Herpes disclosure

[skeas.livejournal.com]

The recent post about herpes brought up some questions for me.

My question is: Is it always necessary for an infected person to tell a potential partner?

From a theoretical standpoint, YES! Yes, yes, yes! But consider a few scenarios:

You haven't had an outbreak since your first one--15 years ago. As most of us know, herpes is transmittable even when the infected person doesn't have a sore. However, plenty of us infected people just avoid sex/kissing when we have a sore, and the other partner is fine. Do you still let your partner know about an outbreak you had at 20, when you are now 35? Do you risk ruining the whole relationship (because people generally freak out when the word "herpes" in involved) over a nearly negligible risk?

You have oral herpes. Studies show that 80% of us have herpes antibodies, and might be carriers of the disease without even knowing it. Yet I've never, ever heard of someone fessing up before a liplock. Do you let everyone you are about to kiss know that you have oral herpes? I personally feel like everyone is aware of--or should be aware of--a certain risk that's involved with intimate behavior like kissing or sex. You could catch mono, a cold, the flu, herpes, et cetera. You do what you can to prevent it, but it's still there.

For that matter, is there a difference between disclosing about oral herpes (which you can write off under the more innocuous name of cold sores) and genital herpes? Do you have more of a responsibility to tell a partner about genital herpes? And why?

Comments

[beloveddoll.livejournal.com]

I had never even thought of telling someone I kissed that I have had cold sores in the past. I barely think about it until I get that familiar bump and start to panic because it hurts! But, my friend had never had cold sores and when she questioned her then partner about the bump near his lip, he said it was a pimple. Turns out he knew he had a sore and didn't want to tell her! She ended up getting sick and having massive fever sores on her lip and cheek.

Now, I try to think about it at all times when in the realm of lip lockin'. My boyfriend has never had a cold sore...and I had to tell him that I get them sometimes when i get sick. If I had genital herpes, I would most definitely tell my partner.

[laurapalmer813.livejournal.com]

I would tell a potential partner about genital herpes, because I'd rather have that up front. I'd rather have him leave me before we ever got intimate, than leave me after we'd been having sex and I had to fess up because I got an outbreak, because that would be a terrible betrayal of trust.

As for oral, I don't know. I'd probably tell him if I had a cold sore that he should stay away from my mouth. Otherwise I wouldn't unless it came up in conversation. I've never had one, but I think cold sores are the sorts of things that wouldn't always be on my mind.

[skeas.livejournal.com]

I was like you and never thought of telling people I kissed that I had herpes. I mean, I'd had a sore in 8th grade and by the time I was kissing, I was in 12th. I didn't even remember it. About a year into my relationship with my boyfriend, a sore popped up, and my boyfriend was suddenly questioning why I hadn't been forthright with him from the beginning.

[skeas.livejournal.com]

I'm just wondering why not telling a partner about genital herpes would be more of a betrayal of trust than not telling someone about oral herpes. Aren't they (basically) the same disease? Is it because we treat genital herpes like a terrible, incurable disease and minimize oral herpes by calling them "cold sores"?

Should we be perpetuating that? Is genital herpes truly more terrible than oral?

[laurapalmer813.livejournal.com]

Its not that I wouldn't tell - its just that I've never thought of cold sores as a huge deal, so I probably wouldn't think about it until the subject came up. I have no idea how similar they are, because I've never dealt with either one. There is definitely more of a social stigma about having a sore on your vulva than one on your lip though.

[dictionaria.livejournal.com]

Well, I know that there's virtually no chance of contracting oral herpes when no outbreak is present, but I understand that the majority of people who get herpes contract it when their partner has no signs of an outbreak. (70% according to that commercial, which is urged on by profits, but viral shedding is apparently more likely with HSV-2.)

You're more likely to spread HSV-2 when showing no signs: "According to Spruance, people with recurrent oral HSV-1 shed virus in their saliva about 5% of the time even when they show no symptoms. In the first year of infection, people with genital HSV-2 shed virus from the genital area about 6-10% of days when they show no symptoms, and less often over time. (Both of these figures reflect shedding as detected by viral culture.)" (http://www.herpes.com/hsv1-2.html)

That article goes more in depth and covers some more technicalities, but with statistics like that out there, not telling a partner about HSV-2 seems like a bigger deal, while the majority of people have HSV-1 anyway. It's mostly social stigma, though, they say.

[jocelina.livejournal.com]

I think that people tend to view HSV-1 as a less troublesome virus because often people become infected with it when they're fairly young and their bodies have plenty of time to build up an immunity to it, so their outbreaks during adulthood tend to be relatively mild (one or two cold sores) whereas adults who contract HSV-2 can have more severe genital outbreaks, at least at first. Initial outbreaks of HSV-1 can be quite unpleasant too (especially for children, according to this NYT article (http://health.nytimes.com/health/guides/disease/herpes-simplex/symptoms.html)), but since most people who have it likely experienced their first outbreak a very long time ago, they may not take this into account when evaluating the risk of passing it on to a partner.

Interestingly enough, one of the most serious (and fortunately very rare) possible complications of herpes, herpes encephalitis (http://professionals.epilepsy.com/page/viral_herp_enceph.html), is usually caused by HSV-1, at least in adults (in newborns, though, it's generally caused by HSV-2).

I think you're right that our collective perception of HSV-2 is a bit out of whack. I can understand why people wouldn't want to have to deal with having it, of course (I know I would much prefer not to contract either type of HSV), but I think that some of that negative association is based on the social rather than the medical repercussions.

[as-she-melts.livejournal.com]

There is no difference between the two physically, and there shouldn't be a difference socially. I don't believe that stigmatizing a disease is the way to go, but I would much rather have "cold sores" demonized along with genital herpes than continue on with the uneven judgement that currently goes on. Admittedly, this is because I'm still really pissed about having some chick's "cold sores" on my vag after my ex messed around with her.

The terms "cold sore" and "fever blister" infuriate me, and we (as a society, not meant as a dig at anyone on this thread) either need to call oral herpes what it is or come up with some cute little euphemism for the genital herp. I have totally had enough of being judged for something I had no part in--yet doctors/pharmacists/friends/ignorant loud people still assume that everyone with an STD is a slutty slutty slut or otherwise did something to deserve it. The guttoral disgust and automatic judgement of people who have genital herpes comes from sex-shaming anyway--it's for the same reasons that STD/STI-free people are referred to as clean* and it's especially worse for women, who aren't supposed to have a healthy (read: fun and possibly even outside of marriage and not only for procreation) sex life to begin with. The judgement comes from a place of sex-negativity, and does nothing to consider people who were lied to, cheated on, raped, infected by people who didn't know, etc etc etc. Ending those negative attitudes would only serve to increase understanding and knowledge of how disease spreads, why it's not all that different from other diseases, and why it's not acceptable to pass judgement on those who have it. Besides, if a child can get oral herpes from an affectionate relative (and pass it to a partner through oral sex later in life... at which point it becomes... gasp... genital herpes), maybe it's time to reconsider just how "terrible" a disease it really is.

That said, NO, I absolutely do not see a difference in disclosing oral vs. genital herpes. It is the exact same virus, only in a different location. It can easily be passed from one location to the other, through oral sex or even by one individual (i.e. touching oral herpes blister, then masturbating/emptying menstrual cup/whatev).

*I realize that this is not a safe-space friendly term, but I have included it for the sake of illustrating the social stigma of STD/STI infections.

[queensugar.livejournal.com]

I just wanted to pipe up and say I agree with a lot of your frustration and concern here.

I think the social anxiety and stigma surrounding STIs can indeed be all out of proportion to the reality. One could probably write a book on the various reasons why that is... a subconscious desire to judge or "punish" sexual activity, a fear of something that is supposed to be desirable producing undesirable results, etcetera.

For me personally? Over the years, especially thanks to my time on vaginapagina, I've really come to categorize most STIs as being no different than any other bacterial or viral infection. Genital herpes is no more frightening than oral herpes; genital warts are easily treatable and rarely return; HPV itself is usually benign; chlamydia, gonorrhea and syphilis can be easily diagnosed and treated with regular preventative care.

In effect, most STIs are little to no different than plantar warts, the common cold, or the flu. This isn't to say that safe sex practices should be tossed by the wayside, but that the fear and stigma of STIs is entirely unwarranted, especially if one is in a position to access appropriate medical care.

The question, though, is what effect that should have on disclosure. In that case, some considerations have to be balanced. For instance, I agree that oral herpes and genital herpes should really be given the same treatment... but for the majority of people, a genital herpes infection is indeed much more frightening than oral herpes.

Taking that into account, I'd have to recognize that any partner who obtained genital herpes from me (well, I don't have HSV2, but let's say I did) might very well feel betrayed, angry, scared, frustrated, and hurt. Because of this, I'd have to choose that disclosing to them my past history with HSV2 would be the right thing to do for them as well as for the relationship; allowing another to make an informed choice is always the superior option in terms of mutual respect and empowerment.

[archangelbeth]

One thing is that you can get a cold sore from your Soppy Aunt Eidith smooching you when you're a baby or kid. It's not quite the same thing as "you have to be having sex to transmit it." And chances are, just about anyone you meet was exposed from a parent or grandparent, or other relative going smoochies on the baaaaby.

On the genitals, though, well... It takes a bit more "effort" to get it there in an innocuous sort of way, I guess. So there's the whole "OMG SEXXORS!" aspect to deal with.

My sleepy two cents, anyway.

[fivesixsevenayt.livejournal.com]

I have nothing to add to this, but just wanted to applaud you on your comment.

*Applause*

[frolicnaked.livejournal.com]

The terms "cold sore" and "fever blister" infuriate me, and we (as a society, not meant as a dig at anyone on this thread) either need to call oral herpes what it is or come up with some cute little euphemism for the genital herp.

I vote for "coochie sores" and "wiener blisters." ;)

[sandi1743.livejournal.com]

actually we know that HSV can be passed when there are not outbreaks - the numbers that you are dismissing were all done on shedding studies and were published in peer reviewed journals.
check out the work of Anna Wald's group as she is one of the leaders in HSV transmission.

[heysmilepretty.livejournal.com]

"You do what you can to prevent it, but it's still there."

Exactly; you do what you can to prevent it. For a lot of people, the right of knowledge of a partner's past sexual history is indeed a factor in preventing it. But that "right" is also a responsibility; if someone doesn't ask a person he or she is kissing whether or not they have oral herpes, that's his/her own fault.

[laurenmarie.livejournal.com]

honestly, i've asked boyfriends if they've ever had cold sores before. I'm 23 and have never had one, so either I'm immune, asymptomatic or i've never caught the virus. so i'd be kind of ticked off i was told no they did not have it and then popped up with one/i got one.

[suicidekitty911.livejournal.com]

you could also use an IUI or vaginal insemination to get pregnant.

[frolicnaked.livejournal.com]

... but then you risk the chance of catching it from your spouse and passing it on to your child.

True, nothing is risk free, but sources suggest that the risk of this happening is relatively low. Planned Parenthood (http://www.plannedparenthood.org/sexual-health/std/herpes.htm) says:

"Most women who have herpes don't need to worry. Rarely does a woman with recurrent herpes pass the infection on to her newborn."

Generally, according to the American Academy of Family Physicians (http://familydoctor.org/online/famdocen/home/common/sexinfections/sti/091.html#ArticleParsysMiddleColumn0013), the only time of "big concern" is during birth:

"The baby is usually safe in the uterus. When the baby passes through the birth canal, it may catch herpes. Your doctor may do a cesarean section ("C-section") if you have an outbreak at the time you go into labor, so the baby won't have to go through your birth canal."

However, if the mother isn't experiencing an active outbreak at the time of birth, Herpes.com (http://www.herpes.com/pregnancy.shtml) (citing the American College of Obstetricians and Gynecologists) lists the standard of care as vaginal delivery.

[totheleft.livejournal.com]

i vote "vajaysores".

[queensugar.livejournal.com]

And although it isn't totally on-topic to the original post, I will add that it is also possible to treat a newborn who was possibly exposed to herpes during delivery in order to prevent them contracting the virus. And also that it is important that pregnant women who think they may have genital herpes are very clear about that with their doctor, and demand appropriate care; the dangers of medical staff unfamiliar with appropriate responses are all too sadly illustrated by a recent high-profile case (http://www.winnipegfreepress.com/local/story/4097027p-4695170c.html) in my city. With proper medical awareness and attention, the risk of illness or damage to a newborn with an HSV2 positive mother is very very low.

[queensugar.livejournal.com]

One thing is that you can get a cold sore from your Soppy Aunt Eidith smooching you when you're a baby or kid.

Oh my god, I have a Soppy Aunt Edith?

...I think she owes me some Christmas presents, damnit!

[emilia-romagna.livejournal.com]

So, before smooching on anyone, we should ask whether they have herpes or not, regardless of appearance of symptoms? Theoretically, its a good idea, but practically, seems a bit much to me. It also seems like this would put all of the responsibility on the person that may get infected. I think a better practice would be to make it the responsibility of both partners to open a dialog about potential or actual risks.

[suicidekitty911.livejournal.com]

oh, i didn't mean YOU you, just a general you. I know some people are unwilling to go to those lengths - or not even know about them - but I was just throwing it out there.
I have fertility issues but I never thought I'd want to go so far as having IVF. It surprised me how quickly IFV was back on the table after the other methods have failed. I would LOVE to be able to have children 'the natural way' but we are lucky in that we can have all the unprotected sex we want without risk of an accidental pregnancy - and during a fertility treatment cycle, there are only a few days out of the cycle we have to abstain. So, with that in mind, i like to think we are still doing it the natural way, just with a little extra help. :)

Good luck with your genetics counseling. I think it is wonderful that we have that technology available to us. I hope everything turns out exactly as you want it to!

[emilia-romagna.livejournal.com]

Uh, she gave you a Christmas present: herpes!

[frolicnaked.livejournal.com]

Hrm. I've never been a fan of the whole "vajayjay" terminology, but I like the economy of a one-word term.

What about both "vajaysores" and "coochie spots" for the female variety? That way, people can choose whatever works best for them. :)

[frolicnaked.livejournal.com]

Okay, sure, for one Christmas. What about all the other years? :P