Cullins explains that the first, or initial, outbreak is usually the worst, and “over time when you have recurrent episodes, you may not have systemic symptoms” or frequent symptoms. But everyone’s body and immune system reacts to the virus differently; while some people may never have many outbreaks, other people may be more chronically symptomatic. The National Institutes of Health indicate that infrequent outbreaks, around one or two per year, are not uncommon.

With the first outbreak of herpes virus infection, an individual may also experience nonspecific flu-like symptoms like fever, swollen lymph nodes, headache, and muscle aches. It is also possible to have herpes virus infection without having any symptoms or signs, or having signs and symptoms that are so mild that the infection is mistaken for another condition.


Antibodies that develop following an initial infection with a type of HSV prevents reinfection with the same virus type—a person with a history of orofacial infection caused by HSV-1 cannot contract herpes whitlow or a genital infection caused by HSV-1.[citation needed] In a monogamous couple, a seronegative female runs a greater than 30% per year risk of contracting an HSV infection from a seropositive male partner.[37] If an oral HSV-1 infection is contracted first, seroconversion will have occurred after 6 weeks to provide protective antibodies against a future genital HSV-1 infection.[citation needed] Herpes simplex is a double-stranded DNA virus.[38]
A scary finding is that more cases of genital herpes than ever before are now being caused by HSV-1 (the type most people assume only causes mouth sores), and about 85 percent of people with genital herpes don’t even know it. (7) Studies show that about 50 percent of the new genital herpes infections in young adults are due to HSV-1 and about 40 percent in older adults. The fact that most people don’t ever find out they’re infected is one of the reasons that transmission rates are steadily climbing.
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Herpes type 2 is one of two types of HSV (Herpes Simplex Virus). The virus is also known as HSV-2 and differs slightly from HSV-1. It is also called genital herpes or herpes genitalis, which is considered a harmless viral infection. Herpes genitalis is usually considered a sexually transmitted disease. However, it is not listed among notifiable diseases regulated under the Public Health Act.
Diagnosing herpes is made much easier if you present to your clinician at the time that the rash is present and if possible, we can take a sample from that to be sent for Herpes PCR (Polymerase Chain Reaction) studies to confirm the diagnosis. Advanced medical investigative techniques such as this will allow us to differentiate type one from type two herpes regardless of the nature and distribution of the rash.
I am looking at this at a totally different angle. Are you 100% sure you saw on paper his negative test results for HSV1 and 2? I am going to speculate here. What if this guy has it and knows he gave it to you since you had lumps and will play the card that you gave it to him when he gets his next outbreak? Just seems kind of odd for someone to take off a condom when you're screaming STD's at him. Something just isn't right and you know what Judge Judy says about things that don't sound right. I would ask your boyfriend for the written results of his HSV tests first and go from there.
When herpes flares up again, it is called a "recurrence" or "outbreak." Herpes does not always recur, and if it does recur, the timing and severity are different from person to person. Some people rarely have recurrences. Others have them often. Herpes is most likely to recur in the first year after infection. Recurrences may be more frequent for people with weakened immune systems.

The most common reason that people develop cold sores on their mouths is due to becoming infected with HSV-1. (4) HSV-1 usually causes cold sore breakouts around the lips or mouth, or what some people describe as “fever blisters.” Someone can become infected with HSV-1 starting as a child, and then the virus can lay dormant in the body until the immune system is weakened, at which point symptoms can surface.


Herpes infection can cause sores or breaks in the skin or lining of the mouth, vagina, and rectum. This provides a way for HIV to enter the body. Even without visible sores, having genital herpes increases the number of CD4 cells (the cells that HIV targets for entry into the body) found in the lining of the genitals. When a person has both HIV and genital herpes, the chances are higher that HIV will be spread to an HIV-uninfected sex partner during sexual contact with their partner’s mouth, vagina, or rectum.
The HSV viruses multiply in the human cell by overtaking and utilizing most of the human cells functions. One of the HSV steps in multiplication is to take control of the human cell's nucleus and alter its structure. The altered nucleus (enlarged and lobulated or multinucleated) is what actually is used to help diagnose herpes simplex infections by microscopic examination. The reason sores appear is because as they mature the many HSV particles rupture the human cell's membrane as they break out of the cell.
The risk of transmission from mother to baby is highest if the mother becomes infected around the time of delivery (30% to 60%),[54][55] since insufficient time will have occurred for the generation and transfer of protective maternal antibodies before the birth of the child. In contrast, the risk falls to 3% if the infection is recurrent,[56] and is 1–3% if the woman is seropositive for both HSV-1 and HSV-2,[56][57] and is less than 1% if no lesions are visible.[56] Women seropositive for only one type of HSV are only half as likely to transmit HSV as infected seronegative mothers. To prevent neonatal infections, seronegative women are recommended to avoid unprotected oral-genital contact with an HSV-1-seropositive partner and conventional sex with a partner having a genital infection during the last trimester of pregnancy. Mothers infected with HSV are advised to avoid procedures that would cause trauma to the infant during birth (e.g. fetal scalp electrodes, forceps, and vacuum extractors) and, should lesions be present, to elect caesarean section to reduce exposure of the child to infected secretions in the birth canal.[14] The use of antiviral treatments, such as aciclovir, given from the 36th week of pregnancy, limits HSV recurrence and shedding during childbirth, thereby reducing the need for caesarean section.[14]
Condoms offer moderate protection against HSV-2 in both men and women, with consistent condom users having a 30%-lower risk of HSV-2 acquisition compared with those who never use condoms.[49] A female condom can provide greater protection than the male condom, as it covers the labia.[50] The virus cannot pass through a synthetic condom, but a male condom's effectiveness is limited[51] because herpes ulcers may appear on areas not covered by it. Neither type of condom prevents contact with the scrotum, anus, buttocks, or upper thighs, areas that may come in contact with ulcers or genital secretions during sexual activity. Protection against herpes simplex depends on the site of the ulcer; therefore, if ulcers appear on areas not covered by condoms, abstaining from sexual activity until the ulcers are fully healed is one way to limit risk of transmission.[52] The risk is not eliminated, however, as viral shedding capable of transmitting infection may still occur while the infected partner is asymptomatic.[53] The use of condoms or dental dams also limits the transmission of herpes from the genitals of one partner to the mouth of the other (or vice versa) during oral sex. When one partner has a herpes simplex infection and the other does not, the use of antiviral medication, such as valaciclovir, in conjunction with a condom, further decreases the chances of transmission to the uninfected partner.[14] Topical microbicides that contain chemicals that directly inactivate the virus and block viral entry are being investigated.[14]

To reduce the chance of acquiring HSV-1, avoid touching saliva, skin, or mucous membranes of people who have HSV-1 lesions. Prevention of genital HSV may be accomplished by latex condoms, but protection is never 100%. Spermicides do not protect against HSV. Some clinicians recommend using dental dams (small latex squares) during oral sex, but like condoms, they are not 100% protective.
If you are pregnant and have genital herpes, it is very important for you to go to prenatal care visits. Tell your doctor if you have ever had symptoms of, or have been diagnosed with, genital herpes. Also tell your doctor if you have ever been exposed to genital herpes. There is some research that suggests that genital herpes infection may lead to miscarriage, or could make it more likely for you to deliver your baby too early.
Avoid touching any sores you have. If you do, wash your hands with soap and water. You should avoid sex while you have sores, and use a male or female condom or dental dam with your partner if sex occurs despite intentions to not have sex. Herpes is most contagious during an outbreak, but it’s also possible to spread herpes when no symptoms are present.
Because the herpes virus is so common most people who have either genital or oral herpes do not know that they have it.   Additionally, the symptoms of HSV1 or 2 may be mild or at time, may not appear for days, weeks, or even years and sometimes no symptoms of herpes are present at all.  It is important to note that symptoms do not have to be present in order to contract this virus, so it is important that you prevent transmission through proper hygiene and awareness.
The risk of transmission from mother to baby is highest if the mother becomes infected around the time of delivery (30% to 60%),[54][55] since insufficient time will have occurred for the generation and transfer of protective maternal antibodies before the birth of the child. In contrast, the risk falls to 3% if the infection is recurrent,[56] and is 1–3% if the woman is seropositive for both HSV-1 and HSV-2,[56][57] and is less than 1% if no lesions are visible.[56] Women seropositive for only one type of HSV are only half as likely to transmit HSV as infected seronegative mothers. To prevent neonatal infections, seronegative women are recommended to avoid unprotected oral-genital contact with an HSV-1-seropositive partner and conventional sex with a partner having a genital infection during the last trimester of pregnancy. Mothers infected with HSV are advised to avoid procedures that would cause trauma to the infant during birth (e.g. fetal scalp electrodes, forceps, and vacuum extractors) and, should lesions be present, to elect caesarean section to reduce exposure of the child to infected secretions in the birth canal.[14] The use of antiviral treatments, such as aciclovir, given from the 36th week of pregnancy, limits HSV recurrence and shedding during childbirth, thereby reducing the need for caesarean section.[14]
The causes of reactivation are uncertain, but several potential triggers have been documented. A 2009 study showed the protein VP16 plays a key role in reactivation of the dormant virus.[71] Changes in the immune system during menstruation may play a role in HSV-1 reactivation.[72][73] Concurrent infections, such as viral upper respiratory tract infection or other febrile diseases, can cause outbreaks. Reactivation due to other infections is the likely source of the historic terms 'cold sore' and 'fever blister'.
STI and sexual health expert Michael Asher (who is also CEO at Better2know, the company behind the STI testing for E4's The Sex Clinic) explains what we all should know about oral herpes. He says, "With 3.7 billion people under the age of 50 being infected with HSV1, it is incredibly common and just a single exposure to the virus can lead to infection."
According to a study in the New England Journal of Medicine, more than 30% of pregnant women in the United States have genital HSV. During pregnancy, people are immunocompromised so that their body doesn’t fight the fetus as a foreign invader. And when a person’s immune system is weakened, they are more likely to have herpes outbreaks. According to Cullins, “Pregnancy is the time period when [a provider] really wants to know whether or not the person has had herpes in the past,” so they can protect the pregnant person and their infant from a herpes infection.
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