Genital herpes - some facts

The appointment
This morning I was 5 minutes late for the appointment at the SHAC. Fortunately there was still some time to wait and compose my thoughts and of course to sneak a mandatory peak at that copy of Heat (ashamed but unrepentant). There was a pretty girl sitting next to me and while it briefly crossed my mind I decided that the waiting room of the GUM clinic is probably not the best place to start chatting someone up - 'Say, what venereal disease have you got? Fancy a drink sometime?'

The advisor I met was very personable and we talked a little about the way people deal with the news that they have herpes (I fall into the pragmatic category - I am sure you have noticed that by now). Then in a business-like way I asked him how long we had (I wanted to make sure I got all my important questions in) and he professionally answered 'As long as you need'. I assumed this meant no more than half an hour so I launched into the questions that have been spinning around in my head for the last 3 months.

What I learnt
I would like to publish here a summarised version of what I learnt. I hope I do not need to remind anyone that I am not a health professional and that this does not constitute professional advice - merely my recollection and interpretation of what he told me (and he was professionally non-committal).

• I have HSV2
• HSV2 can be dormant for a long period of time and activated by penile trauma (his words) and a low immune system
• Outbreaks tend to reduce in seriousness as your immune system gets used to them and may disappear completely
  
• The virus does not typically shed and become contagious unless there are symptoms present
  
• Asymptomatic shedding (i.e. you are contagious without showing symptoms) is possible but most likely the week before and for two weeks after an outbreak
• Penetrative sex with a condom is 'safe' even during viral shedding (clearly it might be more problematic if the area cannot be covered with a condom)
  
• Oral sex without a condom is also 'safe' since it is very difficult to get HSV2 orally (probably unpleasant if you have symptoms though!)
  
• HSV1 on the other hand accounts for about 1/2 of the genital cases but is typically found orally
  
• Many people have HSV2 and never show symptoms or only ever have one outbreak
• 80% of the population have one type of the virus, either orally or genitally
• Antiviral treatment is an option to help suppress the virus (not cure it!) and can be considered if outbreaks are regular and/or severe
  

Note - I have used the word 'safe' to represent an improbably low risk. I do realise that there are always exceptions and improbably low does not mean impossible.

Herpes is not screened as standard when STI tests are taken in the UK because of the number of people who would show a positive result. These people do not represent a risk because they have never been symptomatic and so the screening is deemed unnecessary.

The message
The general message was a positive one. His advice was that I do not need to tell everyone I sleep with right away as long as I always practice safe sex and use a condom. It is also clear that this virus is relatively common and often more of an inconvenience that a serious problem.

Final thoughts
I think it complicated and that not telling someone at the right away might jeopardise things later as I suddenly announce that I have known all along that I have herpes. I recognise that the risk of transmission is tiny while using a condom but other people can have a very different perception of risk when it comes to things like this; especially when they do not know all the facts. I remain undecided about how I will deal with this when I next find myself becoming sexually involved with someone.

During the appointment I also received a very nice leaflet titled 'Genital Herpes . A self-help guide'. Needless to say I walked out of the clinic brandishing this leaflet in my hand unintentionally broadcasting to all who cared to look exactly why I was there. I am happy to say this amused me much more than it made me embarrassed.