At some point after the first drink but before you get naked — whether there’s two hours or two months in between — newly dating couples should discuss their history of sexually transmitted infections (STIs). It may seem awkward to discuss that chlamydia infection you had in college and downright scary to tell your partner about your most recent trip to the doctor, but honesty is the best policy and keeping each other safe should be top priority.
A herpes diagnosis may be one of the most difficult to share because the virus never goes away and symptoms can reappear at any point. There is unfortunately a lot of fear and shame surrounding herpes.
While we can appreciate the initial shock of being diagnosed with any long-term health issue, we want everyone to understand that having herpes is not the end of the world or even the end of your sex life.
Moreover, finding out that your partner has herpes does not have to be the end of your relationship.
We think some basic information can go a long way in quelling some of the alarm people frequently have about what, exactly, it means to be with someone who has herpes.
It is estimated that one out of every eight adults in the United States has the HSV-2 serotype (which primarily — but not exclusively — results in genital herpes), and an even greater number of adults and teens — about 50 percent — have the HSV-1 serotype (which primarily — but not exclusively — results in oral herpes).
There are actually eight identified herpes viruses — two of them are known to infect the genitals, while the others cause common illnesses like chickenpox and shingles. HSV-1 and HSV-2 are spread when cells from infected skin come in contact with either broken skin (like a cut or a sore) or mucous membranes such as the lips or genitals.
HSV-1 primarily causes oral herpes — sores on the lips or in the mouth. We sometimes call these cold sores or fever blisters. This virus is so widespread because lots of people come in contact with it in non-sexual situations, like receiving a kiss from a family member or even sharing a drinking glass with someone with the infection.
In fact, it’s so common and so easy to spread, odds are someone close to you has it — and when it’s spread through non-sexual situations, we don’t think this kind of herpes should be considered a sexually transmitted infection at all.
While HSV-1 can cause genital herpes if transmitted during oral sex, most cases of genital herpes are caused by HSV-2.
If your partner reveals a new or existing diagnosis, being sympathetic and understanding may make or break the situation. Keeping in mind how difficult it may be for them to cope with the news, or how much courage it probably took to tell you in the first place, can’t be understated.
Luckily, there are ways to console them.
You might want to share the good news that while outbreaks can be painful, it’s rare for an adult to have any long-term health issues because of herpes infections.
But it’s important to note that it could be dangerous if you get a herpes infection while you’re pregnant — it could cause you to have a miscarriage or you could even pass it onto your baby, causing serious problems. So be sure to talk to your doctor if your partner has genital herpes and you're pregnant or thinking about getting pregnant.
It’s also worth noting that genital herpes outbreaks — especially the first one — can be very uncomfortable. Some people who get herpes might show no symptoms. Others will exhibit mild symptoms like small sores that they mistake for a pimple or bug bite, or a burning sensation when they pee that they mostly ignore.
The less lucky ones, however, will get the classic fluid-filled blister or clusters of blisters on their genitals or around the anus. Herpes outbreaks can also occur on the inner thighs or buttocks. The blisters usually break, leaving open sores that are painful (especially during urination) and may be slow to heal.
The first time a person has a herpes outbreak, they may also feel like they have the flu with fever, body aches and swollen glands. Some people may only ever get one outbreak of herpes, but others can get multiple recurrences, especially when they are already run down or stressed out.
Either way, being understanding and compassionate toward your partner is essential.
When a new partner tells you that they have herpes before you’ve ever had sex, it can be surprising. But in an established relationship, a diagnosis of herpes often leads to accusations of cheating or infidelity.
However, it’s important to understand that it may take years for herpes symptoms to present themselves. It is easiest to diagnose herpes during an outbreak when a health care provider can look at the sores and take swabs directly from them.
If someone has never had an outbreak or had an outbreak too mild to notice, it is possible that they didn’t even know they have the virus. A blood test can also tell you if you have herpes, but it can’t tell you when you were infected or by whom.
So, unless you both professed to being virgins who had never so much as kissed someone else (remember HSV-1 can be passed mouth to mouth through kissing and then passed to that person’s or another partner’s genitals through oral sex), a herpes diagnosis does not mean that anyone is cheating or lying — react accordingly.
A herpes diagnosis is particularly shocking because the virus stays in your body and outbreaks can recur for the rest of your life. Unfortunately, there is currently no cure. However, there are medications that can help prevent outbreaks (suppressive therapy) or lessen the symptoms and shorten the duration if an outbreak does occur (episodic therapy).
Currently, the FDA has approved three drugs for the either suppressive or episodic treatment of herpes — Acyclovir (also sold under the brand names Sitavig® and Zovirax®), Valacyclovir (also sold under the brand name Valtrex®) and Famciclovir (formerly sold under the brand name Famvir®).
For individuals who have frequent recurrences, studies have shown that suppressive therapy can reduce the number of outbreaks by 70 to 80 percent.
If you are interested in how one of these medications could help your partner, talk to a healthcare provider to see if one of these is an option.
Part of the panic involved in finding out a partner or potential partner has herpes revolves around your own safety, which is entirely understandable. No one wants an incurable life-long viral infection, or the painful outbreaks that go with it.
Choosing to start or continue a relationship with a partner who has herpes, however, does not mean resigning yourself to getting it. There are many things you and your partner can do to lower the risk of transmission.
First and foremost, you should avoid sex during outbreaks. People who have recurrent herpes outbreaks often experience something called a prodrome — a group of early symptoms that can signal an outbreak is imminent.
For herpes, these include itching, burning or even tingling in the area where the virus first entered the body. This often happens in the days or hours before an outbreak. There is a higher risk of transmission during this time. Once your partner becomes aware of what these sensations feel like, avoid skin-to-skin contact ASAP.
The truth is that herpes can be transmitted when there are no symptoms present — a term called “viral shedding.” Since herpes can spread even with no symptoms present, the safest course of action with someone you know has the virus is to use condoms when you have sex in between outbreaks.
Latex condoms reduce the risk of transmitting herpes when the sores are in areas covered by the condom, but sores can occur in places like the scrotum that are not covered by a condom.
In addition, research has shown that suppressive therapy — taking an antiviral medication daily — can reduce the risk of spreading the virus to a partner. Your partner should talk to their health care provider about strategies for managing both their symptoms and the risks to you.
If you’re an adult on the dating scene in any major city, suburban area or even tiny town in this country, you probably have already gone out with someone with herpes. We say that because it’s so common and since so many of the people who are infected don’t know it, your odds of being exposed to it — statistically, at least — are decently high.
So, what should you do if your dream date stops mid-kiss to tell you he’s had herpes for a few years now, or your girlfriend comes back from the gynecologist with some bad news?
The same thing that you would do if you find out they voted for the other candidate, chew with their mouth open, steal the covers or never wash the dishes. Decide whether this is something you can live with.
Whatever you decide, however, be kind. Too often people are stigmatized for having herpes and made to feel embarrassed or ashamed. Herpes is not a scarlet letter or punishment for bad behavior. It’s just a very common virus.