Ask the Sexpert: What’s the risk for herpes with oral sex?

Dear Shanna,

I have recently become sexually active with someone with HSV2 (herpes simplex virus II). My personal safety protocols call for barriers for penetrative sex, but not necessarily oral sex. How do I come to a realistic understanding of the risk of having unprotected oral sex with someone who is HSV2 positive? Would requiring a barrier in this situation be seen as a form of discrimination against those who disclose their HSV2 status if I don’t normally require one?

Unsure About Safety in Parker

Dear Unsure About Safety,

For a while, herpes simplex I and herpes simplex II were designated as oral herpes (cold sores) and genital herpes (respectively), because they were originally found in their respective areas. However, with the increase of oral sex without the use of barrier methods (condoms and dams), the two types of HSV have become much more interchangeable, and so are now referred to by their numbers rather than where they show up. So herpes of both types are found both in the oral/mouth area and in the genital area.

If it were me, I’d personally choose to use barrier methods with anyone who had not been tested recently, because many people who have herpes or other STIs (sexually transmitted infections) are unaware that they even have them, and 70 to 80 percent of sexually active Americans have an STI at some point in their life time. Just running the numbers, you’re likely to have a partner who has an STI, even if they don’t know it yet. Once you know what type of STI(s) you’re dealing with, you can then make educated decisions based on the info. Some, like gonorrhea, can be cleared up with antibiotics, so you’d just need to use a barrier until their next test comes back negative. Others, like herpes, have a much higher transmission rate when sores are present; many people who have either HSV I or HSV II are sexually active without barriers when they aren’t flaring, and do not infect their partners – that risk assessment is up to you.

As a side note, it shouldn’t really matter if they are positive for something as much as where it is located. They might have HSV II, but only on their genitals, so oral sex  on you might not be as high of a risk as something else. However, if they have a history of cold sores, regardless of whether it is HSV I or II, there is a higher risk for transmission during kissing or oral sex. While it is easy for me to say just use a barrier, it sounds like you need to figure out where your comfort level is with potential risks, and make your decisions based on that.

Best of luck!