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A 20-year-old female asked:

if you only have a herpes outbreak in your anus but never noticed a vaginal outbreak, can you still spread herpes through vaginal sex or just anal?

3 doctor answers4 doctors weighed in
Dr. Steven Hebert
Pathology 29 years experience
Difficult to say: Certainly you could infect someone else if you have an active lesion in either location. Use precautions and tell your partner about the risk of contracting herpes prior to relations.
Dr. Robert Killian
General Practice 28 years experience
I may have different information than Dr. Hebert offered. Here are the facts: one who is infected with herpes can be contagious through viral shedding whether they have a lesion or not. If your anal lesion is truly herpes you cannot get infected or be contagious in another spot.90% of those infected do not have outbreaks and can only know they are infected with a blood test.
Oct 9, 2013
Dr. Robert Killian
General Practice 28 years experience
Herpes: Here are some facts: 90% of those infected with herpes never have an outbreak and only know they have herpes with a blood test. Having a lesion or not does not matter. You should know that you are contagious at unpredictable times through viral shedding whether you have a lesion or not. If your anal lesion is truly herpes then this infection cannot migrate to another spot on your body.
Dr. Robert Killian
General Practice 28 years experience
Provided original answer
In the U.S. 25% of adults have been exposed to Herpes Type Two (genital herpes) and 76% of Adults have been exposed to herpes Type One (oral herpes). If one is exposed to Type Two before type one they can never be infected with Herpes Type One. But, if one has Type one they can still be infected with Herpes Type Two.
Oct 9, 2013
Dr. John Munshower
Family Medicine 30 years experience
HSV-2: Herpes simplex virus-2 (hsv-2) is a virus that can be spread sexually, vaginal or anal sex, or even oral sex. Having the lesion with an outbreak, wold certainly increase the chances, but does not preclude a person contracting the disease if having sex other places than the outbreak.

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Last updated Oct 29, 2013

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