STD Awareness: The Herpes Virus and Herpes Medications

herpes medicationOne of the most common sexually transmitted diseases (STDs) is herpes, which affects an estimated 1 out of 6 Americans between the ages of 14 and 49. Herpes is caused by a virus, and one reason that it’s so widespread is that the herpesvirus is ancient. Prehistoric, even — dinosaurs are thought to have been infected by herpesviruses! The Herpesviridae family is huge, with at least 100 members infecting mammals, birds, reptiles, bony fish, amphibians, and oysters.


Herpes drugs from the acyclovir family physically block herpes DNA from replicating — which is pretty amazing!


Humans can suffer from both oral herpes and genital herpes, which are caused by two types of the herpes simplex virus (HSV-1 and HSV-2). Recent genetic analysis reveals that the virus that causes cold sores, HSV-1, has been evolving with us since before we were Homo sapiens, diverging from the viruses that infected our common ancestors 6 million years ago. Interestingly, we didn’t acquire HSV-2 — which mostly causes genital herpes — until our Homo erectus ancestors caught it from early chimpanzees 1.6 million years ago, well before the emergence of modern Homo sapiens around 200,000 years ago.

Most people know what the virus doesgenital herpes can involve blisters, pain, and itching — but most people don’t know how the virus works. Luckily, scientists have uncovered a lot of the virus’ secrets — which has allowed them to develop some pretty effective drugs that we can use to foil herpes’ plans. Continue reading

STD Awareness: Genital Herpes

Herpes viruses inside a cell. Image: CDC

In the most recent Planned Parenthood annual report, a Tucson mother describes her daughter’s mysterious ailment, which stumped doctors at the hospital. Her symptoms included an itchy, tender genital area with painful lesions — but the physicians who “pored over her poor vulva” decided it was nothing to worry about and sent her home. A few days later, though, she called her mother in the middle of the night, sobbing, her condition now worse. “There were lesions, pustules, and the area was deep red,” her mother wrote. So this time, she called the experts: Planned Parenthood.


If you have symptoms, get checked out! An accurate diagnosis is more likely when symptoms are present.


The condition wasn’t nothing — it was genital herpes, and the mother praised Planned Parenthood for “spot[ting] something other pros missed.” Indeed, sexual and reproductive health is what we do — day in and day out! Whether you’re young or old, sexually active or celibate, insured or paying out of pocket or eligible for sliding-scale fees, we’re here to share our expertise with you.

The word “herpes” comes from an ancient Greek word that means “to creep,” after the “creeping” nature of skin lesions that might spread across areas of one’s body. We now know that the herpes simplex virus can “creep” up and down nerves, retreating to nerve cells to go dormant and returning back to the surface of the skin to cause symptoms or “shed” new virus particles. (Like a cat sheds fur, so too can people shed viruses.) Continue reading

STD Awareness: Can Lesbians Get STDs?

couple WSWA couple of months ago, in time for Valentine’s Day, the Centers for Disease Control and Prevention announced that it would start using the term “condomless sex” instead of “unprotected sex.” The move was hailed by many HIV advocacy groups for taking into account other risk-reduction practices, such as medications that decrease the chances of HIV transmission.


Women can transmit just about any STD to one another.


However, while medications can reduce HIV risk, condoms still offer protection from both pregnancy and many other sexually transmitted diseases (STDs), such as chlamydia and gonorrhea. One reason that condoms are so valuable is that they can be placed over a penis to collect fluids before and after ejaculation — dramatically reducing risk for both pregnancy and many STDs. So, even when using anti-HIV meds, engaging in “condomless sex” can still be risky.

But what if partners are engaged in sexual activities that don’t involve penises? Not all sexual couplings involve a cisgender man, and even those that do might not utilize a penis at every encounter. When two people without penises have sex, they’re probably going to be engaging in condomless sex — though condoms can be placed over penetrative sex toys or cut along the sides to be converted into dental dams, they might not figure too prominently in this couple’s safer-sex arsenal. Lesbians protecting themselves with dental dams are technically engaged in “condomless sex,” but it’s still a far cry from being “unprotected.” Continue reading

STD Awareness: How Can I Protect Myself if My Partner Has Herpes?

herpes protectionHas your partner, or potential partner, recently informed you that he or she has been diagnosed with genital herpes? After thinking about it, did you decide to continue with the relationship, despite not being infected with the virus that causes genital herpes yourself? Congratulations — the two of you are now a “discordant couple,” which means that one of you has genital herpes and the other doesn’t. While you might have come to the conclusion that acquiring a herpes simplex virus (HSV) infection below the belt won’t be the end of the world, you still might want to stay discordant — and do everything you can to minimize chances of virus transmission.


Condoms, medication, and abstinence during outbreaks can reduce risk for herpes transmission.


You can read all about herpes elsewhere on this blog, but here’s a quick rundown: Genital herpes can be caused by one of two strains of the herpes simplex virus: HSV-1 or HSV-2. While HSV-1 is more commonly associated with cold sores and HSV-2 is more commonly associated with genital herpes, either virus can infect the genital area. One estimate states that 1 out of 6 Americans between 14 to 49 years of age has a genital HSV-2 infection. Since genital herpes infections can also be caused by HSV-1, the number of people with genital herpes is actually higher.

Barring total abstinence from all sexual activity, you won’t be able to protect yourself completely from acquiring HSV — but there are many steps that you and your partner can take to decrease risk. Studies on discordant couples show that viral transmission can be reduced with condoms, antiviral herpes medications, practicing abstinence when symptoms are present, and patient education.

Condoms

Latex condoms protect against most STDs, especially fluid-borne infections like HIV and gonorrhea. But condoms also provide some protection against STDs that are transmitted by skin-to-skin contact, including genital herpes. One large study found that condom usage was associated with lower rates of HSV-2 acquisition — the more frequently someone used condoms, the lower the risk. Unsurprisingly, risk was also associated with frequency of sex acts: People having vaginal or anal intercourse more than twice weekly were 77 percent more likely to acquire HSV-2 than people having less sex. Continue reading

Can Oral Herpes Be Spread to Genitals?

A cold sore on the lower lip on the second day after onset. Image: CDC

Herpes simplex virus is mystifying, fascinating, and sneaky. Mystifying because we have yet to unravel all of its secrets; fascinating because when we do uncover one of its mysteries, we are amazed by the capabilities of such a tiny, microscopic object; and sneaky because it enters our bodies by stealth and conceals itself in our cells, taking us by surprise when it comes out of hiding and causes outbreaks of blisters and other lesions.

It can also be confusing. Herpes simplex virus actually comes in two flavors: HSV-1 and HSV-2. HSV-1 is associated more with oral herpes, which can cause “cold sores,” a type of blister that appears on the lips or face. HSV-2 is associated more with genital herpes, which can cause blisters and other lesions in the genital area. It used to be standard to describe HSV-1 as an “above-the-waist” infection and HSV-2 as a “below-the-belt” infection — but now many researchers are pointing out that it’s more appropriate to say that HSV-1 is both an orally and genitally transmitted infection while HSV-2 is a predominantly genitally transmitted infection. If HSV-1 enters the body in the genital area, it can cause a genital herpes infection — and likewise, if HSV-2 enters the body in the facial area, it can cause an oral herpes infection.


Using condoms and dental dams during oral sex reduces risk of herpes transmission.


What exactly is a cold sore, anyway? A cold sore, also known as a fever blister, is a cluster of blisters that can pop up around the lips or even in the mouth. Sometimes, cold sores are so painful that eating or drinking is difficult, and in extreme cases sufferers must be treated for dehydration. An especially severe infection could also cause high fever or swollen lymph nodes, and in young adults a first oral HSV-1 infection might be misdiagnosed as tonsillitis, possibly leading to unnecessary tonsillectomies. Most symptomatic first-time cold-sore outbreaks occur during childhood, and take about two or three weeks to clear up. Luckily, the first infection is almost always the most severe, and when the infection is reactivated it usually happens without symptoms.

Because both cold sores and genital herpes are caused by herpes simplex viruses, and because oral herpes is so common, many people are concerned that they might be more vulnerable to acquiring a genital herpes infection than they previously thought. They might have a lot of questions, and if they’ve sought answers to those questions, they might have heard a lot of conflicting answers. Let’s see what the scientific literature has to say.

  • Can I get genital herpes if someone with cold sores performs oral sex on me?

Because HSV-1, the virus responsible for most oral herpes infections, can also cause genital herpes, many people wonder if someone with cold sores can transmit the virus to someone else by performing oral sex, resulting in a genital herpes infection. Other people wonder if HSV-1 can be transmitted via oral contact with the anus, resulting in a herpes infection in the rectal area. The answer to these questions is: Yes! Continue reading

STD Awareness: Oral Herpes

A transmission electron micrograph reveals HSV particles. Image: Fred Murphy, CDC

One of the most common sexually transmitted diseases is herpes, which most people associate with “outbreaks” in the genitals. In actuality, most cases have no symptoms, and the majority of people with genital herpes don’t know they have it. Herpes simplex virus, which causes genital herpes, can also infect facial nerves around the mouth, and its “outbreaks” include blisters called cold sores.

A cold sore outbreak involves an “eruption” of blisters around the mouth, which slowly heal as the virus returns to dormancy. Most cold sores are caused by herpes simplex virus type 1, or HSV-1. Around 60 percent of Americans are infected with HSV-1, and most of these infections are oral, asymptomatic, and acquired in childhood through nonsexual contact. Despite how common this infection is, only 20 to 40 percent of us actually get cold sores — and an even smaller percentage experience cold sores more than once a year. The rest of us don’t get cold sores at all, even if we are infected with HSV-1. That’s one quirk about HSV — an infection is permanent and incurable, but most people never have symptoms!


The virus that causes oral herpes can also cause genital herpes.


Making matters more confusing, there’s a related virus called HSV-2, which most people associate with genital herpes. However, HSV-1 can also cause genital herpes, and anyone with an HSV-1 infection in the facial area has the potential to transmit the virus to a partner’s genitals while performing oral sex — whether or not cold sores are present. However, when HSV-1 strikes the genitals, the infection is usually milder, with fewer (if any) recurring outbreaks. Additionally, a previous HSV-1 infection in the facial area might make you more resistant to acquiring an HSV-1 infection in the genital area — but it doesn’t confer total immunity. Continue reading

STD Awareness: 10 Myths About Sexually Transmitted Diseases

The Internet is brimming with contradictory claims about sexual health, and you don’t know what to believe. Your friends give you advice, but you’re not sure if it sounds right. To make things worse, you might not have had evidence-based, medically accurate sex education in your school. In this edition of our STD Awareness series, we’ll take on a few myths about sexually transmitted diseases to help you sort fact from fiction.

1 MYTH: You can tell if someone has an STD by looking at them.
You might expect that if someone has an STD, their genitals would have blisters, warts, or noticeable discharge. But your partner looks fine, so you might think there’s no need to ask when his or her last STD test was.

However, while many people with STDs do have visible symptoms, they’re the exception rather than the rule. For example, three out of four women and half of men with chlamydia have no symptoms. Herpes is often spread when there are no symptoms present. Someone can be infected with HIV — and capable of transmitting it to others — and go years without showing any signs. A quick visual inspection can’t tell you very much about someone’s STD status.

2 MYTH: You can’t get an STD from oral sex.
While it is generally true that oral sex presents less of a risk for contracting STDs, this risk is not trivial. Most STDs can be passed along by oral sex, including chlamydia, gonorrhea, syphilis, hepatitis B, herpes, human papillomavirus (HPV), and HIV. You can reduce your risk by using barrier methods like condoms and dental dams consistently and correctly.

3 MYTH: Condoms can’t prevent the spread of HIV.
Many proponents of abstinence-only education state that condoms don’t protect against HIV, claiming that latex condoms have holes that are large enough for viruses to pass through. This claim isn’t backed by evidence. An intact latex condom dramatically reduces your risk of being exposed to sexually transmitted viruses such as HIV. (It is true that a lambskin condom does not provide adequate protection against HIV.) Continue reading