Mark was newly divorced and back on the dating scene when he met a woman, another divorcee, on a dating website. They exchanged flirtatious emails for a week before meeting and sleeping together. During that week, he’d found a playful way to tell her he was STD-free: by sending her a photo of a phone booth in India, where he’d lived, with STD lettering on it (which stood for “subscriber trunk dialing”).
“I have been in an Indian phone booth but I always kept my clothes on [disease free],” wrote Mark, who asked that U.S. News withhold his real name for privacy reasons.
“That is such a cute way to say that to me!” she wrote back. He waited for her own disclosure about her STD status, but it never came. “How about you?” he finally asked. Her response was defensive: “What, do you want my vaccination records?”
Soon after having sex, Mark developed a sore on his lip. His doctor said it looked like herpes and prescribed acyclovir, an antiviral medication. When Mark told his partner, she mentioned her husband had sometimes taken that medication, but she never had to.
“I think she hoped she didn’t have it, but I think she knew she should have told me,” Mark says. When he asked her for more information, she blocked him on Facebook. When blood work revealed Mark did, in fact, have herpes, he says it took him a while to understand what that meant. “It was a month or so before I started reading up on it. [I learned] how it never goes away. How you can never be sure if you are shedding,” he says. “I am shy; never very successful sexually. Now I would have to tell every perspective partner about this. It was daunting.”
Understanding What Herpes Is
For many people, a herpes diagnosis is a big blow, says Dr. David Koelle, a professor in the allergies and infectious disease department at the University of Washington in Seattle. That’s true for two reasons: Herpes can be treated but is incurable, and it’s stigmatized because it’s a sexually transmitted disease.
Elizabeth Boskey, a Boston-based STD expert, tries to calm newly diagnosed people down. “I always start by saying, ‘As horrible as it is, it really isn’t the end of the world,'” she says. For starters, people should understand they’re not alone: 1 in 6 people ages 14 to 49 in the U.S. has genital herpes, or HSV-2, according to the Centers for Disease Control and Prevention, and up to 80 percent have HSV-1, or oral herpes.
Many people with herpes never know it because they don’t have symptoms, Boskey says, unless they get tested. And, for those who do have symptoms, outbreaks become increasingly less frequent and severe over time.
Herpes is a virus, but unlike many viruses — like colds, which the body eventually clears — it lingers in the peripheral nerve system. It gets into the nucleus of the sensory nerves, says Greg Smith, a professor of microbiology and immunology at Northwestern University. “Once you have it in the genetic code, there’s no way to get it out.”
[See: How to Find the Right Mental Health Professional for You.]
Testing for Herpes
A herpes test is typically triggered by symptoms, which can include cold sores for HSV-1 and genital sores for HSV-2. Sometimes itching and pain accompany the sores, Koelle says, adding that some people experience neuralgia, a sharp or burning pain in the nerve endings.
Although the cause of “outbreaks” — when symptoms emerge — is unknown, emotional and physical stress are thought to be a cause, Koelle says. That includes college exam periods.
Unless people have symptoms, doctors are hesitant to test for herpes for two reasons, Boskey says: They worry a diagnosis will cause psychological stress about a condition that might never actually morph into a medical problem for them. And there’s a risk of false positives, especially in populations where herpes is not very prevalent.
Still, some people — without symptoms — simply want to know their herpes status, say if they’re in a serious relationship. “I’ve seen several patients who want to settle down and they say, ‘Please check me for everything,'” Koelle says.
Pregnant women should also get tested, since women with symptoms can pass herpes to an infant during delivery, he adds.
[See: What Only Your Partner Knows About Your Health.]
Living With Herpes
Antiviral medications are the only treatment for herpes (scientists are working on vaccines, namely for pregnant women and children). The drugs are used in two ways, Koelle says: to treat outbreaks or on a daily basis, which is called suppressive therapy and reduces the frequency of recurrences and, thereby, the likelihood of transmitting the disease to others.
Suppressive therapy drugs are about 50 percent effective in preventing disease transmission, Koelle says. “Some people go for it, and other people don’t like the idea of putting something in their body every day.” Since herpes is spread by direct contact with the infected area and not bodily fluids, condoms and dental dams during oral sex can also help reduce transmission, Smith says.
“For most people, the biggest effect [of herpes] is the reaction from other people,” Boskey says. That’s why, when people are diagnosed, they often feel both angry and ashamed. “I always try to tell people to try and resist the urge to blame,” she says. “It is a very rare circumstance that people in [the] general population know who infected them.”
She recommends infected people in new relationships disclose their herpes status as soon as possible. “Ideally, this is a conversation people should have before they have sex,” Boskey says, adding that having it afterwards can have negative repercussions.
“Because I get it on my lips, I feel it is necessary to disclose early — before there is any kissing,” Mark says. “The women I have told have generally been appreciative of my honesty and did not seem to shut down because of it, but it is hard to say.”
[See: 10 Ways to Break a Bad Mood.]
There are dating websites specifically for people with herpes, which can be a non-judgmental and less worrisome refuge, Boskey says, adding that people shouldn’t limit their romantic prospects because of herpes. “If you like someone well enough, herpes is like any other inconvenience, like snoring.”
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Living With a Herpes Diagnosis originally appeared on usnews.com
