Debunking the myths about genital herpes

Fact: Genital herpes affects different people in different ways — some people may have sores but others may show no symptoms at all. Only 20 per cent of people affected by genital herpes have recognised symptoms, 60 per cent have unrecognised symptoms and a further 20 per cent have no symptoms present at all.

Fact: Transmission of genital herpes is most likely to occur during vaginal intercourse, oral or anal sex. The majority of transmissions occur when herpes blisters or sores are not present.

Fact: Most type 1 genital herpes is caused by unprotected oral sex. The type 1 herpes virus can be spread through oral sex. If you haven’t already been infected with the cold sore virus previously what was a cold sore on your partner can develop as genital herpes in you.

Fact: While you should always use a condom for extra protection, you can still have sex if you have genital herpes. It is however important to avoid sexual contact if you have any sores (oral or genital) or symptoms. Also, even if sores are not present, you could still be contagious because of asymptomatic viral shedding (you don't have any signs or symptoms but the virus is present on the skin). Even when you are asymptomatic, you should use a condom for extra protection. (Please see your doctor for alternative barrier methods if you're allergic to latex.)

Fact: Genital herpes does not affect fertility. However, it is possible a newborn baby can be infected with the herpes virus if your infection is active at the time of birth. In rare cases, where a sore is present during labour, this is avoided by performing a caesarean section to reduce the contact between the infection and the baby. Please talk to your doctor if you are pregnant, or planning to become pregnant.

Fact: The fact your partner has been diagnosed with genital herpes does not necessarily mean he or she has been unfaithful to you. Genital herpes outbreaks can occur with very mild symptoms that go unnoticed. You or your partner may have contracted the disease from a sexual partner a long time ago or your partner may have genital herpes without knowing it. You may want to consider having an open, honest conversation with your partner about your diagnosis without making any assumptions. Learn more about transmission and talk to your partner.

Fact: Genital herpes is very common. As many as 1 in 8 Australian adults have genital herpes. Because of this, you can get genital herpes even if you've had only one or two sexual partners. However, your risk of getting a sexually transmitted infection like herpes increases with the number of sexual partners you've had in your life.

Fact: Condoms reduce the risk of transmitting genital herpes, however, they do not entirely remove the risk. This is because the condom may not cover all potential sites of viral shedding, may not remain in the same place during sex or may break.

Fact: Genital herpes cannot make you sterile. However, other sexually transmitted diseases such as Chlamydia can make you sterile and your doctor should test for these infections when you are diagnosed with herpes.

The fears that surround talking about this virus are greater than actually talking about it. Educating yourself about the virus and learning how to talk to others about it, is vital.

Fact: The genital herpes virus is a fragile virus that dries out when it is exposed to air. There have been no proven cases of genital herpes transmission from a toilet seat.

Fact: Genital herpes is not associated with the development of cervical cancer. The virus that does cause cervical cancer is the Human Papilloma Virus which is also sexually transmitted. It is important to have regular pap smears to detect early signs of this.

Fact: Most people who have herpes are not more susceptible to other infections. Rarely, some people with herpes develop cellulitis, which is an uncommon bacterial infection due to bacteria entering the genital herpes sores. Cellulitis causes a deep red rash and is often associated with tenderness and fever. This infection can be treated with antibiotics.

Fact: Symptoms, such as sores, tend to go away after an outbreak of genital herpes. If sores do not go away, it is probably not genital herpes. After several years, you may experience fewer outbreaks or no outbreaks at all. It is possible, though, to have an outbreak without any symptoms.

Fact: A full STD test does not usually include a test for genital herpes. The best way of making a diagnosis of genital herpes is to see a doctor when symptoms are present. A specimen will be taken from the sore and sent to a laboratory for analysis.

Fact: There are several ways in which the risk of transmitting genital herpes can be reduced.

First, if someone is infected with herpes, it is important to share this information with a partner. Then the couple can decide together which risk reduction measures they wish to take. The most important precautionary measure is to avoid sexual contact when a person is having signs or symptoms.

There are two other possible strategies to reduce the risk of transmission:

1. One is to use latex condoms, which can reduce the risk of transmitting herpes by around 50%. Since it is still possible to pass on the infection even when no symptoms are present using condoms during all sexual episodes is more effective than intermittent use.
2. The second approach is to use suppressive antiviral therapy (continuous daily therapy over a period of months or years).

Fact: Once one of the HSV viruses has entered the body, it remains for the rest of a person’s life. Some people experience no further episodes of genital herpes but in others, the virus is reactivated from time to time. Recurrences are usually shorter and symptoms are less severe than during the primary infection.

Fact: The symptoms of genital herpes vary from person to person. Only approximately 20% of people with genital herpes recognise they have the infection. Another 20% of those infected with HSV-2 experience no signs or symptoms and do not realise they have the virus. Around 60% of people carrying the virus have symptoms that do not fit the classical description of genital HSV infection and also fail to realise they have the virus. Thus, the vast majority of people with herpes do not realise they have been infected. The only way to know for certain whether infection has taken place is to have a herpes test.