Talking about Herpes
How to Tell a Potential Sexual Partner about Herpes
Herpes simplex virus (HSV), often called herpes, is a common virus that is usually transmitted through sexual contact. According to the National Institutes of Health, 4 out of 5 people in the United States carry herpes simplex virus type-1, HSV-1 (which primarily affects the mouth and appears as cold sores) and approximately 1 in 5 people carries herpes simplex virus type-2, HSV-2 (which primarily affects the genitals). Despite being so common, having herpes often comes with a social stigma that can lead to shame, embarrassment, and distress. If you have herpes, you may find yourself avoiding dating or engaging in sex for fear of spreading the virus, or of rejection when you tell a potential sexual or romantic partner. Even the thought of the conversation may be causing you great anxiety. Following the tips below will give you some starting points for talking about herpes and will likely make the conversation less stressful for you and your potential partner(s).
Where Should I Start When Talking about Herpes?
First, understand that you do not have to tell every person in your life about your HSV. The only people who need to know are those you want to tell, as well as any sexual partners so that they can give informed consent or abstain from activities that may transmit HSV. Talking about herpes is a decision that you get to make on your own terms.
Once you have decided to tell a potential sexual partner, choose a timeframe when you have plenty of time to discuss each of your concerns and answer any questions. In terms of picking a setting, doing a quick assessment can help you choose: what might you need in terms of privacy, physical comfort, noise level, access to the internet for verifying information about herpes, etc.? Is a quiet park bench private enough for you, or would you feel more at ease in your living room?
When Should I Start Talking about Herpes with My Partner?
Whether this is a new or old partner, once you confirm your diagnosis, it is best to start talking about herpes before you become physically intimate in a way that can spread your strain of HSV. For HSV-1, that means before kissing or performing oral sex with a cold sore. For HSV-2, that means before receiving oral sex and before penetrative vaginal or anal intercourse. The reason for this is so that your partner can be risk-aware in deciding to be physically intimate with you, and can consent with full knowledge of the situation. It may also affect decisions that you make together about types of contraceptives and STI (sexually transmitted infection) prevention to use.
What Does My Partner Need to Know about Herpes?
If you haven’t already, it is a good idea to read up on HSV before talking about herpes, both for your own knowledge and so that you can answer any questions your potential partner may have. Websites such as Planned Parenthood and the CDC are good sources of knowledge. They have information on prevalence, testing, treatment options, and transmission, as well as ways to prevent transmitting the virus to your partner.
Helpful things for your partner to know include:
How long have you had HSV?
Which strain do you have?
How often do you get outbreaks?
Are there specific things that increase the frequency of your outbreaks, such as stress or illnesses?
Are you on medication to manage outbreaks?
When your sores or lesions appear, where are they located?
How do you know an outbreak is coming on?
How is the virus transmitted?
When is transmission most and least likely?
What can we do to minimize the risk of transmission?
Where can your partner get tested?
Many of these questions are specific to you, and others can be answered by doctors and trusted resources. Some questions about transmission are addressed below.
What Does This Mean for Our Sex Life?
Good news: your sex life is not doomed. Even if your partner does not have HSV, there are several methods to lessen the chance of transmitting the virus. While no method is one hundred percent guaranteed, many reduce the risk of transmission to near zero percent.
HSV is transmitted via contact with a mucous membrane, such as those in the mouth, genitals, or anus, or an open wound. The majority of the time, the virus can only be spread during an active outbreak with cold sores or genital lesions, when the viral load is the highest and the active lesion makes it easier to access the virus. However, a small percentage of the time, HSV can be spread via asymptomatic shedding: when the virus is present on the skin without noticeable symptoms. Shedding happens the most during the first 6 months to 1 year of having the virus, and lessens with time.
Because HSV-1 is so common, it can be difficult to conclude transmission rates through kissing. However, it is important to note that HSV-1 can be transmitted to the genitals through oral sex, so avoiding that sort of contact while you have a cold sore is recommended.
Even using no barrier methods or medication, the risk of transmission of HSV-2 during intercourse while you are not having an outbreak is less than 10%. Using condoms and dental dams as barrier methods reduces transmission rates of HSV-2, a further 30-50% with proper use. Taking Valtrex, an oral medication for HSV-2, lessens viral load and further reduces rates of transmission by 50% or more. The rates of transmission while having an outbreak are significantly higher, though less data is available about those specific rates.
Some things that you can do to lessen the risk of transmission to a partner include being aware of what your prodromal period (the early signs that an outbreak is coming on) looks like, and using barrier methods when you are not having an outbreak. Most medical professionals recommend avoiding sexual contact during prodrome or an outbreak, both to lessen transmission risk and because it can be physically irritating or uncomfortable for some people with HSV.
What if They React Poorly?
If someone reacts poorly to your disclosure of an HSV diagnosis, that can feel incredibly painful. It may lead you to feel rejected and anxious about future partners. However, know that this is not about you and does not mean you will never find another sexual partner. There are plenty of people in the world with HSV who are in loving relationships and/or having great sex, with partners who may or may not also have HSV.
Some people may need time to process your disclosure but will be fine with it in time. You can start the discussion by saying something like, “I know this may take some time for you to process. Take as much time as you need and we can talk about it again later. In the meantime, let me know if you have any questions.”
What Do I Say When Talking About Herpes?
If this is the first time you are disclosing to a potential partner, you may be nervous and feel the need to build up to telling them. Here are some sample phrases for that conversation:
- “I really like you, so I want to be completely honest with you. This is a difficult thing for me to say. I have HSV (1 and/or 2).” You can then use the information in this document to explain what that means, give more information about your outbreaks, and discuss rates of transmission. “I know that you may need some time to think about this and make an informed decision about what that means for our relationship going forward. Let me know if you have questions and I will address them as best I can.”
- “I look forward to being more intimate with you. Before that happens, I need to tell you something that affects our health. I have herpes. I know that word can be loaded and sound scary, but herpes is actually very common. I am aware of many ways to lower the risk of transmission and would like to discuss those with you before taking our physical relationship further.”
- “I have something serious on my mind that I would like to discuss with you. I was diagnosed with HSV (x weeks/months/years) ago. Since then I have learned a lot about how to manage it. I am interested in hearing your thoughts on how this might impact our relationship. What questions do you have for me?”
- “I have herpes. I know there is a social stigma around that, but I hope that we can have an honest discussion about what that really means. I have some resources that we can look at together.”
If you feel you are ready to take a more direct approach, try these phrases:
- “I have HSV, so I get cold sores on my mouth and/or genitals.”
- “I have herpes, so I prefer to use barrier methods when being sexually intimate.”
- “Sexual health is very important to me. I was tested on (date) and found out that I have (oral/genital) herpes. When is the last time you were tested?”
If you feel that you would like more support in talking about herpes or around your diagnosis, the Center for Growth offers weekly group therapy for people with HSV-1 and 2. For more information, visit https://www.therapyinphiladelphia.com/support-groups/herpes-support-group1/ or call (267) 324-9564.