Can You Transmit Herpes Without Active Sores?
Yes, you can absolutely transmit herpes to your partner even when you have no visible sores—this is called asymptomatic viral shedding, and it accounts for most herpes transmissions. 1
Understanding Asymptomatic Transmission
Sexual transmission of HSV occurs during asymptomatic periods when no lesions are present. 1 This is a critical concept that many people with herpes don't understand:
- Most transmissions to sexual partners occur during asymptomatic viral shedding, not during visible outbreaks 2
- The virus can be present on genital mucosa even when you feel completely normal and have no symptoms 2
- Studies using sensitive PCR testing show viral shedding occurs on approximately 28% of days in infected individuals, even without any visible lesions 2
- HSV-2 sheds asymptomatically more frequently than HSV-1, particularly in the first 12 months after infection 1
Risk Reduction Strategies
Because transmission occurs without symptoms, you must use preventive strategies at all times, not just during outbreaks:
Suppressive Antiviral Therapy
- Daily suppressive therapy with valacyclovir 500 mg once daily reduces HSV-2 transmission to uninfected heterosexual partners by 48-50% 1, 3
- This works by suppressing viral shedding, the mechanism through which asymptomatic transmission occurs 1
- Suppressive therapy should be considered for anyone in a serodiscordant relationship (where one partner has herpes and the other doesn't) 1, 3
Barrier Protection
- Consistent use of latex condoms reduces HSV-2 acquisition and should be used for all sexual contact with uninfected or new partners 1, 3
- Condoms provide partial but not complete protection since herpes can be transmitted from areas not covered by condoms 3
Avoiding Contact During Outbreaks
- You must avoid all sexual contact when lesions or prodromal symptoms (tingling, itching, burning) are present 1, 4
- However, this alone is insufficient since most transmission occurs during asymptomatic periods 1, 2
Partner Communication and Testing
Your sexual partners should be informed of your herpes status and offered type-specific serologic testing to determine if they are already infected or at risk 1, 3:
- Type-specific HSV-2 antibody testing can determine whether your partner is already infected (and therefore not at risk of acquisition from you) 1, 3
- Disclosure of HSV-2 status in heterosexual discordant couples has been associated with reduced transmission risk 1, 3
- Partners should understand they might become infected even if they never develop symptoms themselves 4
Critical Counseling Points
Herpes is not curable, and you remain infectious for life, even between outbreaks 4, 5:
- Genital herpes is frequently transmitted through asymptomatic viral shedding 4
- Safer sex practices must be used in combination with suppressive therapy—neither alone is 100% protective 4
- The combination of daily suppressive antivirals plus consistent condom use provides the best protection for uninfected partners 1, 3, 6
Common Pitfall to Avoid
The most dangerous misconception is believing you're only contagious when you have visible sores. This false sense of security leads to most transmissions. You must assume you are potentially infectious at any time and use protective measures consistently 1, 2.