The herpes simplex virus (HSV) is a very common virus that comes in two subcategories: HSV-1 and HSV-2. The first type, HSV-1, causes oral herpes — more commonly known as cold sores — and is carried by 70% to 80% of the US population. People often don’t even know, unless their immune system is weak enough for the virus to trigger a cold sores outbreak. The second herpes variety, HSV-2, is the primary culprit behind genital herpes. It occurs in about 15% of the sexually active population in the US but is mostly asymptomatic, which means there aren’t any visible lesions and blisters. There’s no gender difference; men and women are infected in equal proportions.
However, with a compromised or temporarily weakened immune system, HSV-2 can cause active outbreaks, which will show as small blisters on the vulva or penis. After several days these blisters break open and turn into somewhat painful ulcers. This process can be accompanied by fever, swollen lymph nodes, and other flu-like symptoms. After 3-4 weeks the body regains control over the virus and the lesions start healing. Once you had an active genital herpes outbreak, you can still get outbreaks in the future but they will tend to be much milder and disappear faster.
While both subcategories thus each have their own established turf, they each can cause infections in both areas. This means that someone with cold sores can pass on the virus through oral sex, and vice versa. In fact, over the past three decades, developed countries have seen a steady rise in HSV-1 genital herpes, which may be due to a greater acceptance of oral sex in the population.
Genital herpes is a contagious disease that typically spreads by direct genital or skin contact of infected areas. It thus can happen during all forms of sex, whether oral, vaginal, or anal. Though people with active sores are more contagious, the virus can even be transmitted by asymptomatic carriers. Several studies indicate that the risk of spreading HSV-2 between partners is about 1 in 10 during a typical year.
This risk factor changes depending on the frequency of sex and what protective steps you normally take. For example, if you strictly avoid sex during an active herpes outbreak (genital or oral), the risk will be lower. It also matters for how long the infected partner has had the virus since the latter gets weaker with every year in the body.
So, given that there’s an undeniable risk of contagion but also that this risk can be reduced with the right steps, you owe your partner a frank discussion. If your partner really loves you, he or she won’t leave over something as trivial as herpes. After all, it’s not a harmful disease, you can do a lot to lower the transmission risk, and the outbreaks, if they occur, are treatable.
And there’s absolutely nothing to be embarrassed about. 8 out of every 10 people have a herpes virus in their bodies. So, having herpes reflects neither on your character or lifestyle. In fact, it’s very likely that your partner already has HSV-1 or HSV-2, perhaps even without his or her knowledge. So, once you have told your partner about your own herpes infection, encourage him or her to also get tested for herpes. It’s a simple and reliable test.
Don’t be embarrassed and be frank. Herpes. Of course, make sure you select an appropriate time and location for telling your partner, as this discussion may take a while.
Start with a general discussion of herpes, stressing how common the virus is and that it doesn’t harm the body or kill you. Mention how a healthy immune system will go a long way to protect you from an active herpes outbreak. Then talk about the risks and how to manage them. Then it’s time to talk about your own infection and for how long you had it. Again, this is also a good occasion to suggest your partner getting tested as well.
If you are too afraid of telling your partner on your own, you can take him or her along to see your gynecologist. In such a professional setting, and upon hearing the reassuring arguments from the doctor, your partner may find it easier to accept the news. Your partner also can ask questions right away.
Have a plan ready for how to minimize the virus’ effect on your relationship, including steps you can take to protect against transmission. Discuss these with your partner and, if needed, give your partner a couple of days to think about the issue. He or she will probably come up with some new ideas, too.
There’s always going to be a certain risk, but, together, the two of you can keep it as small as possible. In fact, condoms offer a high degree of protection — not 100% but they essentially halve the transmission risk. So, if the aforementioned 1 out of 10 risk profile applies to your relationship, with persistent use of condoms the risk can be halved to 1 out of 20. To learn more about the herpes virus and to prevent or manage an infection, talk to your usual doctor or an expert for sexually transmitted diseases.