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Do Condoms Prevent Herpes? Not Really, But This Does

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Despite sex education and STI awareness, people are still misinformed about condoms and herpes transmission. Do condoms prevent herpes? Herpes is not entirely prevented by condoms, but they slightly reduce the risk — studies say by about 30%.

Do Condoms Prevent Herpes?

Do Condoms Prevent Herpes?

It’s commonly known that condoms reduce the risk of transmission of STIs like HIV by a large margin. This is probably why many people assume the same about condoms for genital herpes. Unfortunately, genital herpes is more tricky. Condoms don’t prevent herpes transmission as well as they prevent other STIs, but studies show they reduce the risk.

People are often reminded that condoms are 99% effective for safe sex. But this is misleading, because condoms achieve this for HIV and hepatitis, but not for herpes (or, for that matter, the human papilloma virus). Order STD testing online here.

Why Don’t Condoms Prevent Herpes?

It’s possible to get herpes with a condom because genital herpes is a viral infection transmitted by skin-to-skin contact. Condoms just don’t necessarily cover all of the skin surface areas that may be affected. For example, the virus can affect areas such as the penile shaft that the condom doesn’t cover, vulva, thighs, buttocks, and other skin around the genitals or anogenital region.

Quick transmission facts:

  • The likelihood of passing genital herpes to a partner is highest during an outbreak (times when a sore is present). (Read the early warning signs of an outbreak.)
  • Skin sheds the virus without an outbreak a significant amount of the time. There will be no visible signs, but a partner can still be exposed to and contract the virus. This is called asymptomatic shedding. One study showed that this can be as frequent as approximately 20% of the time (1). For actual transmission rates during asymptomatic shedding, some sources suggest a 4-10% chance depending on gender of the infected party.

Condoms Reduce Herpes Risk by 30%

Although they aren’t that effective at preventing it, condoms do reduce the risk of contracting or transmitting herpes by about 30%, according to a 2009 study by E. Martin in the Archives of Internal Medicine (2).

“Although the magnitude of the protective effect was not as large as has been observed with other STIs, a 30 percent reduction in HSV-2 incidence can have a substantial benefit for individuals as well as a public health impact at the population level,” writes researcher Emily T. Martin, MPH, PhD, of Children’s Hospital Research Institute and the University of Washington, Seattle in the Archives of Internal Medicine.

The study specifically examined the transmission rates of HSV-2 in more than 5,000 people. It showed that subjects who used condoms 100% of the time had a 30% lower risk of infection. The 30% reduction in transmission rates was reasonably just as true for both male and female partners. So can you get herpes with a condom? Yes, but you’ll fare better than without one.

Valtrex and Condoms Reduce Risk More

A study done by the creators of Valtrex, an antiviral medication for the management of herpes outbreaks and transmission rates, also showed that condom use reduces exposure to the herpes simplex virus (3). According to their study, these are the rates of transmission per year of regular sex:

  • If partners avoid sex during outbreaks: 4% chance transmission from female to male; 8% male to female
  • If partners also use condoms or antiviral medication: 2% female to male; 4% per year male to female
  • If partners also use condoms and antiviral medications: 1% female to male; 2% male to female

CDC Advice for Safe Sex

The CDC website says, “The only way to avoid STDs is to not have vaginal, anal, or oral sex.” They recommend sexually active people do so within a mutually monogamous long-term relationship with a tested partner whose results are clean, and using latex condoms correctly every time.

For those with herpes who don’t want to pass it to their uninfected partners, we would add the following: Ask your doctor about the following tips:

  1. Avoid sex during outbreaks;
  2. Use daily suppressive therapy, i.e. take Valtrex every day as prescribed by a doctor; and
  3. Use condoms.
  4. If trying to get pregnant, you may manage the risk without condoms with the use of prescription antivirals and avoiding outbreaks.

So can you get herpes with a condom? Do condoms prevent herpes? As you can see, they can reduce the risk, but not significantly enough to be relied upon entirely. Know your STD status and that of your partners, and be aware of your body and outbreaks if you do have HSV. Practice the safest sex possible. (Read: Sex with Herpes.)

Sources
  1. Cone RW,  Hobson AC,  Palmer J, Remington M, Corey L. Extended duration of herpes simplex virus DNA in genital lesions by the polymerase chain reaction. J Infect Dis 1991;164:757-60. (Link)
  2. Martin, E. Archives of Internal Medicine, July 13, 2009; vol 169: pp 1233-1240. (Link)
  3. Lawrence Corey, M.D., Anna Wald, M.D., M.P.H., Raj Patel, M.B., Ch.B., Stephen L. Sacks, M.D., Stephen K. Tyring, M.D., Ph.D., Terri Warren, M.S., John M. Douglas, Jr., M.D., Jorma Paavonen, M.D., R. Ashley Morrow, Ph.D., Karl R. Beutner, M.D., Ph.D., Leonid S. Stratchounsky, M.D., Ph.D., Gregory Mertz, M.D., Oliver N. Keene, M.Sc., M.A., Helen A. Watson, M.Sc., Dereck Tait, M.B., Ch.B., and Mauricio Vargas-Cortes, Ph.D. for the Valacyclovir HSV Transmission Study Group. N Engl J Med 2004; 350:11-20. (Link)

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