Herpes and Relationships

The more emotionally charged an issue, the more important it is to find out the facts. Most people know little or no facts about herpes. Frequently, what knowledge they have is coloured by myth and misconception. Having the correct information about herpes not only makes it easier for your partner, but it also makes it easier for you.

Following are some of the basic facts about herpes that might be important points to tell a partner.

There is a lot of information about herpes. Have educational materials on hand for your partner to read. Be prepared to answer their questions.

Herpes simplex causes a viral skin condition is known as cold sores (on face), whitlows (on fingers) or 'herpes' on genitals or other skin areas
Most people who have genital herpes do not know they’ve got it. The absence of symptoms does not mean a person has not got genital herpes.
Herpes simplex virus (HSV) most often shows up as small blisters or sores on either the mouth (cold sore or fever blisters) or the genitals.
HSV can be passed on when one person has the herpes virus present on the skin and another person makes direct skin-to-skin contact with the live herpes virus.
The herpes virus is likely to be present on the skin from the first sign of prodrome (tingling or itching where the outbreak usually occurs) until the sores have completely healed and new skin is present.
There are likely to be certain days when active herpes virus might be on the skin even though there are no obvious signs or symptoms.
Always using latex condoms can reduce the risk of transmitting the herpes virus by approximately 50%.
Herpes is very frequently transmitted by infected persons who don’t know they are infected with herpes. Since they have not been diagnosed, they are unaware that they may be contagious from time to time.
There is an effective oral antiviral treatment for people with problematic genital herpes.

Discussing genital herpes with your partner

Many people do not feel comfortable talking about sexuality and sexual health issues. This pamphlet will help you explore ways of feeling more confident in discussing herpes in the context of a sexual relationship.

Cold sores on the face and genital herpes are medically the same condition. The significant difference arises from the stigma that tends to accompany an infection that is associated with being sexually transmitted.

Most people find that their partners are both supportive and understanding. It is a common assumption to initially think that a person may base their judgement of you on the fact you have genital herpes. However, for most this is a minor skin infection. People fear the possibility of rejection but in reality this rarely happens.

Because fear of rejection is a concern, it leads some to question why they should risk talking about herpes. Accordingly, some people choose not to tell their sexual partners. Instead they abstain during outbreaks, practice safe sex at other times, and hope for the best.

This strategy may have more disadvantages than advantages. First of all, you spend a lot of time and energy worrying that your partner is going to get herpes. It’s much harder to tell someone if they just found out they’re infected. For most people, the anxiety over not telling is worse than the telling itself.

On the other hand, telling your partner and allowing them to enter into the relationship with full knowledge of your infection, will provide an opportunity for them to learn about genital herpes. This is because, when you have an outbreak, you can discuss it with a partner instead of making excuses for why you can’t have sex. Excuses create distance between partners and often lead to misunderstanding and guesswork.

Your partner might interpret your excuses in ways more detrimental to the relationship than an honest discussion about genital herpes would be.

If you are able to discuss the situation openly and honestly, you can find imaginative ways to be ‘safely’ sexually intimate. And remember, your partner may already have one or both strains of HSV; just because they have never had symptoms doesn’t mean they don’t have it.

Genital herpes is extremely common, with up to one in three adults who are sexually active having genital herpes, although many remain unaware that they are infected.

Inaccurate and stigmatising articles and advertising have contributed to many of us having negative herpes-related beliefs that make it difficult to convince ourselves that others would want to be with us. It’s important to recognise these beliefs and consciously change them. Accepting the fact that you have herpes and are still the same person you were before will make it easier to have a fulfilling relationship.

Preparing to tell your partner

What you say and how you say it is going to depend on your own personal style.

Your attitude will influence how this news is received. Psychologists have observed that people tend to behave the way you expect them to behave, and expecting rejection increases the chances of an unhappy outcome.

A straightforward and positive conversation about herpes issues is the best approach and may be helped by forward planning.

How long should you know someone before you tell them?

If it appears that you are going to end up in bed with someone then it’s probably important to tell them before that happens.

However, it’s often best to give it a few dates or a little bit of time before telling. Allow the relationship to develop a little. It’s going to be easier if the two of you enjoy a degree of comfort and trust in each other’s company. Where appropriate, it’s probably better to wait until you know and trust each other.

There are good and bad times to bring up this topic. Some of the more inappropriate moments include in a crowded bar or at a party, travel en route to a romantic weekend, or raising it when you’ve just finished having sex. Talking just prior to having sex is not a good idea either.

Bring up the issue when you are not already ‘in the mood’ for sexual intimacy.

The discussion could take place anywhere you feel safe and comfortable. Some people find it easiest to broach the subject over a quiet dinner at home where there a few distractions. Others prefer a more open place, like walking in the park, so that their partner will feel free to go home afterwards to mull things over. This allows both people to walk off a little nervous energy at the same time.

No matter where you choose to have the discussion, it’s important to allow for the fact that one or both of you might get emotional.

Try to be natural and spontaneous. If you find yourself whispering, mumbling, or looking at the floor, stop for a moment and try to speak calmly and clearly. Look your partner in the face. Your delivery affects your message. If you are obviously upset, the person you’re speaking with might perceive the situation as being much worse than it is.

Conversation starters

The following opening statements represent a variety of nonthreatening ways to prompt discussion. They are not intended to be regarded as scripts.

Instead of taking the “I have something important to tell you” route, treat this as an opportunity to discuss how you want to approach sex and dating. This is a good time to ask how recently they were last tested for STIs, and to discuss what forms of protection and contraception you want to use together.
“Have you ever had a cold sore? The reason I ask is that cold sores are caused by a type of virus. Herpes simplex virus. I have the virus. Only instead of getting a sore on my face, I get one in my genital area.”
“When two people get along as well as we do, I think we owe it to each other to be totally honest. I’d like to talk about our sexual histories.”
“I really enjoy being with you, and I’m glad that we’re becoming more intimate. I think it’s important that we talk about sex. Can we talk now?”
“We’re both responsible adults who want to do what’s best for each other and ourselves. Let’s talk about safe sex.”
“I feel that I can trust you and I’d like to tell you something personal. Last year, I found out that I had contracted genital herpes.”

Try not to be melodramatic. This is not a confession or a lecture, simply the sharing of information between two people. Avoid negative words and keep the dialogue simple and factual: “I found out two years ago that I have herpes. Luckily, it’s both treatable and manageable. Could we talk about what this means for us?”

You might even be surprised to learn that your partner has been equally concerned about telling you that they have genital herpes or another sexual infection. In fact, the probability of this is reasonably high, given the statistics on HSV.

Realistic and unrealistic expectations

People may just need a little time to assimilate the information. This is where having good written information helps. Consider giving them reading material or referring them to a sexual health clinic, the Herpes Helpline (0508 11 12 13 toll free from a landline or 09 433 6526 from a mobile) or the herpes website www.herpes.org.nz, to verify the information you’ve given them.

Whatever the reaction, try to be flexible. Remember that it took you time to adjust as well.

Negative reactions are often no more than the result of misinformation. In some cases, they are brought on when a person fears that you’re asking them to commit to a relationship, instead of just informing them of the situation. If your partner decides not to pursue a relationship with you simply because you have herpes, it’s better to find out now. It takes a lot more than the occasional aggravation of herpes to destroy a sound relationship.

Some people react negatively no matter what you say or how you say it. Others might focus more energy on herpes than on the relationship. These people are the exception, not the rule. This is not a reflection on you. You are not responsible for their reaction. If your partner is unable to accept the facts, encourage them to speak with a medical expert or the Herpes Helpline counsellor.

The majority of people will react well. They will respect the trust you demonstrate in sharing a personal confidence with them. With the proper approach and information, herpes can be put into perspective: an irritating, sometimes recurrent skin condition – no more, no less.

Regarding the relationship overall, know that you can have the same level of intimacy and sexual activity that any couple can. It is true that in an intimate sexual relationship with a person who has herpes (facial or genital), the risk of contracting herpes will not be zero, but while there is a possibility of contracting herpes this is a possibility for any sexually active person. And the person may unwittingly already have been exposed to the herpes virus in a previous relationship.

All relationships face challenges, most far tougher than herpes. Good relationships stand and fall on far more important issues – including communication, respect and trust.

Whether or not this relationship works out, you have enlightened someone with your education and experience, correcting some of the myths about herpes that cause so much harm. You have removed the shroud of silence that makes it so difficult for others to speak. And you have confronted a personal issue in your life with courage and consideration.

How has my partner caught genital herpes?

Genital herpes can be transmitted through direct contact with an infected blister or sore, usually through sexual contact. It can also be transmitted when there are no symptoms present. HSV-2 infection is usually passed on during vaginal or anal sex. HSV-1 is usually transmitted by oral sex (mouth-to-genital contact).

If your partner has only just been diagnosed as having genital herpes, this does not necessarily mean that they have been unfaithful to you, or sexually promiscuous in the past.

Your partner may have caught genital herpes from you. It is possible that you carry the virus without knowing that you have it, since up to 80% of people who have been infected with HSV have either no symptoms or such mild symptoms they are unaware they have the virus. So it is very easy for you to have unwittingly transmitted the infection to your partner. The symptoms of the infection vary greatly between individuals – it might be totally unnoticeable in you, but cause severe blistering in your partner.

Since the genital herpes virus can be transmitted through oral sex as well as genital-to-genital sex, it is also possible that your partner caught the virus from a cold sore on your mouth or face. Remember, it is possible you can pass the virus on even if you didn’t have a cold sore present at the time of contact.

Alternatively, your partner may have contracted the virus from a previous sexual partner, perhaps even several years ago. The virus can remain inactive in the body for long periods, so this may be the first time it has caused symptoms.

How do I know if I have genital herpes?

Most people who have genital herpes don’t know because they have either no symptoms or such mild infrequent symptoms, it goes unrecognised. Diagnosis is made from having laboratory confirmation from swabs taken from clinical symptoms of an active episode.

Do the symptoms of genital herpes return?

The symptoms of genital herpes may reappear from time to time. This is because once the virus is acquired, it stays permanently in the body. Most of the time it remains inactive, but every so often it may reactivate and cause another outbreak.

Each individual is different – some people never have a recurrence; others may have recurrences several times a year. However, recurrent outbreaks are usually shorter and less severe than the first episode.

Certain events or situations can trigger recurrences, and you may be able to help your partner avoid or reduce the trigger factors, which may include stress at work or home, fatigue, ill health, loss of sleep, friction due to sexual intercourse.

If your partner has frequent or severe episodes of genital herpes, or if the recurrent outbreaks are causing a lot of anxiety for your partner, then they may benefit from suppressive therapy (taking oral antiviral tablets continuously), which prevents or reduces recurrences.

If my partner has herpes what can we do to reduce my chances of getting the herpes infection?

If you take the necessary precautions, the chances of getting the virus from your partner are reduced. Genital herpes does not mean abstinence from sex or a reduced enjoyment of sex.

The risk of transmitting the virus can be reduced about 50% if you use condoms. The continued use of condoms in a long-term relationship is a personal decision that only the couple can make. Most find that as the importance of the HSV infection in their relationship is seen in perspective, that condom use becomes less relevant if this is the only reason condoms are being used.

However, most couples choose to avoid genital skin-to-skin contact during an active episode of herpes because this is when the virus is most readily transmitted. This period includes the time from when your partner first has warning signs of an outbreak, such as a tingling or burning in the genitals, until the last of the sores has healed. Also, sexual activity prolongs the healing of the episode.

Transmission risk is increased if there are any breaks in the skin. For example, if you have thrush or small abrasions from sexual intercourse, often due to insufficient lubrication. It can be helpful to use a lubricant specifically for sexual intercourse and avoid sex if you have thrush. Sexual lubricant is helpful right at the start of sexual activity.

Sores in other areas – such as the buttocks and thighs – can be just as contagious as those in the genital area, and care should be taken to avoid direct contact with such sores during sex.

At other times, there is still a small risk of transmitting the infection through a process known as asymptomatic shedding, even if your partner is showing no signs of genital herpes. This risk can be reduced significantly if a person with herpes takes suppressive oral antiviral treatment. If you or your partner has a cold sore, it is advisable to avoid oral sex as this can spread the virus to the genitals.

You cannot catch genital herpes by sharing cups, towels or bath water, or from toilet seats. Even during an outbreak, it is only skin-to-skin contact with the parts of your partner’s body which have the sores which you need to avoid. You can still cuddle, share a bed, or kiss.