The Most Misunderstood STD: Dismantling the Stigma of Herpes

Season after season, casting directors for ABC's hit franchise "The Bachelor" have turned down thousands of confident applicants for one main reason: genital herpes. That's right, the leading cause for denying these romantic hopefuls is a treatable condition that affects almost 500 million people under age 50.

Also known as HSV-2 (herpes simplex virus), genital herpes is a sexually transmitted infection (STI) that cannot be cured at this time. It appears—or sometimes doesn't appear—in the form of blisters and sores around the genitals and rectum that come and go throughout your life during outbreaks.

Although we've come a long way in our positive attitudes about sexual health in the past half-century, the fierce stigma against herpes lives on in our society, despite dozens of scientific studies and reports refuting its danger.

How many people live with herpes?

The Centers for Disease Control and Prevention (CDC) estimates that more than 1 in 6 Americans between ages 14 and 49 have genital herpes, while the World Health Organization (WHO) reports only 10 to 20 percent of cases worldwide have been diagnosed. That means the vast majority of people infected with herpes may not even know they have the virus.

Herpes is also more common in women than men, a phenomenon we'll detail later.

Why are the numbers so high? It's because a majority of herpes cases are asymptomatic throughout a life span. For people who do experience symptoms, it can take anywhere from two days to more than six months for the first outbreak or lesion to appear, increasing the chances for a person to spread the virus without knowing.

Most clinics do not test patients for either strain of herpes, HSV-1 (which primarily causes oral herpes) or HSV-2, since it would require a blood sample (versus much more easily collected urine) and often causes more harm than good because of false positives in the results.

Should we be afraid?

If you take an objective look at the virus, it's not scary at all. Although outbreaks can be painful and may cause secondary medical symptoms, genital herpes is a very mild, very manageable virus that has little effect on a person's day-to-day life. In fact, the psychological effects and shame regarding herpes far outweigh any physical grievances.

What's more, your first outbreak will be your worst outbreak, as the body immunizes and develops resistance to the virus over time. Some cases report just one outbreak while others will be indefinite, but outbreaks will decrease significantly when paired with antiviral drugs such as Valtrex (generic: valacyclovir), which cuts the risk of spreading in half when taken daily. It's also less common to contract herpes during a dormant stage (without an outbreak present), though asymptomatic shedding does occur.

Although there is no cure for genital herpes, a doctor or clinic can help prescribe treatments that can relieve symptoms or minimize outbreaks.

What difference do condoms make?

Unfortunately, condoms are only about 65-80 percent effective against herpes, with the effectiveness declining when the infected partner is female.

A woman's vulva and anus provide more surface area and more opportunities for unplanned skin-to-skin contact. Herpes spreads very easily from one mucous membrane to another, so you can even get herpes in your eye or give yourself genital herpes by touching an open sore and then touching another region of your body.

While the chances of infecting a monogamous partner are slim, it's always crucial to disclose your herpes status and allow your partner to give informed consent. Even people in monogamous or married relationships should be aware and talk to their doctor if they notice symptoms of genital herpes, as open relationships and infidelity are not impossible scenarios.

Communication is key

The most important component of living with genital herpes is a direct line of open communication with any and all partners before you begin a sexual relationship. The more upfront and honest you can be with a prospective partner, the more you'll put them at ease.

It's unfortunate our society still views herpes in such a negative light, but while the rest of us catch up to speed, be sure to provide your potential intimate partners with as much information as you can.