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:  Not entirely.

Condoms are really effective for preventing most STDs. Unfortunately they can only reduce the risk of herpes, not prevent it. 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 the spread of herpes.

That said, condoms do offer a significant benefit. One large study published in 2012 found that there was a 3.6 percent  increase in the odds of getting herpes every time someone had unprotected sex! In contrast, having protected sex didn't increase the odds of getting herpes at all.  

That's why condoms should unquestionably be a part of your arsenal in protecting yourself from a herpes genital infection. 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. Still, that doesn't mean the reduction in the risk of herpes transmission is insignificant. A different 2009 meta-analysis looked at six pre-existing studies that all peripherally addressed the question of how condoms affect herpes transmission. What did it find? Consistent condom users saw a 30 percent reduction in their risk of getting herpes from their partners.

Consistent is the operative word. Condom use had to be a regular practice 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.

You also need to use them correctly. 

Interestingly, in the context of vaginal intercourse, condoms appear to be more effective at protecting women from herpes than men. This shouldn't be surprising. During vaginal sex with a condom, the woman has much less contact with potentially infectious male skin than a man does with potentially infectious female skin. 

Other Ways To Protect Yourself Against Herpes

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. Suppressive therapy can 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. However many people shed herpes virus even when they've never had noticeable symptoms.Therefore, you should not rely on the presence or absence of symptoms to decide on whether you want to use condoms. 

The bottom line is that no matter what 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. Remember,  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. It's thought that the majority of these transmissions probably happened during receptive oral sex.  HSV-1 used to be thought of primarily as the cold sore, or oral herpes virus, but no longer. Now it's the main cause of genital herpes in some countries.

 

Sources:

Magaret AS, Mujugira A, Hughes JP, Lingappa J, Bukusi EA, DeBruyn G, Delany-Moretlwe S, Fife KH, Gray GE, Kapiga S, Karita E, Mugo NR, Rees H, Ronald A, Vwalika B, Were E, Celum C, Wald A; Partners in Prevention HSV/HIV Transmission Study Team.. Effect of Condom Use on Per-act HSV-2 Transmission Risk in HIV-1, HSV-2-discordant Couples. Clin Infect Dis. 2016 Feb 15;62(4):456-61.
doi: 10.1093/cid/civ908.

Martin ET, Krantz E, Gottlieb SL, Magaret AS, Langenberg A, Stanberry L, Kamb M, Wald A. A pooled analysis of the effect of condoms in preventing HSV-2 acquisition. Arch Intern Med. 2009 Jul 13;169(13):1233-40. doi: 10.1001/archinternmed.2009.177.

Stanaway JD, Wald A, Martin ET, Gottlieb SL, Magaret AS. Case-crossover analysis of condom use and herpes simplex virus type 2 acquisition. Sex Transm Dis. 2012 May;39(5):388-93. doi: 10.1097/OLQ.0b013e318248aa8a.

Woestenberg PJ, Tjhie JH, de Melker HE, van der Klis FR, van Bergen JE, van der Sande MA, van Benthem BH. Herpes simplex virus type 1 and type 2 in the Netherlands: seroprevalence, risk factors and changes during a 12-year period. BMC Infect Dis. 2016 Aug 2;16:364. doi: 10.1186/s12879-016-1707-8.

 

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