- Who is more likely to have genital herpes (HSV-2)?
A. Teens in High School
B. Professionals in their 30’s and 40’s
C. Grandparents in Assisted Living Facilities
If you said, C – You’re right. By the time a person has lived 70 or more years, they’ve had lots more opportunities to be exposed to this virus. There’s plenty of research that shows that about 35 -50% of folks in this age group have the antibody to genital herpes (HSV-2).
If you said B – Then guess what, you won’t be surprised that about 1 in 5 (20-25%) of people who live in the suburbs, have jobs, have health insurance, and pay taxes have herpes. And here’s the thing, 80% are unaware that they have the virus, because they have few, if any, symptoms. Now that many of us know more about Covid-19 and how it’s often transmitted by people who are asymptomatic, it’s not that hard to understand that herpes, another virus, is also transmitted when someone does NOT have symptoms.
If you said A – then, no. But what is true, is that in this group, and with kids in college, there is something else going on. They are more likely to have HSV 1 transmitted to their genitals via oral sex. Here’s how that works:
- If you know you have oral herpes (HSV–1) from symptoms or from a blood test, then you CAN’T also get HSV–1 on your genitals from oral sex with another person, because you already have the antibody to HSV-1 in your body.
- However, you if you don’t have the antibody to HSV–1, and are receiving oral sex from someone who has oral herpes, even if they have no symptoms, then you can become infected.
- And remember, regardless of whether you have HSV–1 or not, you’re still at risk for acquiring genital herpes (HSV–2) on your genitals from partners who have it. This is why testing for herpes is a good idea before you become intimate with someone.
And also, if you are someone who has genital herpes, it’s normal to feel like you’re alone and that somehow this is a reflection on you as a person. The reason I’m providing this information is because you are not alone. And, plenty of people have been exposed to this virus, it doesn’t define who you are and it’s certainly a viral infection we can treat.
2. True or False: Most people get herpes from sex.
False: Did you know that 60-80% of the world’s population has oral herpes, also known as herpes simplex virus or HSV-1? It is…
- acquired from non-sexual contact with family members.
- the cause of those tell-tale cold sores on the mouth, nose and lips.
- also transmitted to the genitals. There are estimates that 1/3 of genital herpes is caused by HSV-1.
3. True or False: I would know if I had genital herpes, it’s obvious.
False: Not all people who have genital herpes will have overwhelming, obvious outbreaks with pain, burning with urination, feeling achy, and cold sores. Many people just have a slight irritation that goes away in a few days and they forget about it. For many people, the first outbreak is the worst. When genital herpes is caused by HSV-2 the average number of recurrences is 6 times/year. If genital herpes is caused by HSV-1, then recurrences may occur once every 5-10 years. Here’s more information about testing for herpes https://www.nursebarb.com/testing-herpes/
4. You’ve just found out you have herpes, what do you do next?
A. Call your current partner and scream at them.
B. Do some detective work to pin point who, what, when, and why.
C. Stop and breathe.
D. Have a fight, flight, or freeze reaction.
Answer: C. Before you go into a dark place of blame and shame, stop and breathe. Many times, the first time you notice a herpes lesion it is NOT a sign of new infection. (See question 3 above)
Often it is a recurrence. How would you know if it’s new or a recurrence? If there are visible or active symptoms, such as sores, blisters, small bumps, crusted over lesions, or small tears in the skin, then a healthcare provider can do a swab of the area and send it out for a PCR (Polymerase Chain Reaction) evaluation.
This is the most accurate way to test the lesion because it looks for the viral DNA, which is present in the skin even a few days after symptoms appear.
A new herpes infection will be:
PCR positive & Antibody negative.
A recurrence of herpes will be:
PCR positive & Antibody positive.
5. True or False: Emotional Stress and lack of sleep can trigger a herpes outbreak.
True: Other triggers include:
- Sexual intercourse – Friction causes irritation
- Menstrual periods – It’s the hormones
- Body Trauma – injury, illness, surgery
- Low immunity – HIV, diabetes, and chemotherapy
- Sunlight exposure – Lots of exposure to UV rays can stimulate an outbreak of both oral and genital herpes.
What is surprising to many people is that even when their bodies are covered, let’s say, while skiing on a sunny day, having lots of UV exposure just on their faces, can spark an outbreak of herpes in the genitals.
6. True or False: Condoms completely prevent the transmission of herpes.
False: This is a trick question. Condoms do a great job at reducing the risk of transmission, but they are not 100% protective, and here’s why. Condoms cover a portion of the genitals, but can’t cover the entire “boxer short area” that is any part of the body that could be covered by a pair of boxer shorts, both front and back, even buttocks and thighs and even areas where you don’t get outbreaks. This boxer short area can shed the virus without symptoms, which is known as asymptomatic transmission.
In fact, that’s why we think that this is why there is so much transmission. People don’t know they have the virus; they have no symptoms, they are asymptomatic, and then unwittingly pass it on through contact with another person. A person does not have to have intercourse to acquire herpes. That said, condoms are still the smart choice to prevent all Sexually Transmitted Infections (STIs) and lower the risk of herpes infection.
7. True or False: Taking Lysine will prevent herpes outbreaks.
Trick question! Just because there are no studies showing that Lysine works, doesn’t mean that taking it doesn’t reduce some people’s stress and their outbreaks. If it works for you, then it works. I have many patients who swear by Lysine and others who use a daily antiviral medication, acyclovir or valacyclovir, or a combination to prevent outbreaks.
8. Who is more likely to get herpes, men or women?
Answer: Women. We know that women are 6 to 7 times more likely than men to become infected with herpes. A report from the World Health Organization estimates that 28% of women will be infected with herpes by age 50. The percentages are higher if you live in certain areas of the world. Yes, this is true, which is why condoms just might be a girl’s best friend. They aren’t 100% protective but do offer an added layer of protection. More here on why women are more susceptible to herpes.
9. True or False: There are no medications that can slow the transmission of herpes.
False: Taking daily anti-viral medications, such as Valacyclovir, Acyclovir or Famciclovir, was shown in a study to reduce transmission by 75%. Read here about my patients Brittany and Matt, a couple in their late 20s, who came to my office for information about how to prevent Matt from passing herpes on to Brittany. So far so good!
So, how did you do on the quiz? My bet is that those of you living with active herpes did pretty well, and would advise others that the more you know, the better.