What recommendations can you make to a patient with genital herpes to reduce the risk of transmission to his or her partner?

At the very least, avoidance of sexual contact during clinically apparent disease (i.e., until lesions are completely dry) is advised. In light of the problem with asymptomatic shedding, the safest practice is the routine use of a condom, even between active episodes. The systemic antiviral agents decrease, but do not eliminate asymptomatic shedding. However, in the case of monogamous but discordant (one partner has genital herpes and the other does not) couples, chronic suppressive therapy taken by the infected partner may reduce the likelihood of transmitting the disease to the uninfected partner.

Gupta R, Warren T, Wald A: Genital herpes, Lancet 370:2127–2137, 2007.