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Herpes simplex virus type 2 (HSV-2) is a type of herpes virus. Transmission through oral sex alone is rare, though it is possible to acquire the virus through sexual contact.

HSV-2 causes lesions, such as sores and blisters, to form on the skin. The virus is transmissible through skin-to-skin contact, and transmission can occur even when a person does not have any visible lesions.

This type of infectious agent is the main cause of genital herpes, according to the World Health Organization (WHO).

Although it is rare that HSV-2 spreads through oral sex, the virus can be transmissible through the genital-oral route. People with compromised immune systems have a higher risk of contracting the virus.

This article will explain how HSV transmits from one person to another. It will also suggest some steps a person can take to reduce the risk of transmission.

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It is rare for HSV-2 to transmit through oral sex.

HSV-2 generally passes between hosts through vaginal or anal intercourse. It is less common for this infectious agent to transmit through oral sex.

Herpes simplex virus type 1 (HSV-1) is a different form of herpes that spreads more commonly through oral sexual contact than HSV-2, according to a 2019 review of studies.

HSV-2 is transmissible when areas of skin with the virus come into contact with mucous membranes. These are moist linings in certain parts of the body, including the vagina, anus, and mouth.

Because the mouth is an area lined with mucous membranes, HSV-2 can still spread through oral sex.

If the genital area of a person with HSV-2 makes physical contact with the mucous membranes in another person’s mouth, the virus may enter the nervous system and lead to oral herpes.

Similarly, HSV-2 can pass from the mouth of a person who carries it to the genital area of another person as a result of giving oral sex.

Some people have a higher risk than others of acquiring HSV-2 through oral sex, including:

  • people with compromised immune systems, such as those who have HIV
  • individuals receiving chemotherapy treatment
  • people taking immunosuppressant medications after an organ transplant
  • those with autoimmune conditions, such as lupus

Skin-to-skin contact is necessary for the transmission of HSV-2. It is not possible to acquire the virus from coming into contact with semen, touching toilet seats or other objects, or using hot tubs.

HSV-2 passes from one person to another when areas of skin containing the virus come into contact with mucous membranes in or open areas on the skin of people who do not have it.

When the infectious agent is active, it travels to the mucous membranes or parts of the skin that already contain the virus and replicates itself. This process is known as shedding.

Shedding can cause sores and lesions in the area that has the infection. The virus transmits to others more easily after shedding.

The virus will eventually move through the nerves from the skin to the sacral ganglia, which is an area near the base of the spine. Here, it will remain dormant until it eventually reactivates.

Symptoms are not always noticeable even when the virus is active, and HSV-2 is still transmissible when no symptoms are showing.

Oral herpes, also known as cold sores or fever blisters, occurs due to HSV-1. Over half of all adults in the United States have oral herpes, according to the American Sexual Health Association (ASHA).

Genital herpes, on the other hand, tends to be a more direct result of HSV-2 transmission. In the U.S., the ASHA estimate that 1 in every 8 people aged 14–49 years have HSV-2.

The majority of people who test positive for an HSV-2 infection are unaware that they carry it for the following reasons:

  • They do not display any symptoms.
  • Their symptoms are mild.
  • Doctors have linked the symptoms to a different health problem.

Both HSV-1 and HSV-2 can have effects in either the oral or genital regions. However, having one type of HSV does not mean that an individual will acquire the other.

HSV-1 and HSV-2 are genetically similar, so the immune system of a person with herpes will produce antibodies to fight one infectious agent and potentially reduce the risk of contracting the other.

Nonetheless, it is possible to have both types of HSV at the same time.

Learn more about herpes here.

HSV-1 and HSV-2 pass from person to person in different ways.

HSV-1 causes oral herpes. It is usually transmissible through kissing or the sharing of drinks and utensils.

Most people with HSV-1 acquired it during childhood through nonsexual contact and by kissing family members and friends.

Less commonly, HSV-1 may transmit to the mucous membranes of the genital area through mouth-to-genital contact during oral sex.

Learn more about the link between kissing and herpes here.

The symptoms of HSV-1 and HSV-2 are similar.

People with the virus may display no symptoms or very mild symptoms, or they may mistake their symptoms for those of a different illness. However, the virus remains transmissible, even if the symptoms are not obvious.

Once transmission occurs, any initial symptoms will usually appear within 2 weeks of exposure, according to the ASHA. This is known as the primary outbreak. It may be more severe and last longer than future outbreaks.

However, symptoms may take several days, weeks, or months to develop after a person acquires the infectious agent.

People who do display symptoms may experience:

  • an itching, tingling, or burning sensation around the lips and mouth or genitals
  • painful sores
  • irritated skin
  • small blisters that ooze or bleed

Learn more about how to recognize herpes symptoms here.

There is currently no cure for either HSV-1 or HSV-2. Therefore, it is important to reduce the risk of transmission.

Several precautions can help prevent the spread of HSV, including:

  • Using barrier contraception during all sexual activity: Condoms and dental dams are available for purchase in pharmacies and online.
  • Getting regular sexually transmitted infection tests: It is important to make sure that any sexual partners also receive frequent testing.
  • Limiting the number of sexual partners: If an individual limits their number of sexual partners, it reduces the risk of skin-to-skin contact with a person who has acquired an HSV infection.
  • Avoiding sexual activity during outbreaks: If a person notices any symptoms of an outbreak, such as visible lesions in the affected area, they should avoid sexual contact.
  • Taking medication: A person can talk to their healthcare provider about whether or not a daily anti-herpes medication is right for them.

Looking for physical symptoms of herpes infections is not always effective. HSV-1 and HSV-2 can pass from person to person even when there are no symptoms present.

Also, using a condom or dental dam does not guarantee prevention, as a barrier cannot cover all areas that herpes can use to pass from the skin to a mucous membrane.

Both HSV-1 and HSV-2 are mainly transmissible through anal and vaginal sex. Although HSV-2 can sometimes pass from person to person through oral sex, this is rare.

Even when a person does not observe any active symptoms, it is still possible for HSV to pass from one person to another.

There is currently no cure available for HSV, so it is best to take preventive measures against transmission, such as using barrier contraception and possibly taking regular medication.

Although the symptoms can be painful and uncomfortable and precautions are necessary to prevent transmission, it is possible to live a full, sexually active life with HSV.

Any person who suspects that they have contracted HSV2 should speak to a doctor. They can advise people who have acquired HSV on strategies to manage the virus, ways to reduce the frequency and severity of outbreaks, and methods for preventing further transmission.