The 4th of September is World Sexual Health Day, and this year’s theme is consent. Consent is crucial in any sexual encounter, but it’s also important that your partner knows the risks they may be taking.
Herpes is a viral infection commonly affecting the mouth (cold sores) or genitals. There are treatments to help alleviate the symptoms of herpes, but there is currently no cure for the infection itself.
With this in mind, you and your sexual partner need to be aware of the infection, the risk of passing it on and what you can do to reduce that risk. Herpes disclosure is a vital part of consent, but it can be difficult to discuss. In the lead-up to World Sexual Health Day, we’re trying to break down the barriers and encourage open conversation around herpes and consent.
Understanding Herpes Simplex (HSV-1 and HSV-2)
What is Herpes?
Herpes infections are caused by the herpes simplex virus (HSV). There are two types of this virus, known as HSV-1 and HSV-2. HSV-1 is the most common type of herpes virus – it is the type that causes oral herpes, also known as cold sores. In some cases, HSV-1 can also cause genital herpes, but most genital herpes is caused by HSV-2 infection. Once you are infected, there is no cure for the virus; it hides in nerve tissue between outbreaks, making it difficult for the immune system to remove from the body.
How is Herpes Spread?
Herpes is spread by contact with affected skin surfaces – kissing someone with active cold sores or having sex with someone with an active HSV infection. HSV-1 can be transferred from the mouth to the genitals via oral sex. Herpes transmission is much more likely to occur if someone has active visible sores; however, it is possible to contract the virus from normal-looking skin in infected individuals.
How Likely am I to Get Herpes?
Herpes is very common. According to the World Health Organisation (WHO), 67% of the global population is infected with HSV-1. 13% of people between 15-49 years of age have genital herpes caused by HSV-2; the rates are even higher in older age groups. Women are also twice as likely to become infected as men when they have sex with someone who has herpes.
What are the Symptoms of Herpes?
Herpes symptoms can vary. Most people with herpes have very mild symptoms, or no symptoms at all. It is possible to infect someone else with herpes without knowing that you are infected yourself.
The typical symptoms of herpes include painful fluid-filled blisters or sores. This can occur around the mouth in oral herpes, or around the genitals or anus in genital herpes.
When you are first infected, you may not notice any visible sores. Instead, you may experience flu-like symptoms, including fever, body aches, swollen lymph nodes (glands in your neck or groin) and headaches. Oral herpes can also cause a sore throat.
It is important to be aware of these symptoms of a primary infection of herpes, so you can be on the lookout for symptoms of your first outbreak. The first outbreak of herpes typically begins with a tingling or burning sensation on the skin, then the sore will appear shortly after. Your first outbreak of herpes may last 2-4 weeks, but subsequent outbreaks tend to be shorter.
Typically, people with HSV-2 infection will experience approximately 4-5 outbreaks a year, but these can become less frequent over time.
Herpes Testing and Disclosure
How is Herpes Tested?
Genital herpes is usually diagnosed by taking a swab of a blister or sore. The swab is analysed to detect the virus which can lead to a diagnosis. Unfortunately, a swab test cannot be used if you do not have any visible sores. If you do not have any visible sores, a blood test can be used; however, this is not always reliable, especially if you have only recently been infected.
You can get tested in a sexual health clinic and at some GP practices. Alternatively, you can request a home test kit for herpes which will allow you to take a swab at home yourself and then post it to a lab for analysis. Here at Simple Online Pharmacy, we offer a test kit for men who have sex with men, with the full panel test kit including a herpes test.
When to Disclose a Herpes Infection
You must let your partner know about a herpes infection before any sexual contact takes place. This is really important, even if you do not have any active sores or you plan to use a condom. In order to consent, your partner must be aware of the risk of infection. They cannot properly consent if you have not disclosed your infection.
It can be difficult to discuss a herpes infection, but it is very important for both you and your partner. In the UK, you can even be prosecuted if you pass on herpes to someone without informing them of your infection.
Exactly when you disclose your herpes infection is up to you – but it must happen before any sexual contact that could put the person at risk of infection.
What is ‘Reckless Transmission’ of Herpes?
‘Reckless transmission’ is a legal term that applies when you infect someone with an STI such as herpes or HIV without informing them of your infection. If found guilty, you could serve up to 5 years in prison for each person you have infected. In England and Wales, you could be found guilty of reckless transmission if the following criteria apply:
- You knew you had herpes
- You understood how herpes is transmitted from person to person
- You infected someone with herpes
- You were not taking daily antiviral medication for herpes
In Scotland, the law is more strict. The maximum prison sentence can be higher, with one individual being sentenced to 10 years for a case of reckless transmission of HIV. In Scotland, you could be prosecuted if you put someone at risk of infection, even if they did not actually become infected.
Safe Sex with Herpes
Avoid Sex When You Have Active Sores
The risk of transmission is highest when you have active herpes sores, for both genital and oral herpes. If you are having a herpes outbreak, you should avoid any skin-to-skin contact with the affected areas between you and your partner. Sexual intercourse should be avoided for anyone with an outbreak of genital herpes, and oral sex should be avoided by anyone with an outbreak of oral or genital herpes.
You should also be aware that the virus can be carried on sex toys and hands. Do not share sex toys, and wash your hands before any sexual activity that may include contact between your hands and the genitals, mouth or anus of your partner.
Herpes Antivirals
The best way to prevent spreading herpes to your partner is to take daily herpes antiviral tablets. This significantly reduces your levels of the virus and makes it very unlikely that you could transmit it to your partner. Here at Simple Online Pharmacy, we can supply prescriptions for both Aciclovir and Valaciclovir; both are antiviral treatments that use the same active ingredient. Valaciclovir is the generic version; chemically identical and just as effective, but better value for money.
Do Condoms Protect Against Herpes?
Condoms can offer some protection against genital herpes, but they are not perfect. One study found that condoms reduce the risk of transmission from men to women by 96%, but it only reduced the risk by 65% from women to men. This is because condoms do not create a barrier over all the areas of skin that could be affected by the herpes virus. If a sore or an area of affected skin is not covered by the condom, there is still a risk of transmission.
Dental Dams and Herpes
A dental dam is a thin latex sheet that acts as a barrier between the mouth of one person and the vagina or anus of another. They are used to reduce the risk of infection passing between the two individuals. Dental dams can be very useful for people with herpes, as they provide a physical barrier between the skin surfaces of two individuals.
Herpes Treatment Options
There is no cure for herpes, but the symptoms can be treated. The best treatment for genital herpes is antiviral tablets such as aciclovir or valaciclovir. These are available on prescription from your doctor and online pharmacies. They can be used to treat an outbreak, or they can be taken daily to reduce the chances of an outbreak occurring. Daily herpes antivirals are the best way to reduce the chance of passing herpes on to your partner.
Oral herpes is generally treated with topical antiviral treatments that are applied directly to the skin. These are not suitable for genital herpes and, if used, can cause the virus to develop resistance to the medication, making it harder to treat in future.
Herpes can also be very painful. Painkillers such as paracetamol or ibuprofen can offer some pain relief; cool compresses and loose-fitting cotton underwear can also help to alleviate the pain.
Take an assessment to see your herpes treatment options
Summary
- Herpes can affect the mouth (oral herpes/cold sores) or genital areas.
- During outbreaks, herpes causes painful sores or blisters to the affected areas. This is the best time to get tested.
- Herpes can be passed on to others even if you do not have any visible sores.
- Avoid sexual contact during a herpes outbreak and avoid kissing and oral sex if you have active cold sores.
- Antiviral medications are the best way to protect your partner from infection. Dental dams can offer protection during oral sex. Condoms offer better protection against male-to-female transmission but offer little protection against female-to-male transmission.
- Disclosing your herpes infection is an important part of consent. Failure to do so could lead to criminal charges and even a prison sentence
- Antiviral treatments are available for both oral and genital herpes and can be combined with pain relief
- It is possible to have a healthy and safe sex life with herpes, but make sure you discuss it with your partner before any sexual contact occurs.
