It’s natural to have a lot of questions about herpes. Talking with your health care provider or a sexual health educator in Community Wellness at MIT Medical can help you decide whether to be tested for herpes, how to treat it, and how to discuss it with your sexual partners.
Herpes is a very common infection that is caused by one of two different types of viruses:
Both of these viruses can affect the mouth or genitals. HSV-1 has traditionally been associated with an infection in the mouth, while HSV-2 typically infects the genitals. However, recent research shows that the majority of cases of genital herpes are with HSV-1.
HSV-1 is widespread—in the U.S. among 14-49 year olds 53.9% are infected with HSV-1 and 15.7% with HSV-2.
Once someone has been infected, both HSV-1 and HSV-2 remain in the body for life. Most of the time, the immune system suppresses the virus so it’s dormant, but it still exists in the nerves deep within the skin. Even if your immune system is strong, however, the virus may start reproducing again, and you may experience an outbreak. Although there is no cure for herpes, certain medications can help prevent and shorten outbreaks. Herpes is not life-threatening and does not affect fertility in women or men.
The symptoms of herpes depend on what type of herpes virus you have and which part of the body it affects. Many people with HSV-1 or HSV-2 don’t experience any symptoms during an outbreak. This is called asymptomatic infection, and this makes it easier to unknowingly spread the virus to others. When HSV-1 and HSV-2 do cause symptoms, the two types of illness often look and feel the same. The main difference is that HSV-2 in the genital area is more likely to relapse, or cause outbreaks, than HSV-1.
Symptoms of oral herpes can include:
Symptoms of genital herpes can include:
Studies suggest that having genital herpes may also increase your risk of contracting HIV (the virus that causes AIDS). This is because open herpes sores on the genitals make it easier for the HIV virus to enter the body.
HSV-1 is spread through contact with saliva, including kissing and mouth-to-genital contact (oral sex). HSV-2 is usually transmitted by direct genital-to-genital or genital-to-anal contact. In the past, HSV-2 was responsible for most cases of genital herpes. However, recent research suggests that almost 80 percent of college students with genital herpes have HSV-1, likely due to the fact that rates of oral sex are high in this group. Remember, a person with herpes doesn’t have to have symptoms to spread the virus to someone else.
The best way for clinicians to determine if someone has HSV-1 or HSV-2 is to perform a laboratory analysis on a sample from a fresh herpes sore. But because not everyone with herpes has symptoms, your clinician may use a blood test to detect antibodies to the herpes viruses. A blood test can reveal if you have herpes and specify whether you are infected with HSV-1 or HSV-2. However, the test cannot tell you what part of your body the virus will affect.
Talk with your clinician if you wish to be tested for herpes. Even if you have a standard screening for sexually transmitted diseases, it may not include herpes unless you specifically ask.
Remember, however, that HSV-1 is a very common virus and there is about a 50–60 percent probability that you will test positive for it. If you are a sexually active adult who has had multiple partners, there is a 10-20 percent probability that you will test positive for HSV-2.
Here are some other things to consider before you get tested:
Learning that you have herpes can be confusing and scary. We encourage you to have an in-depth conversation with your health care provider before you decide to get tested.
There is no cure for herpes, but antiviral drugs can help you manage outbreaks and relieve symptoms. There are currently three types of antiviral herpes medications:
All three of these drugs are available in pill form. Acyclovir is the oldest of the three and is less expensive.
Antiviral medications can be taken two ways to treat herpes:
Despite claims that certain supplements or other alternative approaches can successfully treat or prevent herpes, there is no good evidence that these approaches are effective. Stress and illness can weaken your immune system, making you more susceptible to herpes, but it remains unclear whether maintaining a healthy lifestyle can protect against outbreaks.
The best way to prevent transmitting or contracting genital herpes is to avoid sexual contact or to be in a monogamous relationship with someone who has tested negative for the virus. That may not be realistic for many people, however. Although the following tips cannot completely prevent the spread of genital herpes, they can help lower your risk of transmission:
Because oral herpes is so common, it can be difficult to prevent transmission. If you are concerned about contracting or transmitting oral herpes, avoid kissing people or sharing items like utensils, washcloths, and lip balm when cold sores are present.
© MIT Medical, 2011