QUESTION
I want to perform oral sex on my boyfriend but he has genital herpes. He hasn’t had an outbreak in about seven years. I was told that even though he hasn’t had an outbreak for a while, it is still possible to spread it. Is it safe for me to give oral sex to him without a condom? Would it be okay to do with a condom?

ANSWER
Herpes is very common and there is a lot of confusion surrounding its transmission. Though genital herpes is less contagious when there is not an outbreak, there is still a possibility of spreading it even when no sores are present. It is best not to have direct genital to genital or genital to oral sexual contact during an outbreak.

Condoms are very helpful in preventing the spread of STDs during oral sex. They greatly lessen the risk but certainly change the experience for some people. Talking about sex and the type of fun each partner wants to have is important.

In terms of herpes, a regular partner of someone with herpes should learn his or her herpes infection status. That requires what’s called a type-specific blood test available from a doctor, clinic or in San Francisco, STDTest.org. If both partners have the same type of herpes (type 1 or 2), then many would say that condoms are not necessary because both partners are already infected.

If indeed, only one partner is infected, then discussing risk and what type of sex and protection to use is important. Finally, some doctors recommend the use of medications like acyclovir to reduce the risk of the spread of herpes from a regular partner with herpes to one without herpes infection. Being open and honest with your partner is always a good idea.

To your health,
Dr. K