This week, I will be inaugurating a new tradition: the first ever STI Spotlight column! On weeks when topics seem evasive, I’ll write an in-depth piece about a sexually transmitted infection to do my part to educate the public about the not-so-fun side effects of unprotected sex between all combinations of genitals. We’ll discuss common misconceptions, symptoms and signs, treatment and risks. This week, I’ll start with the basic herpes simplex virus, the classic “gift that keeps on giving.”
First, let’s dispel the myth that there is a clear distinction between oral and genital herpes. In fact, the same virus, herpes simplex, causes both types of outbreaks. The difference lies in the type of virus, one of which (Type One) tends to cause blisters around the mouth while the other (Type Two) tends to prefer the genital region. It’s important to note, however, that both types have the ability to cause either type of sore. What does this mean practically? That it’s probably a good idea to skip the oral-to-genital contact during a cold sore outbreak, not to mention an outbreak of genital blisters. Over half of Americans ages 18-49 have oral herpes simplex, in part because the virus is extremely contagious during outbreaks. The prevalence numbers for genital herpes hover around 20 percent, with the current statistic estimating about one in six sexually active Americans carry the Type Two virus.
Both oral and genital herpes involve fluid-filled, often painful blisters that appear around the mouth, genitals and/or anus. Some outbreaks involve multiple sores, while others may only cause one or two visible lesions. The sores are often mistaken for pimples, bug bites, ingrown hairs or minor skin abrasions. Unlike pimples and bug bites however, sores from the first outbreak can remain open and moist for up to a month before finally scabbing over. The first outbreak begins within a month of initial infection and involves intense flu-like symptoms including nausea, severe head and body aches, fever and chills. When the sores heal, the symptoms will abide and all subsequent outbreaks will be relatively mild, the painful sores being the only true sign of viral activity. With time, even if left untreated, outbreaks will become shorter and less frequent, sometimes recurring only every few years. At present, there is no cure for herpes, but antivirals have been developed to lessen the number of outbreaks and decrease the risk of spreading the virus to others.
So many people have genital herpes that it’s great news that it doesn’t involve any serious complications. The one serious risk of the virus, neonatal herpes, can occur when a pregnant person becomes infected during later stages of pregnancy. If the baby is delivered vaginally, the virus can transfer to the child and lead to serious complications and even the infant’s death. Luckily, those already infected with genital herpes at time of conception pose no real risk of infection to their child, though a medical professional may recommend a Cesarean section if the child is due to be born in the midst of a viral outbreak. The worst thing about herpes, it seems, is that the sores can look and feel pretty gnarly during a viral flare-up. Its serious tendency for contagion is another downer, as you even have to be careful not to touch an unhealed sore before touching your eye, at the risk of accidentally giving yourself ocular herpes. Chapstick, water bottles, cheek kisses and sharing silverware all risk contagion during a flare-up. In fact, perhaps it’s best to quarantine those with cold sores in rooms filled with Abreva (just kidding!).
Let’s talk about how to protect yourself. The fact is, if you’re an adult in the United States that engages in sexual acts of any kind with any gender, there is a pretty good chance you’re going to get infected with a type of herpes. That’s okay! Don’t panic! Herpes is so common it’s hardly considered taboo anymore, especially the run-of-the-mill oral simplex. That being said, there’s a few things you can do to protect yourself from the virus. First, use common sense (a good rule to follow in any sexual encounter!). Don’t have any type of sex with someone who has an open leaking blister on their mouth, anus or genitals. Wait a few days and try again. As I always recommend, use some sort of barrier method for STI protection, be that dental dams or internal or external condoms. Herpes is a tricky one though, as any type of skin-to-skin contact risks contagion, meaning that barriers will only go so far in preventing the virus’s spread. If you or a partner is HIV positive, there is a higher risk of infection during a herpes outbreak because the open sores of the herpes virus are hotspots for other types of contagious diseases. This only underscores the importance of barrier methods for all types of sex, including vaginal, anal and oral.
Most importantly, and the take-home message of all my STI Spotlight columns: Go get tested for STIs regularly! It doesn’t take long, especially if you can get an appointment at Health and Wellness so you can stop by right after class. Most of the time, you’ll walk away from the appointment knowing your results so there’s no waiting anxiety. If you test positive for herpes (or any other STI), please tell all your most recent sexual partners. It might be embarrassing, but it’s the right thing to do for yourself, the other person and any other partners that person may have had. It’ll be your good deed for the day!
Questions? Comments? Insults? Email me at [email protected] but remember that it won’t be anonymous.