“My New Love Interest Has Herpes. What Do I Do?!”

By Kendra Holliday | September 22, 2014

Dear Kendra,

I’m about to start a relationship and the woman told me she has genital herpes. I like her, but sex is a really important part of a relationship to me and I’m not sure how to safely deal with this. I want to do the right thing by both of us and I just don’t know how to proceed. I’m also worried that this will make me more timid when/if we do have sex, which would not be as much fun for me.

My reply:

My friend had this posted as her status update on facebook the other day:

“When I was in 2nd grade we were given an assignment to write about the three things we feared most. I chose 1) killer bees 2) Russia 3) herpes.”

Good news for those who haven’t been properly educated since the 2nd grade – herpes is not as big a deal as you think. Here, a man who has herpes tells his story:

“I’ve had herpes for 35-plus years. It’s been an occasional complication when dating, but rarely a deal breaker. I can only remember one woman deciding not to have sex after I told her about the herpes. It did take my now-fiancée a number of months, a lot of research and an evaluation of the risks to decide to have protected sex.

I’ve (almost) always told potential lovers about the herpes *before* sex. That’s just plain respectful and ethical. It’s best to have the discussion before you start seriously thinking about ripping each other’s clothes off. I’m not proud of the few times I was not honest and ethical. Liquor and lust are not acceptable excuses.

A surprising number of times the woman (including my to-be/now-ex wife) has said ‘Oh. I have herpes too.’

Blood tests show that around 16% of the U.S. population has herpes. Of those, only around 20% are aware that they have it; the other 80% have no symptoms or symptoms so mild that they don’t recognize them. Infection rates are higher for women (nearly 21%) than men (11.5%). (Source: CDC)

(If one person knows that they have herpes and the other person believes that they don’t, that person might want to get tested. Maybe he/she already unknowingly has herpes.)

More to the point, non-monogamous people should include testing for herpes in their periodic STI tests. People entering into a monogamous relationship should include testing for herpes in their STI tests.

I got herpes from a woman who insisted that she didn’t have it. Thirty five years ago there weren’t the blood tests that showed most people with herpes are asymptomatic.

More recent research has also shown that there can be viral shedding – and transmission – even when there aren’t any signs of an outbreak. Shedding can occur from tiny skin lesions on the genitals and around the anus. Condoms aren’t complete protection against transmitting/catching herpes, but they do reduce the amount of exposed skin.

I did give one long-term (15 years) partner herpes even though we used condoms.

There is a drug called Valacyclovir which can be used with herpes. You can take it when an outbreak occurs to shorten the duration of an outbreak or take it every day to reduce the numbers of outbreaks. I take it every day and I haven’t had an outbreak for (I’m guessing) at least 10 years. The drug recently became available in generic form and the cost is now very reasonable. As noted above, however, you can still shed the virus even without having symptoms of an outbreak.

A study in 2002 followed 1494 monogamous, heterosexual couples, one of whom had herpes, for 8 months. In half the couples the person with herpes took Valacyclovir daily and the others received a placebo. The couples were repeatedly counseled on avoiding sex during outbreaks and on the full-time use of condoms, but adherence to this counseling was not tracked. The results of the study were that 3.8% of the partners of placebo recipients developed herpes (1.5% of them without symptoms) vs. 1.9% of partners of people taking Valacyclovir (1.4% of them without symptoms).

Using Valacyclovir and condoms together reduces the chances of transmitting herpes, but there is no absolute protection.

All of these are even more reasons to use safer sex practices until all members of a given sexual network have been tested for STI’s including herpes.

As far as diseases go, herpes definitely falls in the ‘annoyance’ category. There don’t appear to be any other health effects beyond the outbreaks and the social stigma.”

And now, let’s hear from a woman dating a man who has herpes:

“I have been involved with my significant other for more than two years. We are both sexually active together and with other people and have a very open, loving, hot and sexy relationship. He has herpes and I do not.

He had not mentioned in advance that he had herpes, that is, before it was clear we were headed towards definite sex. I understand why. It is something that you don’t really need to talk about unless you are going to have sex with someone. It was the first time that we connected sexually and we were kissing and definitely headed in the direction of intercourse… that freight train that can’t be stopped kind of moment…. but he stopped.

He said, ‘I need to have a serious conversation with you before we go any further.’ He told me he had genital herpes, for how long, what the risks were and that we could wait and I could go and investigate it myself if I needed to before we took that next step. I ended up asking him questions that night and chose to take the risk. I am glad that I did… and I did not hold back or express any timidness once I made up my mind. I then went home and researched the hell out of it.

The reality of genital herpes is that if you have had more than four sex partners, you have likely already had sex with someone who has the virus… they may just not have known or they may have failed to tell you. 1 in 4 American women and 1 in 5 American men have them… and that is just the genital kind (H2). Something that a lot of people don’t know is that herpes 1 (H1), the kind people get around their mouths from kissing their mother, can also be passed to the genitals, so you can get H1 on you genitals and H2 on your mouth.

What has helped me accept it and not hold back at all with my partner is this…. in the end, it is simply a skin condition. It is a skin condition that some people never even get an outbreak from. My boyfriend gets one outbreak a year. And, all that means is that we don’t have sex for that week. There are no other health consequences. Yes, it is contagious at times when you don’t have a breakout, but if you partner is on suppression meds (like Valtrex) the percentage rate of passing the virus goes down to like 3% a year with a regular sex partner.

I have accepted that I may get it and I am OK with that. I get tested about three times a year. We have had sex with four other women together… and he has been with at least a few separate from me… and none of them said ‘No, I don’t want to have sex with you because you have herpes.’ He just tells them the truth, confidently and calmly and lets them make their own decision. He lets them know it is a matter of their own health and is their choice to make, and let’s them know in a sexy way that if they don’t want to have sex because of that, they can do other things that can be just as fun. 😉

Having herpes does not mean never having another sex partner, like some people might think… I have proof. ;P

Also, I take Valtrex myself as a precaution. Many doctors believe that preemptive use may further help lower the chances of catching it with a regular partner. It is expensive without insurance though ($400 a month), but your insurance should cover it as a preventative treatment. When I bring up getting tested for it, most doctors, even when I am in for an STD screening, almost laugh that I want to get tested. In their medical opinion, it carries such little risk. They have often tried to talk me out of being tested since I have never had an outbreak. In my opinion, it is a vanity STD. It is mainly the shame factor that bothers people about getting it… and the fear of having to talk to a potential partner about it.

One more thing. If someone has H1, their chances of getting H2 are much lower. Not sure by how much, but that is another factor. If you have ever had a cold sore, your chances are diminished of getting genital herpes.

I don’t hold back at all with my man. I enjoy every minute I am with him. If you are into this girl and chose to take that next step, don’t second guess yourself. Lose yourself in it. There is absolutely no reason to be timid.’

Comments

laloca 2011-11-10 08:03:37

HSV-1 may confer a protective effect against HSV-2, but how much has never been conclusively demonstrated in clinical studies. a 2005 literature review in the BMJ actually found an increased risk of HSV-2 among those infected with HSV-1 in european populations, although that may be due to confounding factors. (http://sti.bmj.com/content/81/2/103.abstract) 2008 guidelines released by canada’s OB-GYN society also note that prior infection with HSV-1 may reduce the signs and symptoms of HSV-2 infection at a new mucosal site, but it doesn’t confer full protection against infection. (http://www.sogc.org/guidelines/documents/gui207CPG0804.pdf) indeed, in a quick literature search, i couldn’t find a single published article that would estimate the level of protection HSV-1 might offer against HSV-2.

the other thing to note is that herpes isn’t “simply a skin condition” – at least, it shouldn’t be considered as such by women who plan to get pregnant. the herpes simplex virus is the most common cause of acute life-threatening neonatal encephalitis (the clinical summary on medlink is unfortunately impossible to link to, but a good resource). with drug therapy, the risk is greatly reduced, but if you don’t know your status, you wouldn’t know to be on preventive therapy during delivery. also, contracting genital HSV during pregnancy increases the risk of herpes simplex encephalitis to 40%. (http://emedicine.medscape.com/article/1165183-overview#a0101)

Reply

    Kendra 2011-11-11 07:04:05

    Thank you for clarifying and supplying more info!

    Reply

Oroboros 2011-11-10 08:17:44

Thanks for posting this. There’s a kind of feedback loop at work here, where the stigma causes people to hide their infection in shame. That reinforces the stigma and ultimately causes herpes to spread more widely than it would if everyone was willing to disclose their status.

A significant percentage of people who contract genital herpes consider suicide as a result of their infection. Google finds more than 3 million results for “+herpes + suicide”. I can’t recall the exact statistic but it’s something like 30% of people who report having contemplated killing themselves over this “vanity STD” (I like that portrayal, btw).

For me, a big turning point in my angst was reading a column by Midori entitled “How Herpes Saved My Life”: http://carnalnation.com/content/34509/736/how-herpes-saved-my-life

I’m out about my infection. I “Liked” this post here on Facebook. It’s the only way I know of shedding the stigma (no pun intended).

Reply

    Kendra 2011-11-11 07:05:34

    Midori is coming to St Louis next week! See her at Shameless Grounds Thursday!

    Reply

Carrie Oakie 2011-11-10 09:36:58

As was mentioned above, herpes is not just a skin condition, to think so could be harmful. There are several strains to each herpes virus, which for women can lead to cervical cancer in extreme cases, skin outbreaks in milder ones. I’ve had a few abnormal pap smears that showed signs of HPV strains & resulted in further testing, an uncomfortable colposcopy. Everything came back clear, & my doctor explained how common it is in women & that while women can be tested for HPV relatively easily, aside from an outbreak, there are no tests for men that are as clear. I was also told the same applies for herpes. Many people have no idea they’re carriers & are spreading even when there is no outbreak, a common misconception. Were I faced with a partner with an STD, I’d need to have a lot of trust in him to proceed.

Reply

    Pippi 2011-11-10 12:45:51

    This is part of the stigma and confusion. HPV is not the same thing as Herpes. Both can cause genital warts, but both might not as well. You are absolutely right that there are risks with HPV regarding cervical cancer.

    Your comments and understanding of HPV and Herpes are unfortunately adding to the confusion. HPV can be a temporary condition. You body *could* fight it off. With Herpes, that is not the case. Still, there are less medical risks with Herpes (obviously that is my opinion and understanding…. and I am certainly not a doctor).

    Reply

      laloca 2011-11-10 13:05:11

      while HSV and HPV are not the same virus, HSV has also been linked to cervical cancer.

      the notion (put forth in the article above) that HSV is “just a skin condition” or a “vanity” disease is, IMO, just rose-colored glasses. while it is possible to minimize the impact that HSV has on one’s life, the disease can have real repercussions beyond just skin outbreaks that people should be aware of before knowingly exposing themselves to it.

      Reply

bob 2011-11-10 09:45:47

No judgement on either man or woman. Those are your choices. I didn’t grow up back then. I am in my mid 20’s and I have gotten tested after every partner I have had. Its for my own piece of mind. Yea, I guess you can be fine with it and tell people, but I wouldn’t want to put myself in that situation either.
I disagree that its a vanity disease. Have you seen some of the pictures? Maybe I am vain, but if I caught an STD that was incurable, I would logically believe that the best thing for me to do is to never have sex again, unless it was with another infected person of the same disease. Because even if you had kids, they might get it. And face the difficulties of it. And unless you plan on staying monogamous the rest of your life with one person, you are just spreading a virus around irresponsibly.
Also, being educated is a choice. I decided to remember the things I was taught and keep testing in mind all the time.

Reply

DaddyFr0gg 2011-11-10 09:57:29

There are a couple things to know regarding testing for HSV-1 and HSV-2 that your contributors touched on.

1- You can’t just go in to a random clinic and ask for full STD testing and expect to find out your HSV status. Many places do not consider herpes important enough to include in their STD testing. You’ll need to ask the place you go to (clinic or regular doctor) whether the testing will include HSV-1 and HSV-2.

2- Even if the place you go includes HSV testing, you cannot rely on them telling you the results. You will likely need to call and specifically ask, especially if the test comes back positive for HSV-1. Again, because many doctors don’t consider it an important infection, many places will not notify you of a positive HSV-1 outcome.

Reply

    Kendra 2011-11-11 07:13:36

    Good point. I went to http://www.anylabtestnow.com/ and got a blood test for herpes. It cost $50 and I got the results back the next day. Honestly I was surprised I tested negative.

    Reply

CWD 2011-11-11 01:59:19

Good follow-up from laloca about the risks from Herpes in pregnancy.

There is lots of good information at Herpes.Org.

The retail price (without insurance) of generic Valacyclovir at Costco is $61/month (not the $400 cited by one of the contributors). This lower price might lead more people to take the drug on a daily basis to suppress outbreaks.

I’m not sure about Valacyclovir providing protection to a non-infected person. I couldn’t find anything using Google. Does anybody have any references or citations? Valacyclovir works by blocking a step in the replication of the virus, but the virus has to already be inside a cell in order to replicate. Maybe Valacyclovir keeps the virus from spreading beyond the one or two cells where it first gets a foothold.

Reply

Kendra 2011-11-11 07:11:20

Whew there are a lot of statistics and facts being thrown around here! Please keep in mind that for this Q&A, I wanted to feature real people living with the virus, not disease specialists, so keep doing your research. Thank you for all the helpful comments!

Another update someone just shared with me: “The retail price (without insurance) of generic Valacyclovir at Costco is $61/month (not the $400 cited by your other contributor). This lower price might lead more people to take the drug on a daily basis to suppress outbreaks.”

Reply

Maureen 2011-11-14 10:45:12

I don’t know much about statistics, but there are times I feel it has completely ruined my life.

I have not known a single day of my life without herpes. I was born with it, passed down from my mother during childbirth. Growing up, I didn’t have many friends because their parents were all afraid of their kids catching it. My outbreaks couldn’t be nice and confine themselves to my genitals. They had to rear their ugly heads on my hand and my arm, so it was obvious and hard to ignore. My mother did the best she could with coverings, long sleeve shirts and informing my friends’ parents. But no one wanted their kids to play with the herpes kid.

I don’t know if they had anti-virals in the 90s for preventative purposes, but I sure wish I was on them. The summer of my 7th grade year, the herpes manifested in my left eye causing major inflammation, retinal detachment and the eventual loss of the eye completely.

Herpes was always something I was very ashamed of, even at that age. I wasn’t stupid. I knew it was the reason Mary and Susan’s mom wouldn’t let me play at their house, or that David wasn’t allowed to come over and build forts anymore.

I wish I wasn’t. I wish my mother educated me on the virus. I wish my mother wasn’t as ashamed of it as I was. I wish she had educated herself on it so I knew better how to deal with it.

Twenty years of the occasional outbreak (once every 2 years or so), I didn’t count it as a big deal. Until two Julys ago… it manifested in my right eye. I was so scared. I didn’t want to go blind. Thankfully I have had a team of incredibly understanding doctors who are brilliant at their jobs, save all the eyesight they could. I’m not blind, I can see well enough to legally and comfortably drive. But, it never escapes me that I was so close to having herpes rob me of my sight completely. And I am religious about taking my anti-virals twice a day as ordered.

Socially – I’ve only told one of my husbands. I’m ashamed I didn’t tell my first. I was young, and it was still something I needed to hide in order to feel loved and accepted. My second husband, I told. He shrugged and said “Okay, doesn’t change anything but thanks for telling me.”

It has stopped me from enjoying intimate companionship because of the “what if they don’t like me anymore”. The fear of relationships in general because of it, unfortunately all the educating I’ve done for myself has not helped my fear any.

I hope to one day be as strong as those in the article. YOu give me hope and a glimmer of strength.

Reply

    Kendra 2011-11-22 21:56:21

    Dear Maureen, I’m sorry for the delay responding to this powerful comment you left – we had some technical difficulties with the comments during a website upgrade.

    I so appreciate you sharing your story – your situation sounds like an extreme case. Is what happened to you common? How did your mom get herpes? How did she feel regarding unintentionally giving it to you?

    The husband that you told – how could he react in such a nonchalant way after seeing how devastating it was for you? Did he end up getting it from you? If so, how did it affect him?

    I hope featuring this topic helps everyone gain a better understanding of the virus and clear up some unnecessary stigma. Please everyone, do your research and practice safer sex!

    Reply

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