The older you get, the more you learn that certain things that seemed scary and intimidating are just not as big a deal as you’d originally thought. When it comes to sexually transmitted infections — and especially more common ones like herpes (experts say that one in six people are living with genital herpes and one in two people living with oral herpes) — unlearning the stigma and fear-mongering that we’ve carried since our (more likely than not) less-than-stellar sex educations is a long process.
However, it’s also one that will ultimately help us, our partners and our kids develop smarter, more proactive attitudes about living with an STI and make sure they’re educated about what exactly is happening in their bodies. After all, it’s totally possible to have a healthy and fulfilling sex life when you have herpes — you just need to be on the same page with your medical providers and make sure you’re consistently making the right choices for your health.
Since reproductive health telemedicine company Nurx began offering online consultations and prescription delivery for people living with genital herpes or oral herpes in the last week, they report that they’ve already had “several hundred” people reach out for treatment. For members of their team, they believe it represents the clear desire from patients to have access to treatment that respects their privacy and removes shame from the equation. To further help that goal alone, Dr. Julie Graves, a family medicine/public health doctor and Associate Director of Clinical Services at Nurx, shared what she believes are some of the most important things for people to know about herpes in 2020.
Herpes is common, but testing isn’t routine.
“According to the CDC, almost half of Americans have herpes simplex type 1 infection, and one out of every four or five people has herpes simplex type 2,” Dr. Graves tells SheKnows. “Most people get genital herpes from people who are infected but don’t know it — for many people it doesn’t cause symptoms. So the person who knows they have herpes and takes medication to suppress the virus is less likely to transmit it to a partner than someone who has it but doesn’t know it.”
Yet, Dr. Graves notes that, because blood tests that are standard right now aren’t very helpful in determining whether a person can transmit herpes or not, there’s still a bit of extra work put in to diagnosing and treating herpes.
“Testing for herpes is not routine, because the blood tests we have now aren’t good at determining if someone can transmit it or not. The best way to be sure is to have a culture or PCR (polymerase chain reaction) test done with a medical provider — a swab of one of the blisters,” she says. “This is frustrating for people who get blood tests, urine tests and swabs for other STIs; they want to know if they were tested for herpes. Unfortunately, there isn’t a good test for that unless the person is having an active outbreak. We need more research to get a better test developed.”
It’s always good to be prepared.
Dr. Graves says that, regardless of the frequency of your break outs and the status of your partners, it never hurts to keep medication at the ready.
“People who break out rarely and aren’t having sex with people who don’t have herpes can have medication on hand so they can start taking it right away— it’s best right when they feel that they are breaking out,” she says. “People who break out frequently or who have a partner who doesn’t have herpes often take the medication daily. This can reduce the risk of transmitting the virus as well as reduce or eliminate outbreaks.”
Herpes stigma wasn’t always such A Thing.
One thing that Dr. Graves adds is that we haven’t always had such a harsh cultural reaction to herpes — that energy came a bit more recently.
“Back before Time Magazine did a cover story on herpes in the late 1970’s, we didn’t think of it as an STI. We thought of it as a normal thing — fever blisters, we often called it — and it wasn’t a big deal. Because most everyone had a cold sore now and then. But then, acyclovir came out and the [pharmaceutical] companies wanted to make a lot of money, so they started advertising it,” Dr. Graves says. “Because of misogyny, they made it this big dramatic thing and the ads mostly were about how women wouldn’t want to transmit it to partners. So it became stigmatized.”
While, yes, we’ve definitely made progress in treating the infection and in unlearning the shame, she says there’s still a ways to go: “It’s way better now because there is suppressive medication and also people point out misogyny and shaming people for normal sexual behavior,” she says. “But still, we all need to be less judgmental about it.”