Do Condoms Prevent Herpes?

Why Condoms Don't Always Protect Against Herpes

Woman holding condom
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Question: Do Condoms Prevent Herpes?

Answer:  Condoms are really effective for preventing most STDs, but unfortunately they can only reduce the risk of herpes. Unlike many other sexually transmitted diseases, herpes spreads by skin-to-skin contact instead of through bodily fluids. Since condoms don't cover all potentially infectious skin, they can not completely stop herpes spread.

Still, condoms should unquestionably be a part of your arsenal in protecting yourself from a herpes genital infection.

Although the amount of protection from simply using a condom will be less than for a disease like HIV, that can be completely prevented by blocking secretions, that doesn't mean the reduction in the risk of herpes transmission is insignificant. A 2009 meta-analysis of six pre-existing studies -- that all peripherally addressed the question of how condoms affect herpes transmission -- found that consistent condom users saw a 30 percent reduction in their risk of getting herpes from their partners. However, condom use has to be consistent to get that much risk reduction. The study also found that every unprotected sex act increased the risk of herpes transmission. In other words, if you want to effectively use condoms to protect your partner, or yourself, from herpes, you need to use them every time you have sex... and you need to use them correctly. 

There are other ways of reducing the risk of herpes transmission.

One very useful tool is to have the infected partner investigate the use of suppressive therapy to reduce both symptoms and the amount of viral shedding. This can be quite helpful, particularly in combination with reliable condom use. Another important way to reduce risk is to avoid having sex during or right before an outbreak when prodromal symptoms are present.

These are the times when the highest quantity of virus is usually present, although many people shed herpes virus even when they've never had noticeable symptoms.

The bottom line, however, is that what every other risk reduction techniques you try, condoms can play an important role in reducing the spread of the herpes virus. For maximum benefit, you should use them or other barriers every time you have sex since herpes can be spread even when a person has no symptoms. Barriers should also be used for oral sex since genital herpes can be spread to the mouth and cold sores can also infect the genitals. In fact, scientists have discovered that a growing percentage of genital herpes cases are caused by HSV-1, the virus that used to primarily be associated with oral herpes, or cold sores. It's thought that the majority of these transmissions probably happened during receptive oral sex. 

Sources:

Martin, E.T. et al (2009) "A Pooled Analysis of the Effect of Condoms in Preventing HSV-2 Acquisition" Arch Intern Med. 169(13):1233-1240

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