On the Savage Love podcast, Dan Savage talks talks about sex in a no-holds-barred way. On episode 195, he has a fun time with Dr. Anna Kaminski from Planned Parenthood talking about a number of sex-related topics, a major one they focus on is herpes (starting in the audio at 12:02). It’s a funny and informative discussion ultimately breaking it down to the fact that herpes is simply “not a big deal.”
The discussion of herpes was prompted by a call by a guy asking for advice. This guy (who has herpes) went on a few dates with another guy, had the herpes talk and he got pretty scarce. He wants to know how to disclose to potential future partners.
Dr. Anna says “Herpes causes so many tears and fights and breakups … It’s really important for people to understand how common it is, how little problem it causes and how much strife goes into the discussion about it.” Both Dan and Dr. Anna agree: herpes is just blown way too far out of proportion.
She also talks about how there is an interesting double standard when it comes to cold sores. She explains that a majority of people have HSV 1 (she says 60% of people, but the number is more like 80% now). She says, “I just can’t get freaked out about a cold sore. Everyone has cold sores.” HSV 1 (herpes simplex virus 1) is so common and nobody thinks twice about it. Most people get it when they are kids when an unwitting adult kisses them innocently and passes it on in that way. “HSV 2 is the one that prefers the wet and warm environment of genitals (although you can get it on your mouth). 25 percent of us have antibodies by the time we’re over 12.” This is simply to say that herpes is common! [Sidenote: So many people are silent carriers due to herpes dormancy, but will never know they have genital herpes if they don’t get a herpes blood test. The problem here is that you can still get herpes when there are no herpes symptoms due to viral shedding.]
Dr. Anna says to expect initially 4-6 outbreaks per year and for the first year to go on suppressive therapy to keep the herpes outbreaks at bay. When you suppress herpes, you’re much less likely to transmit it to a partner since it lessens shedding by around 50%. Dan Savage jumps in to say you would suppress the possibility of transmitting the herpes virus, and chances are that your partner has already been exposed to herpes anyway at some point. And if they don’t have herpes, you have the herpes talk that you will be as safe as possible with suppressive therapy and condoms. And here’s the kicker: “Herpes risk = Small. Aren’t I worth it?” Here, they touch on the whole point of the herpes opportunity for deepening authenticity and intimacy: honesty. By telling potential partners, you’re showing them the kind of person you are deep down and that you care.
Dr. Anna also talks about having a first herpes outbreak: “People have fevers, chills, pretty impressive headaches … you’re down for a few days the very first time. That being said, 70-80% of people have no idea when they got it and are absolutely unaware that they had a primary outbreak.” So even though the first herpes outbreak tends to be the most severe for a lot of people, it really isn’t something that a lot of people notice. She says 15-20% of people who have an initial outbreak never have another outbreak, but they can shed herpes.
To address the original question, Dr. Anna says that the caller is doing everything right by disclosing “I have herpes” to his potential partner. She suggests getting more confident about talking about herpes to partners. The more we realize herpes isn’t a big deal, the easier it will be to talk about and less likely to scare people away.
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