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Sexually Transmitted Diseases/How to reduce risk of herpes transmission to boyfriend who had hand eczema


I have had genital herpes for about 38 years.  The outbreaks are now mild, and clear up in 2 to 5 days usually.  I find Lysine tablets to be especially helpful.  I am not on any drugs like Acyclovir.
My boyfriend, who does not have herpes, has severe hand eczema flare-ups at times and I want to be sure we use the best practices possible to keep him from getting herpes.  He also has a highly reactive immune system and has gone into shock a couple of times in his life reacting to allergy triggers, so his system seems very sensitive in general.  I also read about eczema herpeticum which is very concerning.   
We mostly use sex toys, or I perform oral sex on him on his genitals and anus.  I have never had a cold sore on or in my mouth.  He does not perform oral sex on me.  On the rare occasion we have intercourse (vaginal or anal) he uses a condom, and it is never when I have a prodrome, outbreak or am getting over a recent outbreak.
He does not have any type of sex with me when he has a bad flare-up of hand eczema, but the skin on his hands tends to be chapped between attacks anyway, and he may have some fissures around his nails between attacks.
What can he do to make sure the sensitive skin and fissures on his hands are not affected by herpes?  Say, if I am shedding asymptomatically, and he places a sex toy in my vagina or anus and accidentally touches my skin as he does that, how risky would that be? Would it help if he washed his hands shortly afterwards? With just soap? Gloves bother his hands.
Thanks for any insight on this.  The articles I saw that were written by you make good sense to me.

Hello Camry,
Thanks for a thoughtful question. The problem with herpes is that asymptomatic shedding from the skin area infected, can occur a day or so before an actual outbreak. The best thing to do is to make sure that the eczema is effectively treated in your partner. There are lots of treatments available to make sure that eczema goes into remission, but since his immune system is so reactive, I would want to make sure that the right doctor is providing the best treatment. One thing for people with eczema, is to avoid severely strong soaps and other topical chemicals/irritants. The other important thing is to avoid being dried out, and using an effective hand moisturizer. As long as there are no cracks in the skin, virus can't get in to cause infection.

Virus from you in bodily fluids and secretions on sex toys can conceivably get transmitted through cracks and abrasions in the skin cracked and irritated from eczema.

Good luck!

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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