One Reader’s Response On Herpes: ‘Not Necessarily A Big Deal’

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Please tune in to Radio Boston at 3 p.m. today to hear Dr. Lydia Shrier of Children’s Hospital Boston (and yours truly) talk about this recent post on how easily genital herpes can be spread.

During the taping, I found myself saying that I thought the takeaway message was double: “Be very, very careful, there’s a lot of this going around,” and also, “If you do catch it, you have a whole lot of company.”

One reader responded to the post with a consoling message that went one step further: If you do catch herpes, it’s not necessarily a big deal. At least, not for everyone.

True, herpes can cause pain, make people more susceptible to HIV and in rare cases, cause dangerous infections in newborns. Some people suffer through several outbreaks a year. But still, I thought the message-writer, Jeffrey Hunter, was making important points that are relevant to millions of people with herpes — and that might help offset the initial emotional pain that some may feel when first diagnosed. (And yes, he gave me permission to use his name.) Here’s his eloquent message in full:

I recently came across your article titled “Why You Should Assume Everyone Has Herpes” from a link on the npr.org website. I first off want to say thank you for bringing up the issue of how widespread herpes is. I don’t think most people are aware enough of just how common it is, how it is transmitted, or what the symptoms are.

There are a couple common assumptions about herpes, however, that I think we should be doing more to challenge. The first is that there is an automatic assumption that herpes is something really horrible to be avoided. I certainly won’t argue that herpes is good, but I felt your article was written from the point of view that contracting herpes must definitely be avoided, without actually examining that assumption. If in fact the prevalence among unmarried women between 45 and 50 is more than 50% in the country, at some point we have to ask, just how dire is this?

I myself tested positive for HSV-2 a little over a year ago. As you might imagine, that was a bit devastating to see on a test result, but after talking to my doctor about it and learning more about herpes I eventually found myself saying, if I have a virus which poses no long-term health risks and whose symptoms are so mild and infrequent that I would never have noticed them without a blood test to detect the virus, then just how serious is this? For myself I have to say, not very. Sure, it would be nice if I didn’t have the virus, and I certainly inform my partners about my status, but there are plenty of much more important health issues for me to spend my time worrying about (like, say, making sure my cholesterol levels remain healthy).

Again, I’m not trying to make the argument that herpes is good, or even a non-issue, but a quick analogy might illustrate my point better. According to the CDC, genital HPV (the human papillomavirus) is “the most common sexually transmitted virus in the United States,” and they’re just talking about genital HPV. There are plenty of other types of HPV running rampant in the population. Yet, how much time do we spend worrying about HPV? Although perhaps not clearly articulated, we seem to have more or less come the conclusion as a society that we need to be concerned about HPV infections that cause warts (which can be removed) or increase the risk of cancer. I don’t think anyone’s really too worried about the other types.

Herpes may not be as benign as HPV, but there are certainly some parallels. Like HPV, herpes is contracted through skin-to-skin contact, making condoms less than fully effective in preventing its transmission due to the fact that condoms do not cover all areas of skin which may be infected. I guess what I’m actually arguing for is to have people fully informed about both the mechanism of transmission as well as the actual consequences of an infection (which is not the same as just assuming all infections are bad). Because, contrary to what we often assume with STDs, prevention is not as simple as just slapping on a condom during intercourse, people really need that level of information in order to make an informed decision about how much risk they feel comfortable running and how to actually reduce risk when they aren’t comfortable with it.

The other important point that I feel cannot be stressed enough is that HSV-1 is not the same as orofacial herpes and HSV-2 is not the same as anogenital herpes. Yes, HSV-2 is the most common type of herpes involved in anogenital infections, but it can cause orofacial infections, and the reverse is true for HSV-1. The important point there is that, unless you happen to never have oral sex, you can be at risk of acquiring herpes from either type of infection. Yet, how many people would think to disclose their orofacial infection to a partner before having sex (or even think to ask about it)? I believe getting past that mental barrier is important not only for preventing the spread of herpes, but also in getting past the stigma of talking about herpes infections in general.

Well, I guess what I thought was going to be a quick note about your article turned into something a bit longer. In any case, I want to thank you again for brining up the topic of herpes. I hope you’ll consider some of what I’ve brought up should you be covering the topic in the future.

Jeff

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