DEAREST ABBO,
February 2020
​
Dearest Abbo,
Dearest Abbo,
I have gone on a few dates on this really awesome girl, and things are going really well - we have a ton in common, lots of fun when we spend time together, and great chemistry. We’ve done some physical stuff, and this past week we were getting ready to have sex for the first time, when she disclosed to me that she has genital herpes. We had a great conversation about it, but I asked for a little time to think and do my research before we have sex. Abbo, I’m really interested in this girl - and I want to have more than safe sex with her, I want to have GREAT safe sex with her! Tell me what I need to know!
Sincerely,
More Than Safe Sex
​
Dearest MTSS,
Thanks for writing in! Believe me - you are not the only one with these questions on your mind. Since I think a lot of readers will identify with either you, or with your new lover, I’m going to address both of you.
First and foremost, everything that I write here can be summarized in one single sentence: It is MORE than possible to have amazing, hot, and safe sex when one or more than one participants have genital herpes!!! Of course, you KNOW we’re going to get into the nitty gritty, but with all the misinformation and stigma out there, I had to get that out into the ether. So, let’s start with the basics.
BASICS
Herpes simplex virus (HSV) comes in two forms, HSV-1 and HSV-2. In the past, HSV-1 was associated with “oral herpes,” commonly known as “cold sores,” and HSV-2 was thought of as “genital herpes,” as it is more commonly found around the genitals. However, HSV-1 can and does cause genital herpes, especially in people with vulvas - a partner with a cold sore can easily (and often unknowingly) infect a partner by performing oral sex on them. If you have ever had a cold sore in your life, you have “oral herpes” (HSV-1). If you have HSV-1, you’re in really good company - the World Health Organization estimates that 67% of people under the age of 50 are positive for HSV-1. If you have HSV-2, or genital herpes, you’re still in pretty good company - estimates vary somewhat based on sources, but around one in six people between the ages of 14 and 49 have genital herpes - or around 17% of people in that age group.
I think a lot of people are somewhat familiar with the symptoms of genital herpes, but I think it’s worthwhile to discuss them - if nothing else, you’ll have an idea of what your new datemate is going through! For many people, the first outbreak starts with “flu-like symptoms,” such as fever, chills, achiness, and tiredness. Sores around the genitals, inner thighs, and buttocks are the classic symptom. The sores typically cause a burning or stinging feeling, and they last anywhere between two and four weeks. They can burst open and release the fluid that they contain, after which they crust over and eventually go away. Sounds pretty awful, right? The good news is, the first outbreak is almost always the worst one by far - latter outbreaks don’t typically involve any of the flu-like symptoms, and they last between five to seven days on average. Some people experience warning signs before outbreaks, such as burning or tingling in or near the genital area, or even in the lower back or the thighs. Some more good news: recurrent outbreaks are typically less painful, and they become less frequent over time. Some people do not have any symptoms at all, or very mild symptoms that might go unnoticed. And some people, especially people with HSV-1 in the genital area, may only ever have one outbreak.
So, that’s symptoms for you - pretty straightforward. Let’s talk diagnosis. One thing that separates herpes from other sexually transmitted infections is the fact that it’s really hard to test for if you’re not actively having an outbreak. If you do have genital blisters or sores, there is a simple swab test that is done on the blister site which will diagnose herpes with excellent accuracy. In the absence of active symptoms (aka, sores to test), the only option is a blood test - and current guidelines advise against routine HSV blood tests due to the very high rate of false positives (as many as one in two!) In short, if you’re not having symptoms, most doctors will not test your blood for HSV, and probably for the best - a false positive can cause a ton of stress and anxiety over nothing!
​
​
​
​
​
​
TREATMENT, MINIMIZING TRANSMISSION RATES
As far as treatment: as most people know, there is not yet a “cure” for herpes, that is, once you have the virus it remains in your body for life. However, there are a few medications that can lessen the severity and frequency of outbreaks. They are all in the same category of antiviral medication: acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex). These drugs can be used in a variety of ways. During an initial outbreak, providers may prescribe a seven to ten day course of one of these drugs in order to minimize pain and discomfort and prevent more sores from forming. After the first outbreak, providers will often prescribe a two to five day course of the medicine that people can have on hand and start at the first sign of an outbreak - when the first sores appear, or when “warning symptoms” appear if people experience them. This short course of the drug will typically minimize the severity of the symptoms and shorten the duration of the outbreak. For some people who have severe or recurrent outbreaks, they may be prescribed long-term antiviral therapy which they take continuously - this usually controls outbreaks really well. Anyone with herpes symptoms should, of course, talk to a healthcare provider in person to figure out the best treatment options.
There are a lot of techniques and practices that can minimize transmission rates in a “discordant” couple (where one person is HSV-negative and one is HSV-positive). As discussed above, people on long-term antiviral therapy have a “reduced viral load” (simply, they shed less of the herpes virus than others do), and are less likely to transmit to partners. This is a great option for some people, but of course, many are not keen to be on medications long-term if they can avoid it, and some people’s outbreaks are not frequent or severe enough to warrant long-term medication use. In this case, barrier methods and abstaining from sex during an outbreak are the best techniques. And then, of course, there are many discordant couples who accept the risks of transmission and have unprotected sex as long as the HSV-positive partner is not in an active outbreak. Many people, especially folks in long-term relationships, are comfortable with the risk of transmission - of course nobody wants to acquire genital HSV, but a person in a long-term relationship may be comfortable with accepting that risk in exchange for the fun and intimacy that bare sex can offer. One important note about safety - genital herpes and HIV can have a “compound effect,” in that genital herpes can increase the risk of acquiring HIV, and these two viruses sometimes worsen the effects of the other. Folks with genital herpes who are at higher risk for HIV should definitely consult with a medical professional in order to reduce those risks, and vice versa.
SEX WITH HERPES
Alright dear reader - I believe I’ve gone and left my nurse hat on for a bit longer than I planned to! A lot of information, I know. So, let’s get to the heart of the matter. So much of sex can be about fear. Fear of rejection, fear of embarrassment, fear of abandonment. From personal experience, I know there is a lot of fear as well as shame surrounding this question and all questions about sexually transmitted infections. People rightfully worry, “what if I disclose and they think I’m gross? What if they think I’m a slut? What if they don’t wanna have sex with me anymore?” Or, on the other side of things - “what if I catch it from them despite all the precautions? Will my sex life be over?” There is so much misinformation and cultural stigma (“herpes is for life, bro!”) in our society. The only way to move forward is through fear, with open and honest communication. Talking about a herpes diagnosis can be hard, and emotional, and scary, but you might find that it results in some of the most intentional and lovely sex of your life! Similarly - have a partner disclose their positive status to you might be surprising, or unexpected, or even a little nerve-wracking, but believe me, with some knowledge and high-quality communication, you can set your mind at ease. Welcome to the 20s - we’re having great, communicative, safe sex and destigmatizing STIs while we’re at it. Come on in, the water’s fine.
​
Sincerely,
​
Abbo
​
Please Note: Dearest Abbo is for entertainment purposes only, and the opinions above do not constitute medical advice. Please visit the references listed below for more information about safe sex, herpes simplex virus, and more.
​
Abby is a medical professional and a human living in Cleveland Heights, Ohio. Dearest Abbo is a monthly advice column about sexuality and everything else.
Send your questions to perraneumagazine@gmail.com
​
http://www.ashasexualhealth.org/stdsstis/herpes/
https://www.cdc.gov/std/herpes/stdfact-herpes.htm
https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/herpes
https://www.mayoclinic.org/diseases-conditions/genital-herpes/symptoms-causes/syc-20356161
https://www.acog.org/Patients/FAQs/Genital-Herpes
https://www.womenshealthmag.com/health/a30753236/living-with-herpes-emily-l-depasse/
https://www.avert.org/sex-stis/sexually-transmitted-infections/herpes
​
​
Talking about herpes diagnosis can be hard, and emotional, and scary, but you might find that it results in some of the most intentional and lovely sex of your life!
back to jan. 2020 - breakfast
back to feb. 2020 - more
do you or don't you have a relationship with your social media account where you feel like unfollowing people is directly affecting your life? this is not an article just a question.
the staff of perraneu works within a framework of paying that has been plucked from the near future
​
we invite you to subscribe, donate, sponsor, or simply "up vote" with your small donations of as low as $1
​
upvoting:
if the articles or topics you upvote are not "paid for" by the community by the end, we will still do basic reporting on that topic, you just won't see expanded media surrounding it
​
​
&
contribute
​
photography
​
writing
​
video
​
dance
​
voice
​
instrumentation
​
​
