Clearly, it is not inevitable that a person who is sexually active with a partner who has herpes will contract herpes. Some couples have been together for years, and even after years of unprotected sexual contact only one of the partners has herpes. Then there are those who are sexually intimate with a person with herpes just once or only a couple of times and acquire herpes from that contact.
A few truths seem to hold for most people regarding transmission of the herpes viruses. First, a person who has had a past infection with one type of herpes virus will not get reinfected in that area of the body with the same strain of the virus. For example, a person with genital type 2 herpes will not be repeatedly infected with genital type 2 herpes on reexposure. Therefore couples in which both partners are infected with genital type 2 herpes, for example, do not need to worry about transmission to one another. They will not reinfect one another through genital sexual contact. Furthermore, the likelihood of acquiring a new infection with type 2 herpes in another area of the body is low, because the antibody that is produced following the initial infection, which circulates through the body, offers protection at other sites.
People with type 2 herpes will almost never acquire a new type 1 infection, because the antibody to type 2 offers nearly complete protection against a new type 1 infection. Therefore, neither oral nor genital sex for this couple poses a risk of reinfection. Although type 1 herpes offers some protection against acquiring type 2 herpes, the protection is not as complete, and someone with type 1 can acquire a type 2 infection if exposed. However, as discussed later, it is unlikely that a person will acquire type 2 herpes in the same area where he or she has the type 1 infection.
Similarly, two people who are infected with oral type 1 herpes will not reinfect one another through kissing. However, there is a risk that they could infect one another through oral sex, although this risk appears to be low If only one partner has oral HSV-1, then the uninfected partner can more easily acquire genital HSV-1 through oral sex, especially if it is performed while the infected partner has a cold sore.
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