Question:

“A lady whom I really care for just told me that she has herpes. I am on the verge of asking her to be my girlfriend. I feel so scared but I do think she is special. What would you advise me to do?”

My Answer:

She does sound like a special person! She is being vulnerable, would rather risk losing you than hide her herpes diagnosis from you. It must have taken her courage to be honest and disclose having herpes to you, and risk being rejected. Regardless of the way she revealed her health condition, this must have come as a shock to you.

According to Centers for Disease Control and Prevention in the United States, genital herpes infection is common and it is estimated that 776,000 people in the United States get new herpes infections annually. Due to the lack of sexuality education in Singapore, many people in remain ignorant as to what herpes is. And if they learn about herpes, they are scared and know not what to do. Herpes is not a death sentence and often more of an inconvenience than anything.

What is Herpes?

Herpes is caused by the herpes simplex virus type 1 (HSV1) or herpes simplex virus type 2 (HSV2). Genital herpes can be caused by either virus, while oral herpes is more commonly caused by HSV1.

How to tell if you have Herpes?

Most people with herpes are unaware they have it and have no noticeable signs or symptoms. In the United States, an estimated 87.4% of 14 – 49-year olds infected with HSV-2 have never received a clinical diagnosis.

For those with outbreaks during the initial episode, there may be:

• Pain at the site of the sore(s)
• Painful urination
• Vaginal discharge
• Swollen glands
• Fever
• Body aches
• Rash

Typically, subsequent episodes will almost always be less severe and shorter in duration. Early warning signs of repeated genital herpes outbreaks experience may include:

• Fever
• Tingling at the sight of outbreak
• Itching
• Pain, burning, or pressure at the site of original infection

How to know if you have Herpes?

If blisters are present, a health-care provider can diagnose HSV1 & HSV2 by sight, but clinical diagnosis should be confirmed by a laboratory blood test.

How can herpes be prevented?

Correct and consistent use of latex condoms can reduce the risk of transmitting or acquiring genital herpes because herpes virus shedding can occur in areas that are not covered by a condom.

Persons with herpes should abstain from sexual activity with partners when herpes lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms, he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected and they should use condoms to reduce the risk. Sex partners can seek testing to determine if they are infected with HSV.

Daily treatment with valacyclovir decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences.

In Conclusion

Ethically I cannot tell you what to do with your life.  I am confident that you would have done internet research and reading about herpes, with much of the information reflected below. Yet nowhere have I found the risks of infection as well documented as on this website (H)Opportunities. Do check out the downloadable PDF “Herpes disclosure cheat sheet” from this link https://herpeslife.com/resources/. According to this fact sheet, it states that the unprotected transmission rate is 4% for herpes female to non-herpes male assuming there is no sex during active outbreaks, not on daily antiviral medication, and no regular use of condoms. Simply put, there is a 4% risk of getting herpes if she is not having an outbreak – even without condom use.

Daily suppressive therapy of antiviral medication would reduce transmission rates by 48%, while condoms would reduce transmission rates by another 30 – 50%. Awareness of prodrome (going to have outbreak) helps to protect transmission as sex can be avoided during such sensations. Essentially what this means is that the risk of transmission with some preventive measure can be negligible. You decide if the risk is worth giving up a promising relationship with a wonderful person.

By the way, you may wish to watch this TEDx talk about herpes stigma https://elladawson.com/herpes/

Jenelle Marie Davis of The STD Project

STI project and has herpes herself. She is very aware of the issue of stigma. Here is an interview with her:

References

Genital Herpes – CDC Fact Sheet (Detailed), Centers for Disease Control and Prevention https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm?fref=gc&dti=1581193582125758  (accessed 10 Oct 2017)

Herpes – A Very Common STD Caused by HSV1/HSV2, The STD Project https://www.thestdproject.com/herpes-very-common-std-caused-by-hsv1-hsv2/  (accessed 10 Oct 2017)

What’s the risk?, (H)Opportunity, https://herpeslife.com/resources/ (accessed 10 Oct 2017)

McGowan, E. (2020, February 7). What You Should Know Before Telling A New Partner You Have Herpes. Retrieved from https://www.bustle.com/p/do-you-need-to-tell-a-new-partner-you-have-herpes-experts-explain-21780017

Depasse, E. L., & Depasse, E. L. (2020, February 11). ‘When I Was Diagnosed With Herpes, I Thought My Life Was Over. But It’s Given Me Purpose And Direction In My Career.’. Retrieved from https://www.womenshealthmag.com/health/a30753236/living-with-herpes-emily-l-depasse/

About Dr. Martha Tara Lee

Surrounded by friends who were sexually inhibited and struck by dire lack of positive conversations around sex and sexuality in Singapore, Dr. Martha Tara Lee set out to make a positive difference in embarking on her doctorate in human sexuality before launching Eros Coaching in 2009. Today, she remains dedicated to working with individuals and couples who wish to lead self-actualised and pleasure-filled lives.