Thanks to STI stigma, being diagnosed with herpes might provoke anxiety about your dating life, especially when it comes to having sex. But thankfully, the reality is, many people with herpes and other STIs are having normal love lives every day.
“Although it is understandable to experience a range of negative emotions after a diagnosis, people with herpes can and are able to have enjoyable, healthy romantic and sexual relationships,” says sexual and reproductive health researcher S. Robyn Charlery White, Ph.D., M.P.H.
A little-known fact is that the majority of people have some form of herpes: Approximately 13% of the world’s population has genital herpes (HSV-2), and 67% has oral herpes (HSV-1), according to the World Health Organization. (Within the U.S., around 50-80% of adults have HSV-1 and 12% have HSV-2, Charlery White says.)
So, if you’ve received a herpes diagnosis, you’re in good company. Here’s what you need to know about how herpes can affect your dating and sex life and what measures you can take to protect your and your partners’ health.
What exactly is herpes?
There are two types of herpes: HSV-1, commonly known as oral herpes, and HSV-2, commonly known as genital herpes. HSV-1 typically is either asymptomatic or causes sores on the lips, mouth, or throat, explains Raegan McDonald-Mosley, MD, MPH, OB/GYN and CEO of Power to Decide. Less commonly, it may infect the genitals or eyes. “Oral herpes sores may be uncomfortable and annoying, but they are generally harmless,” says McDonald-Mosley.
HSV-2, the virus known as genital herpes, is also often latent, with as many as 75-90% of carriers having no symptoms. When symptomatic, HSV-2 usually causes sores on or around the genitals or anus. It can also sometimes lead to sores on the mouth, lips, throat, or eyes, says McDonald-Mosley, so the categories of “genital herpes” and “oral herpes” are general rather than precise terms.
How can you avoid spreading herpes?
HSV-1
Herpes is most infectious during outbreaks—that is, when you have visible sores—so the best way to prevent transmitting HSV-1 is to avoid kissing anyone if you have a cold sore, says McDonald-Mosley. It’s also wise to avoid performing oral sex when you have an oral herpes outbreak, since HSV-1 can be transmitted from mouth to genitals, says Charlery White. “Research shows that up to 25% of HSV-1 infections are genital, and the majority of genital HSV-1 infections are due to oral-to-genital transmission via oral sex.”
HSV-2
Similarly, HSV-2 can spread through vaginal, anal, or oral sex as well as kissing, says McDonald-Mosley. Barriers like condoms and dental dams don’t prevent transmission perfectly, since the virus can exist on skin outside the genitals, but they do make a big difference: A 2016 study in Clinical Infectious Disease found that condoms reduced HSV-2 transmission by 96% from men to women and 65% from women to men. (Condoms may be less effective for preventing transmission from those with vulvas because the virus may live in a broader region, including the whole vulva and perineum, as opposed to just the penile shaft, according to the paper.)
Another way to avoid spreading HSV-2 is to cease or limit sexual activity during outbreaks. If the outbreak is on your genitals, sex involving genital contact is riskiest, but oral sex also carries some risk. “Lesions or sores may be present on the genitals, but asymptomatic shedding may occur in the mouth region, where the virus has reactivated but shows no symptoms,” says Charlery White. “Wait to have [oral or PIV] sex until the flare-up or outbreak is gone and all sores heal completely.” Pleasing a partner with your hands is safe as long as your hands haven’t made contact with the affected area, she adds, and you can wear gloves for extra protection.
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If you have either type of herpes, Charlery White cautions against touching a sore and then touching someone else or even another part of your own body, as it can spread this way. If you’ve touched a sore on your skin, wash your hands right away.
Since abstaining from sex during outbreaks doesn’t eliminate your chances of spreading the virus completely, another option is to take an antiviral medication like Acyclovir or Valacyclovir to avoid outbreaks and transmission. Antivirals reduce your risk of transmitting herpes by about 50%, says Charlery White. This option may be especially helpful if you and your partner have decided that using barriers isn’t for you.
In addition to spreading easily during outbreaks, herpes is also highly contagious right before an outbreak, says Charlery White. So, it can help to learn what it feels like for you when an outbreak is coming. “About 50% of people with recurrent outbreaks experience symptoms such as itching, tingling, or pain before herpes lesions erupt,” McDonald-Mosley says. Some might also experience fever, fatigue, swollen lymph nodes, or flu-like feelings, according to Charlery White.
How to talk to partners about your herpes diagnosis
Telling a partner or potential partner that you have herpes can be nerve-wracking, but it’s best to do early on so you can weed out people who have a problem with it, says Stephen Snyder, M.D., sex therapist and author of Love Worth Making: How to Have Ridiculously Great Sex in a Long-Lasting Relationship. “You need and deserve the acceptance that only someone who’s truly comfortable with it can give. So, best to advise a potential partner of your herpes status before you fall in love with them,” he says. “Also, best to tell them before too many articles of clothing get removed. After all, you don’t want anyone to feel pressured or uncomfortable.”
Some people may even mention that they have herpes in their online dating profile to weed out people who are uncomfortable with it right away.
That said, you don’t need to tell all your dates about your STI status immediately, if that’s stressful for you. Snyder recommends bringing it up by the second or third date, or whenever sex is on the table.
It’s helpful to provide a prospective partner with as many details as possible, including how often you have outbreaks, what you do for treatment or prevention, and what your preferences are regarding barriers, says Snyder. “Have a ‘starter script’ prepared. Something like, ‘I need you to know: I have the virus that causes genital herpes.’”
If you’re not sure about what the risks are to your partner, what safer sex methods work best for you, or how medication might help you, McDonald-Mosley suggests consulting your doctor before talking to partners.
However someone reacts, “Just remember, it’s not personal,” Snyder says. “Everyone has their unique medical personality. Some will be concerned. Others will take it in stride.”
“Remember that herpes, like many other sexually transmitted infections, is common,” McDonald-Mosley adds. “You are not alone and should not feel ashamed.”
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