shaft or head leaving many areas exposed to getting herpes and other skin-to-skin STIs. Some individuals feel that shaving helps them be safer as they can do better visual checks of the area for herpes sores prior to sexual activity for others; shaving is a trigger that increases outbreak amounts. Having or shaving pubic hair is a personal decision but herpes transmission should not be a deciding factor.

Source:

  1. Urinating After Sex: though this is an important step after sex to prevent infections like UTIs, yeast infections and BV this does nothing to help prevent contracting herpes from a partner.
  2. The Pull Out Method: Some STIs (HIV, Chlamydia and gonorrhea) are primarily spread through bodily fluids like semen or  vaginal fluids the pull out method may offer some protection from transmission. However herpes is mainly transmitted through skin-to-skin contact and not through bodily fluids. Therefore pulling out prior to ejaculation offers no protection from transmitting or contracting herpes.
  3. Doubling Up on Condoms: Though this may seem safer if you use 2 condoms, or a male and female condom at the same time this actually increases the risk of infection and pregnancy. When the material from the condom rubs against another condom it increases the amount of friction which causes tears and condom breakage. This increases the likelihood of skin-to-skin contact which increases the risk of STI transmission and pregnancy.

Can A Herpes Negative Partner Do Anything To Help Reduce The Risk?

For STIs such as HIV there is a preventative medication for negative partners to take (PREP) to help reduce the risk of contracting HIV unfortunately there are no such medications on the market currently for herpes. There are some preventative measures that a partner can do to help reduce the risk of contracting herpes but there is currently nothing as concrete as PREP.

  1. Get Tested: Most people with herpes are unaware of their status (Up to 80% of people with herpes do not know they have it as they are asymptomatic and have never been tested) Herpes tests are not recommended by the CDC unless there are physical symptoms present so most doctors will not test for it unless you specifically ask for it. When you ask your doctor for a full STD panel herpes is rarely included so if you are with a partner who tells you that they have herpes get tested and see if there is even a risk of transmission. You may already have it and just not be aware. This is all the information on herpes testing, where and how to get tested and which test would be right for your situation: https://docs.google.com/document/d/12WNIb6LT4uzTTIqp07vtfWjm5oclHav3ZyED_U0mI8o/edit?usp=sharing 
  2. Listen To Your Partner: if you are with someone who disclosed their herpes status to you listen and follow their lead. If they say that they cannot have sex currently due to viral shedding symptoms (invisible symptoms of herpes that you may not be able to see but your partner can feel) do not pressure them to have sex. Trust their judgement and be patient to help ensure your safety.
  3. Do Not Complain or Be Mopey During Times of Outbreaks or No Sex: complaining about not being able to do sexual things if your partner is experiencing symptoms or making them feel insecure about having herpes or not being able to perform sexually can cause your partner to partake in sexual activity during times when they are unsure if they are having symptoms rather than being honest with you. There are times your partner is 99% sure that a razor bump is just a razor bump but will avoid sexual contact on the 1% chance it is herpes but if every time they come to you and let you know that they are not able to have sex you gave them a hard time or make them feel bad they may not be as open with you out of guilt or fear. There are also times that someone with herpes has invisible symptoms that can be signs of herpes or can be signs of something else (i.e. lower back pain: can be a sign of viral herpes shedding or a symptom of a menstrual cycle or going to the gym). Being an open and honest partner can only happen if the receiving end is understanding and non-judgemental. If this is something that you are unable to provide for your partner's mental health and your own safety you may want to find a herpes negative partner.
  4. Use protection and condoms: While condoms are not 100% effective at protecting against herpes they do offer some protection over the covered area. For oral sex you can also use things like dental dams for added protection from giving or getting herpes.
  1. Immune System: Herpes is a virus and like most viruses they attack the immune system if a herpes negative partner is under the weather already they are more likely to catch additional viruses including herpes. Same vice versus, if your herpes positive partner is not feeling well they  are more likely to have an outbreak or be virally shedding. Exposure to HSV can still lead to infection, regardless of immune strength. So though boosting your immune system through supplements / vitamins is not a method of transmission prevention it is a helpful tool in:  
  • Reducing the severity of infection: Once infected, a healthy immune system may help control viral replication and reduce the frequency and severity of outbreaks. So having a stronger immune system may make your initial outbreak less severe.
  • Limiting duration of symptoms: People with robust immunity may experience shorter and milder lesions.

Remember having sex with a partner that knows their herpes status and understands their triggers, symptoms and health is MUCH safer than someone who has never been tested and is unaware of their status. It is also important to note that 50-80% of the global population has herpes in some form and up to 80% of people with herpes may not be aware they have it because they experience no symptoms or only mild ones that they don't attribute to herpes. Herpes testing is not included on a standard STI Panel so most people who claim they do not have herpes are untested, and asymptomatic.

Sources:

Transmission Facts:

  1. Antivirals help lower transmission to a partner:

Antivirals have been proven to lower viral shedding and outbreak amounts. You are most contagious during an outbreak and still contagious during times of viral shedding. The main transmission concern for most people is the viral shedding that there are not always signs or symptoms that you can feel. So taking antivirals helps lower the amount of viral shedding and outbreaks therefore lower your transmission risk to a partner. Study data shows that people with symptomatic herpes who take valacyclovir are almost 50% less likely to transmit the virus to others than non-medicated people with herpes. In one study, the HSV-2 acquisition rate was reduced from 3.6% to 1.9% using valacyclovir treatment.

Sources:   

  1. Asymptomatic carriers virally shed less than if you had symptoms:

Around 80% of people who have herpes are asymptomatic meaning that they never have had an outbreak or any visible symptoms of herpes. People who are asymptomatic are capable of transmitting to a partner HOWEVER asymptomatic carriers virally shed less than symptomatic carriers. This means that people who have never had an outbreak are LESS likely to transmit to a partner. This also means that over time if you have less outbreaks or become asymptomatic you also virally shed less and are less likely to transmit.

Sources:

  1. Yes, you can have oral sex:

Transmission from genitals to oral is not common and unlikely. If you have oral outbreaks transmission risk is higher to genitals but not guaranteed. You can use protective barriers such as dental dams and condoms for added protection (not 100% protection but does offer protection of the covered area). Also avoid any skin to skin contact during times of active outbreaks or viral shedding symptoms (tingling of the skin, nerve pain, itchy skin, unaccounted for red bumps etc. ) If you have anxiety around oral sex or want added protection you can always use barriers such as dental dams or protective underwear.

Examples:

HSV-1: With HSV-1 if you have oral cold sores make sure to avoid having oral sex with an active outbreak or if you have signs of viral shedding (tingling sensations, itchy lips, red bumps along the lip line).  If you have genital HSV-1 also avoid receiving oral sex when any of those symptoms appear. HSV-1 has a higher transmission rate of oral to genital than genital to oral. This is due to the fact that genital HSV-1 sheds much less than oral HSV-1. Always disclose and discuss with your partner.

Sources:

HSV-2: Oral HSV-2 is rare so getting oral HSV-2 from someone with genital HSV-2 is not common. This is because HSV two tends to live in your nerve endings at the base of your spine, rather than at the base of your neck, like HSV1 . As always to be safe, avoid having any sexual contact during visible outbreaks or viral shedding symptoms (tingling sensations, itchy skin, lower back / leg pain, nerve pain). If you have a confirmed case of oral HSV-2 you are at risk of transmitting it to someone's genitals during oral sex  just as someone with oral HSV-1 is. Always disclose and discuss with your partner and avoid having oral sex with an active outbreak or if you have signs of viral shedding (tingling sensations, itchy lips, red bumps along the lip line).

Sources:

  1. Transmission between genitalia has different rates:

Genital herpes infection is more easily transmitted from penis to vagina than from vagina to penis during penile-vaginal sex. This is due to how the genitalia is situated and that more of a mucus membrane is exposed with vaginas.

Sources:

Vector of Transmission

Chance of Transmission (per year)

Penis to Vagina

7%-31%

Vagina to Penis

4%

Source: https://stdcenterny.com/odds-of-getting-herpes.html 

  1. Having a strain of herpes in one location makes it much harder to get it again in a new area:

Passing herpes to another part of your OWN body is called autoinoculation. This CAN happen but it is only likely  to happen during your primary outbreak or rarely during an outbreak. After your primary outbreak your body builds up antibodies to herpes meaning that it is not only harder to catch the same herpes strain from others but also from yourself. This is why having your partner get tested is a great idea to see if transmission is even something to worry about because if your partner has the same strain as your transmission risk is much more unlikely. The longer you have herpes the less likely you are to re-catch it in a different area. When you are having an outbreak is when you are the most contagious in general, to play it safe make sure to wash your hands after touching a herpes sore with soap and water. (Simple warm water and bathroom soap kills the herpes virus no need for harsh chemicals)

Sources: 

  1. Having a strain of herpes can protect you from getting the other strain:

While there have been limited studies on this the indication is that if you have one strain of herpes it will make the next strain that you get symptoms more mild and make you much more likely to be asymptomatic for the new strain. Terri Warren believes that getting HSV-2 first will offer some protection from getting HSV-1 later on, however this is only one expert's opinion and is only a theory as of now.

Sources:

  1. Different strains of herpes have different levels of transmission:

GHSV-1 Shedding Statistics:

  1. GHSV-1 sheds about 3-10 times less frequently than GHSV-2 and 5-8 times less frequently than OHSV-1.
  2. The use of Suppressive Therapy reduces shedding rates by around 50%.
  3. GHSV-1 shedding rates. 0-3 months from initial infection: 13.7%, 4-24 months from initial infection: 7.1%, 2 years + from infection: 1.3%
  4. Note that someone with an established GHSV-1 infection (2 or more years old) sheds about 10 times less frequently than someone who has just had their initial outbreak.
  5. Genital HSV1*1% of the time (4 days per year) after 2 years; more frequent in the first 6 months 
  6. HSV1 as proportion of new genital infections in college students >75%

Sources:

HSV-1 Oral vs Genital

  • HSV-1 Genital virally sheds 11% of the time
  • HSV-1 Orally virally sheds 37% of the time

Source: https://stdcenterny.com/odds-of-getting-herpes.html 

  • Oral HSV-1, during an outbreak 36% of the time
  • Oral HSV-1, without outbreak 27% of the time (99 days per year)

Source: https://pubmed.ncbi.nlm.nih.gov/29175899/ 

GHSV-1 Shedding Over Time

Genital HSV-1 shedding was detected on 12.1% of days at 2 months and declined significantly to 7.1% of days at 11 months. Most genital shedding was asymptomatic; genital and oral lesions and oral shedding were rare. 

Source:

HSV-2 Oral vs Genital

  • Chance of oral shedding: 6.5%
  • Chance of genital shedding: 78%

Sources:

Oral HSV-2 1% of the time (4 days per year)

Source: https://westoverheights.com/wp-content/uploads/2014/08/Updated-Herpes-Book.pdf 

Transmission / Dating Myths:

This is a list of common myths about herpes and why they are wrong with cited sources.There are specific sections for dating and transmission myths. https://docs.google.com/document/d/1-6oZmnfywTFNYScKYC7Mh7MXZKrA0GUcztS8Bz5bW0k/edit?usp=sharing 

Transmission Rates Between Sexual Partners:

The document has all the different transmission statistics that I could find, it is important to note that transmission rates and viral shedding rates are very hard to measure so these charts should NOT be taken at 100%. Shedding varies from person to person and sometimes daily. This is just an estimation hence why some percentages have such a wide range. https://docs.google.com/document/d/1xRL3jM3qLB5nh-b2B7tXOU2wrRoPgXclFBu7lCGpkbI/edit?usp=sharing 

If you have any further questions or if any of the source links no longer work you may reach the creator of this document. You can also reach out if you found a different method that works for you and your partners.  HOWEVER I will NOT look at images of your genitals or outbreak and tell you if something looks like herpes. Instagram at Bubblieinblu or Reddit at Mylovelyladylumps69.

This document was last updated on 22AUG2025.