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Hopping Mad About Herpes

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Anonymous asks:

I've been reading Scarleteen since I was at least 16, and the vital knowledge has kept me safe thus far... UNFORTUNATELY after getting through high school and college completely unscathed and mostly responsible, I finally dropped my guard for a nice, geeky, Christian boy who'd never kissed a girl EVER. And now I have oral herpes. I'm pissed. Really, really pissed. One day he greeted me with a kiss and when he pulled back I noticed his lips were a bit on the gross side. When he said, "Oh, I just have a cold sore," I completely freaked. Apparently his whole family caught it from his parents and they never made it clear to them that A) Cold sores/Fever blisters ARE Herpes and B) they can be spread to others. They act like it's completely normal. The last time I went to his house I saw a BULK sized bottle of Lysine on the kitchen sink. When my boyfriend asked his mom about why they never warned him, she replied that I was simply overreacting and that I should get over it.

I want to know how I can get through this without hating him and his generally very nice family. He's a great guy, and he didn't do it on purpose (I've never met anyone who has), but I'm just so pissed at him and at myself. I feel dirty, ashamed, and like I should have known better.

Thanks,
Newly Blistered Sister

Heather Corinna replies:

When I was in high school, I was -- as I still am now -- in the habit of hugging friends and warmly kissing them on the cheek, the sides of their mouth or on the mouth entire when greeting them, passing them in the halls, or just because I loved them and liked to demonstrate my affection. You can imagine how much everyone loved me during the week we all found out the hard way that I had mononucleosis and had spread it to nearly the entire junior class in the span of around fifteen minutes of kissy-greetings.

I couldn't have known I had mono, mind you, because I hadn't had symptoms yet, and even if I had, I likely wouldn't have been able to figure out that's what it was until I was sick for a week or more, despite growing up with a healthcare professional. But too, mono is so common, and chances are good that if it wasn't me who passed it around, someone was going to eventually and most of us were going to get it. It's very common in young adult populations, it's highly contagious, and people who get mono usually don't know they have until after they have already been in the most contagious period.

Oral herpes is a lot like this, despite the fact that cold sores or "fever blisters" are a common symptom and are sometimes present and visible among those with Herpes. I can't begin to tell you how many people in the world don't know that they have oral Herpes, and don't know that cold sores are a symptom of oral herpes. Most people get it in childhood and have no memory of sores (some won't have them at all) back then when they contracted it, and some people will never see a sore again, even though they have and can possibly transmit Herpes. Chances are very good this is not even your first exposure to HSV-I: you've probably already been exposed to it many times in your life before this without even knowing, and for all you know, you already had it yourself and are only seeing a sore now due to re-exposure. And if your whole family had it, you might very well have the same attitudes about it as his do.

Getting mad at laymen about this only makes so much sense to me, even though I understand your disappointment at contracting a virus you can't ditch.

Plenty of doctors will refer to oral herpes as "cold sores," and not explain that those sores are Herpes symptoms, and that the emergence of those sores -- and the time just before -- also signals the period of the highest risk of transmission. Plenty of doctors do not tell people with oral Herpes about potential risks of genital transmission (in part likely because some really aren't comfortable talking to people, especially young people, about oral sex, nor are many people comfortable talking about sex with their doctors, either). Of course, for doctors to even have these kinds of responses at all, they have to either see a sore when a patient has a visit with them or be asked by a patient about cold sores, so we can only hold doctors so responsible, too. Often a doctor won't see active sores or be asked about them by their patients. But when even healthcare pros and others in the know don't pass this information along to laymen, we can only hold laymen so responsible.

Some of that "Oh, it's nothing," stuff comes from the fact that oral Herpes is one of the most common and benign viruses out there. As many as 80% of people in the U.S. people have it, and most contract it in childhood from casual, everyday contact. If people act like it's normal, it might have to do with the fact that it is normal: more people have Herpes than not, and it's pretty safe to say that all of us have been exposed to it in life, usually multiple times before we've even started being worried about cooties, let alone Herpes.

As a regular reader of Scarleteen, I hope I don't have to tell you the this guy's (lack of) sexual experience, his geekiness or his religion have squat to do with any of this, and that we can't figure someone is somehow free of illness based on things like this. There is no one kind of person who has -- or does not have -- Herpes or any other virus. For sure, it's sound to figure our risks of, say, Syphilis are very minimal if we have sex with someone who has never had any kind of sex with anyone else, because that's an infection that is often only sexually transmitted.

But oral Herpes isn't Syphilis, not when it comes to its epidemiology, and also not when it comes to the possible severity of effects it can have on your life. Heck, for most people even Syphilis isn't Syphilis anymore in that respect.

Oral herpes really isn't likely to be that big of a deal when it comes to your health and the health of others. I swear. Yes, you can transmit it easily (and often it is passed around in families nonsexually as happened with this guy and his folks), and yes, there can be a risk of transmitting oral Herpes genitally. However, that is relatively uncommon: genital Herpes, or HSV-2, is usually the type of herpes one gets and transmits genitally.

Let me share some basic information with you from the American Social Health Association on this, as well as what you need to know now so far as protecting yourself and others:

Oral herpes is transmitted through direct contact between the contagious area and broken skin (a cut or break) and mucous membrane tissue (such as the mouth or genitals). Herpes can also be transmitted when there are no symptoms present. There are several days throughout the year when the virus reactivates yet causes no symptoms (called asymptomatic shedding, viral shedding, or asymptomatic reactivation).

If a person is experiencing symptoms orally, we recommend abstaining from performing oral sex and kissing others directly on the mouth until signs have healed and the skin looks normal again. Because most adults have oral herpes, we do not advise that a person stop giving or receiving affection altogether between outbreaks (when there are no signs or symptoms) simply because they have oral herpes. However, using a barrier (such as a dental dam) or condom when performing oral sex (even though there are no symptoms present around the mouth) can reduce the risk of contracting genital herpes.

By performing oral sex on someone who has genital herpes, it would be possible to contract oral herpes - but this is rare. Most cases of genital herpes are caused by HSV-2, which rarely affects the mouth or face. Also, and even more importantly, most adults already have oral HSV-1, contracted as a child through kissing relatives or friends.

(A geeky aside of my own: ASHA, originally called the American Social Hygiene Association, was the first official sex education organization in the United States. Around the turn of the century, despite some profound differences in attitudes around sexuality and sex ed, the ASHA was basically Scarleteen for Victorians. )

In many ways Herpes really IS no big deal for most people. In immunosuppressed (in case it's not obvious, people whose immune systems are suppressed, or not functioning well) people, Herpes, like many any virus, can present some serious health risks. Having herpes -- though more often this is about genital herpes, rather than oral -- can also up the risks of us acquiring other infections sometimes. But for the most part, not only is there nothing dirty about it, there's not usually anything dangerous about it either. It's unlikely to impact your health or your life, though how you think about it can certainly have an impact.

You say that you feel dirty and ashamed, despite the fact that the virus you contracted has nothing to do with cleanliness, and is about as common as the common cold. It is no more or less dirty than cold viruses, leukemia, the flu or chicken pox (which is in the same family as the Herpes virus). I understand why you feel that way, but only because our culture has stigmatized some viruses rather than others, often based on all kinds of isms and phobias, and in this case, based on the fact that Herpes viruses can be sexually or intimately transmitted, which is the case for a ton of illness including, again, things like colds and flus. We can probably factor in, too, that looksism is a factor, as Herpes sores are visible. Sure, it makes sense in some degree for all of us to want to be healthy, and not have illnesses, and to view illness as something we want to avoid. But if you didn't feel this way if and when you got the chicken pox, and don't feel this way when you get the seasonal sniffles, I think your feelings about this illness probably have more to do with stigmatization coming from a not-so-great place than with worries about your health. I'm not wagging fingers at you, by the way: none of us are immune (no pun intended) from these attitudes, and we do live in a world where we have to deal with these notions.

I'd implore you to do what you can to diffuse your anger about this: I'd say those feelings are more likely to bum out your life than a cold sore now and then, or than letting someone know you've got oral Herpes like most people do. Stress presents more health risks than HSV-I does. I'd also try to let go of your anger towards him, his family and yourself. None of you did anything wrong, nor is there anything wrong with you besides being human and being people who don't live in a plastic bubble. We pick up viruses in life, and while there absolutely are plenty of things we can do to reduce our risks, there really is nothing we can do to remove those risks completely. This is just the world we live in, whether we have never kissed anyone before or we volunteer to run the kissing booth every year without fail.

You say you should have known better, but what I wonder is what you mean when you say that. How would you have behaved instead? I think it's safe to say that most of us don't ask everyone we kiss, be it romantically or platonically -- and that would include relatives and friends -- if they have ever had a cold sore before we kiss them. We don't also tend to give people we're used to kissing a super-close inspection of their mouth before we kiss them. And I think we all know how often a friend will have us taste something they're drinking, or we share water bottles, without many of us giving it any thought at all. Now, if Herpes was very dangerous to us (and again, for some groups of people it is), it would make sense to do and ask things like that, though we'd likely also be asking then if they had been sick with anything else lately, too, if it was safe for us to have that close of contact at all. But a lot of why we don't tend to engage in those kinds of behaviors is because it's usually not dangerous, because our quality of life (which includes relaxed affection with people) is also a factor in the choices we make, and because in a lot of ways, there is just very little we can do to avoid being exposed to oral Herpes, and we're either going to get it or not, which is also often based on pretty random factors.

My advice to you at this point, beyond trying to adjust your headspace on this, is just to talk to you own doctor about oral Herpes. You absolutely can discuss and consider treatments, if you like, which reduce outbreaks for you. There are also some support groups out and about on the web for people with either type of Herpes who are having a tough time adjusting, so if this stays hard for you, you might want to seek one of those out for yourself.

An etiquette point: I don't know what "freaking out" is for you, but when I say I freaked out on someone, I'm usually talking about some pretty high-key behavior on my part where I am not being particularly sensitive to the feelings of others. If that's what it means for you, too, and it involved any shame or blame to this guy or his family about their Herpes, I would personally say an apology is likely in order. It feels pretty crappy to be treated like a leper, even if you have lepracy, and all the more so when you don't. I don't know what your feelings are per if this is still a relationship you want to pursue, but whether you do or you don't, I'd make some peace. After all, you clearly don't like how you're feeling right now, so you can imagine how they probably don't like feeling that way, either.

Okay? You're not dirty, and neither you nor this guy have anything to be ashamed of. Seriously, this will be okay, and if you let yourself, I think you'll get okay with it, too, in fairly short order. I'm going to leave you with a few extra links I hope can help you get there:

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