Over the years, we’ve talked to thousands of people about herpes, both through our previous phone lines and email service and now through ours Ask the experts program. We probably answer more questions and address more concerns about herpes than any other STD.
Why the great interest? First, while herpes can be treated, it cannot be cured, so people naturally have questions about managing symptoms, reducing the chance of passing the infection to sexual partners, and managing herpes in relationships. But perhaps a bigger challenge is the stigma associated with herpes—TV shows, movies, and society as a whole create and perpetuate fear and shame around herpes and treat the infection and people living with herpes as a joke. This unnecessary and harmful stigma makes dealing with a very manageable infection that much more difficult.
What we try to do when we answer questions is counter the stigma and misinformation with facts that help people better understand this very common infection and how to treat it. Here are five key facts to get you started:
1. Herpes is common. Very common.
According to the World Health Organizationabout 3.7 billion people (that’s billions, with a si) under 50 years of age (67%) worldwide have herpes simplex virus type 1 (HSV-1) infection. HSV-1 is the main cause of oral herpes infection, but HSV-1 is also an increasing cause of genital herpes. HSV-2 mainly causes genital herpes, and approximately 491 million people aged 15–49 years (13%) worldwide have herpes simplex virus type 2 (HSV-2) infection.
In the US, the Centers for Disease Control and Prevention estimates that about 12% of people aged 14-49 (about 1 in 8) have genital HSV-2 infection. This does not include people who have genital herpes caused by HSV-1, so the actual number is higher.
If these facts seem surprising to you, it may be because many people with herpes are unaware of the infection. Studies have shown that about 85-90% of people diagnosed had no idea they had an infection. This is because many people have no symptoms or have symptoms so mild that they don’t notice or mistake them for something else (like an ingrown hair or a basic pimple). There are people who have a different experience with herpes, but we will talk more about this below.
2. Any skin-to-skin contact can spread herpes
Unlike other STDs that are spread through bodily fluids, herpes is spread through direct skin-to-skin contact, such as kissing, oral, anal, and vaginal sex, and genital rubbing. This can happen when a person has a wound or damage to the genitals, but it is also possible even when there are no obvious symptoms. There are ways to prevent transmission of the virus during intimate contact.
To be extra careful, it’s a good idea not to share towels and sex toys that come into direct contact with the skin of the anus and genitals where there are sores, even though this would be an unlikely way to spread the virus. Transmission through other inanimate objects such as a utensil or razor is also highly unlikely, but it may be best not to share lipstick or lip gloss.
3. Herpes can be transmitted even when there are no symptoms
As mentioned above, herpes (both oral and genital) can spread even when there are no symptoms or sores. This is called an asymptomatic miscarriage. There is a treatment option, referred to as suppressive antiviral therapy, that can significantly reduce asymptomatic shedding (and outbreaks). Valacyclovir taken daily can reduce the chance of passing herpes to a partner by up to 50%. Using condoms can also help, although herpes can be present on skin not covered by the condom.
4. Herpes is manageable
This is an important message—for most people, herpes is a very manageable skin condition. As mentioned above, most people with herpes, both oral and genital, have no idea they have it. Imagine a person who has a single sore as a child or teenager and then never has another—that’s an HSV-1 infection that caused an outbreak and was never thought of again. This person has herpes but probably doesn’t know it as they never show any signs or symptoms. The same can happen with genital herpes, either HSV-1 or HSV-2.
There are other people who will have regular breakouts – commonly referred to as relapses – and experience painful symptoms. Everyone’s experience with herpes is not the same. For those with more frequent symptoms, there are treatment and self-care options, both to help manage symptoms and reduce the number of relapses.
5. Herpes doesn’t have to stand in the way of relationships
This is also a very important message – people with herpes have very normal romantic and sexual relationships. After a diagnosis, a person may feel like their life may never be the same again, but we’ve heard countless stories and even research in the past that shows these feelings diminish over time. Again, everyone is different. Some people find herpes to be nothing more than an occasional minor inconvenience and have partners who feel the same way. Others find it more difficult to manage symptoms or negative reactions from partners and potential partners. It can be helpful to explore online communities and support groups to talk to other people who have been there and share their experiences—with therapy, relationships, and more.
