Everyone loves a good True or False session!

All of the following statements are either True or False:

1) If you had genital herpes, you would know it, because you would get outbreaks.
2) You don't have to worry about asking your partner to get tested for STDs until you are ready to ditch the condoms.
3) It is safe to assume that non-promiscuous people who have been mostly in steady relationships do not have genital herpes.
4) If you have been married for 10 years and all of a sudden you come down with genital herpes, your partner must have cheated.
5) If you get genital herpes and go back and ask all your exes and no one has it, or never gave it to someone else, then someone is lying.
6) You cannot get genital herpes from someone who does not have genital herpes.

Ok, got your answers?

All of those 6 statements, believe it or not, are absolutely FALSE. Read on, this will be more exciting than Ripley's Believe it or Not!

1) If you had genital herpes, you would know it, because you would get outbreaks.
FALSE.
Although 20% of Americans have genital herpes (HSV2), only 2% are aware that they do. Huh? Here's why. 90% of those infected have either non-existent or not obvious symptoms. Only 10% of people who have genital herpes have obvious text book outbreaks. But even those who are completely asymptomatic can spread it to someone else, who can end up having obvious outbreaks. SO, if someone tells you they don't have any STDs, they actually have no way of knowing that unless they have gotten a type-specific HSV blood test. This test is not included in STD testing unless specifically requested. (A travesty on behalf of the healthcare system, which we can go into in another post.)

2) You don't have to worry about asking your partner to get tested for STDs until you are ready to ditch the condoms.
FALSE.
You do have to have the STD conversation before sex, even if you're using condoms. Here's why - genital herpes (and HPV) can be transmitted DESPITE condoms. They are viruses, and can be present on the genital area skin that the condom does not cover, even if the person is not having an outbreak. OK, so you're not having sex with someone if they have a visible outbreak, and you're using condoms, so if these two things aren't enough to prevent getting HSV2, what else can be done? Well, the person with HSV2 can take Valtrex daily, or one of the other anti-viral meds. It's a Godsend in preventing transmission (it's not 100%, but it is something like 97% effective, which is comparable to birth control pill rates.)

3) It is safe to assume that non-promiscuous people who have been mostly in steady relationships do not have genital herpes.
FALSE.
This stereotype is one that is hard to break. Sure, all STDs including herpes are going to be more prevalent amongst people who have had lots of sexual partners, since your risk of getting one increases with each new partner you have. But that does not mean that those who have only had one or only a few partners can't get it. So you only slept with one person in your life, but that person had an ex who had an ex who had HSV2. Get it?

4) If you have been married for 10 years and all of a sudden you come down with genital herpes, your partner must have cheated.
FALSE.
This is a common scenario. If your spouse is adamant that they did not cheat, they very well might be telling the truth. There are two reasons why. a) Your spouse could have had HSV2 for years, going back to before you were married, and have no idea they had it. And you can sleep together for years without it being transmitted to you (in many cases, it will never be transmitted.) b) You yourself can have had HSV2 for years, going back to before you were married, and had no idea you had it, but all of a sudden your first outbreak can be triggered by an unknown cause.

5) If you get genital herpes and go back and ask all your exes and no one has it, or never gave it to someone else, then someone is lying.
FALSE.
Again, someone can have it and not know it. But another common justification that people will use is that none of the other people they slept with ever got it. But that is not valid, because a) you are not going to transmit it every time you sleep with someone. As we discussed earlier, it is actually pretty hard to transmit. and b) they could have transmitted it to someone who showed no symptoms and still has no idea.

6) You cannot get genital herpes from someone who does not have genital herpes.
FALSE.
This is the biggest doozy for me. You CAN get genital herpes from someone who does not have genital herpes. WHAT? Yes, it's true. Someone who only gets cold sores (which, yes, is a form of herpes) on their mouth from time to time can transmit the herpes virus to you genitally when giving you oral sex, even if they are not having a cold sore at the time. This is what happened to me. Essentially, I got an STD from someone who did not have an STD. Awesome! In that case, you have genital HSV1, which is a different animal than HSV2. (For more on this, read the post following this one called Type 1 - to tell or not to tell?)

Still trying to wrap your brain around all this? Don't worry, you're not alone. Much of this info my be new to most people, because unfortunately, the info we need to know about herpes is just not out there. But I do have a feeling that studying up on these facts may be of a greater practical use for most of us than any of those calculus tests we sweated over back in the day.

Class dismissed!