(Previous working title: How to make STI talks sexy. Unfortunately this working title lost its work permit; it just couldn’t be taken seriously.)
Herpes Simplex Virus-1 (HSV-1), Herpes Simplex Virus-2 (HSV-2), the two types of the Herpes virus, are very common viruses and both are transmitted orally and genitally. HSV-1 is known traditionally as oral herpes, but can be transmitted to the genitals by oral contact either through contact with active lesions (painful blisters or sores) or viral shedding. HSV-2 is known as genital herpes and can also be transmitted orally by contact with active lesions or viral shedding. 90% of Americans, ages 14 through 50, are infected with one or both of the viruses. The prevalence rate for HSV-1 ranges from 50-80% and 1 in 5 people have HSV-2. Keep in mind that prevalence rates are not listed for people over 50 and studies show that prevalence rates increase with age.
You may be curious about viral shedding. Viral shedding means that the viruses can both be transmitted even when the virus is not apparent/causing lesions. That is, you may have Herpes and not know it. Viral shedding is highest when someone has a lesion or is recovering from a lesion(s). Shedding, and thus transmission risk, decreases rapidly during the first year after infection. However, HSV shedding still occurs and therefore viral transmission can still occur, particularly because shedding occurs predominantly in the absence of symptoms. To prevent transmission of any type, condoms are needed. Recommendations regarding how to manage Herpes can be found on the CDC website, but in general shedding is highest during the first 7-12 days after the lesions resolve and no symptoms are present.
Put it in the unfair category, but women have a greater risk of getting HSV-2 due to both increased biologic susceptibility and pattern of relationships with older men, who are more likely to be HSV-2 seropositive (the virus is in their system). HSV-2 prevalence in the United States is higher among African-Americans than among whites and Asians. As you can see, there is great disparity in infection rates according to both gender and race.
Like most people, you are probably curious about your HSV status. The problem is that not all healthcare providers test for HSV-1 or HSV-2. This may be fine if you are not in a high risk category, however, if you have a number of sex partners you should assertively request that along with testing for other sexually transmitted infections (STI), you want HSV-1 and HSV-2 testing.
The STI talk with a potential partner is rarely sexy, but if you are in a high risk category you have to consider your HSV status. Although HSV-1 and HSV-2 testing is not recommend if you are low risk and are asymptomatic, you can always request HSV testing; however, recognize that there can be drawbacks to testing. Talk to your healthcare provider.
For tips about having the STI talk, contact Dr. Babin at knowthyselfintimately.com
