Letters posted here are associated with the following article:

223
Letters
Wednesday, November 22, 2006 12:00 AM

I have herpes. Do I have to tell all my partners?

Is it fair of me to ask someone to accept getting this by becoming involved with me?

The letters thread is now closed.

View:
Wednesday, November 22, 2006 11:46 AM

Not so fast

I tend to think someone with herpes should tell a potential partner as soon as it becomes apparent that they might be having sex, but I don't think it's necessary to tell them far in advance, before things get hot and heavy. Here's why:

As a previous writer mentioned, a full 30-35% of sexually active adults have HSV2, and only about 1 in 4 of them know it. Then on top of that, as another writer mentioned, about 75% of people have HSV1, or "oral" herpes, which is just as easily transmitted to the genital area via oral sex as HSV2 is transmitted via intercourse. So basically, anyone who has EVER had even one little cold sore has a virus, even if it's dormant, that immediately becomes an STD as soon as they go down on someone.

And the truth is, condoms aren't really much help--they only cover the shaft, and the virus is transmitted by skin-to-skin contact. There's plenty of non-shaft skin down there by way of which you can get it--like the entire genital area.

Many doctors no longer even make a real distinction between HSV1 and HSV2, since both can be transmitted to or from the mouth to the genitals and vice versa and back and forth.

And what's more, since so many people have it (again, that's SEVENTY-FIVE PERCENT for HSV1) but never have any symptoms, many doctors will tell you that unless you have had an outbreak, for all intents and purposes you don't have herpes at all. This is because the only way to tell if someone who doesn't have outbreaks has it (and even without outbreaks, they can still shed the virus), is to give them a blood test for antibodies--and so many people have the antibodies, and thus the virus, that it's not worth ruining nearly everyone's sex life by giving them blood tests to let them know.

There's actually a big debate in the medical community about this. When you go to get screened for all the usual STDs, in most cases they don't do a blood test for herpes antibodies because between HSV1 and HSV2, nearly everyone has them, and to tell everyone they did would create mass hysteria (or mass neurosis, at any rate). This is why only 25% of people who have it know it. Some doctors say to test everyone anyway, because it's better to know, but waaaay more say it's just not worth it, because the virus is already so widespread, and it's only spreading wider, and there's nothing we can do about it.

So that said, even though I think one should tell (I have it and I do), I don't think it's a horrible crime not to. Not telling would probably cause some problems later in the relationship if it becomes one, because eventually it will of course come up, but still... Since they probably already have it (75%!!!), and since they're nearly guaranteed to get it sooner or later if they don't, is it soooo bad not to tell?

And if you do tell, is it so bad to wait until things get hot and heavy? Is it worth it to kill your chances of being with someone who might be really special over something they most likely can't avoid anyway, before you've even had a chance to see if there's any chemistry?

I'm not at all sure it is.

Wednesday, November 22, 2006 11:49 AM

Catherine is right.

Catherine has hit the nail on the head. Some of us know we have it (and in my case, I have HSV-1 - "cold sores" - in my genital area and have for three years, without any outbreaks past the initial one), and we manage it. We are protecting you already. The only reason we would EVER NOT tell you is because you WOULD stigmatize us. You would. You would think we were dirty whores and that we would make your genitals itch and ooze. Sorry, that never happened to me, even the first time. I know what my condition is, and I take all precautions to protect you from it. I exercise, I eat right, I take monster vitamins, and I use Acyclovir as a daily suppressive. Have I had an outbreaks in three years? Nope. Have I kept up with my sexual partners and do I know whether or not I've passed it on? Yup. I have not. And why does that matter? Because my efforts at doing my best to protect them have worked. Because I am conscious of this virus and I take the necessary precautions. What good would it serve in telling you? The fact that you could look at me differently, make judgments, and still walk away uninfected. You would do that anyway, based upon the measures I've taken.

My body isn't a petrie dish for infection, and my psyche isn't your tabloid. I do my part.

Wednesday, November 22, 2006 11:55 AM

Re: I was going to ask that

You have to be proactive in your health care, especially when health insurance is involved. A doctor is incentivized to keep costs down, so if you are perceived as "low risk", meaning you have relatively few partners, don't have anal sex, don't use drugs, etc., they will not order tests for stuff you don't likely have. But the tests do exist, and you can ask for them. Don't take my word for it - look at one of your old invoices. You'll see all the diagnostic codes and all of the things you can be tested/treated for. When I walk into the doctor's office, I tell them I want to be tested for everything in the book. I usually get a quiz (to assess my risk factors), a lot of eyerolling and an attempt to talk me out of it. But I insist and so they do them. It usually involves two large vials of blood and a couple small ones (keeping in mind they're also doing cholesterol, etc. at the same time).

There are limitations, as has previously been pointed out. But if I have no antibodies to a disease, then I either have not been exposed to the disease or was exposed so recently that I haven't yet generated antibodies. And if my behavior is such that I can reasonably rule out recent exposure, well then I can sleep peacefully at night.

Your doctor will treat your symptoms. That's pretty much it these days. You're responsible for your preventative health care. If your doctor doesn't want to at least assist in that effort by ordering tests you request, find a new doctor. Ask questions. Fight for your right to keep yourself healthy.

(And those last two statements don't just apply to doctors!)

Most Active Letters Threads

740

The commendably missing element from Obama's speech

There was no pretense that human rights is our goal, or the likely outcome, in escalating the war
411

Do Obama officials know what his Afghanistan plan is?

What explains the completely contradictory statements from key aides on a central plank of the war strategy?
407

America's regression

It's almost impossible to find a nation with as many torture advocates as the U.S. has.
321

Palin: Birthers have "fair question" about Obama

Of Obama birth, the ex-governor says, "the public is still, rightfully, making it an issue" (Updated)
211

The poster boy for progressive self-delusion

Read Hayden's 2008 Obama endorsement to remember the way the left sold our centrist president to itself

View all »

Letters Help

Currently in Salon