A. You say you've tested negative for herpes 1 and 2 antibodies, while your partner has tested positive for the herpes 2 virus, though he has not shown symptoms. I don't find your situation unusual, and it does pose a bit of a conundrum. The reality is that using condoms is the most reliable way to prevent transmission, but in a long-term relationship, I understand that it's not desirable.
I find that the most up-to-date and reliable information regarding herpes (and other sexually transmitted infections) is the Centers for Disease Control and Prevention, which is what I use to counsel patients:
Herpes can be transmitted when lesions are not present.
Anyone with a herpes diagnosis is encouraged to inform current and future intimate partners and to abstain from sex when lesions or their precursor symptoms are present.
Correct and consistent use of latex condoms might reduce the risk of transmission.
"Daily treatment with valacyclovir 500 mg decreases the rate of HSV-2 [herpes simplex virus 2] transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences. Episodic therapy does not reduce the risk for transmission and its use should be discouraged for this purpose among persons whose partners might be at risk for HSV-2 acquisition."
What that last point means is that ongoing daily treatment with a prescription for an antiviral therapy by the affected partner can be effective protection to reduce the chances of transmission; "episodic therapy," meaning the antiviral is taken only in cases of an outbreak of lesions, will not provide that protection.
I hope this is clear. You can have intimacy confidently, and I'm glad you're researching the steps to take.
Barb DePree, MD, has been a gynecologist for 30 years, specializing in menopause care for the past 10. Dr. DePree was named the Certified Menopause Practitioner of the Year in 2013 by the North American Menopause Society. The award particularly recognized the outreach, communication and education she does through MiddlesexMD, a website she founded and where this blog first appeared. She also is director of the Women's Midlife Services at Holland Hospital, Holland, Michigan.