Get Real! Hopping Mad About Herpes

Heather Corinna

I can't begin to tell you how many people in the world don't know that they have oral herpes, and don't know that cold sores are a symptom of oral herpes.

sunlitx asks:

been reading Scarleteen since I was at least 16, and the vital
knowledge has kept me safe thus far… UNFORTUNATELY after getting
through high school and college completely unscathed and mostly
responsible, I finally dropped my guard for a nice, geeky, Christian
boy who’d never kissed a girl EVER. And now I have oral herpes. I’m
pissed. Really, really pissed. One day he greeted me with a kiss and
when he pulled back I noticed his lips were a bit on the gross side.
When he said, "Oh, I just have a cold sore," I completely freaked.
Apparently his whole family caught it from his parents and they never
made it clear to them that A) Cold sores/Fever blisters ARE Herpes and
B) they can be spread to others. They act like it’s completely normal.
The last time I went to his house I saw a BULK sized bottle of Lysine
on the kitchen sink. When my boyfriend asked his mom about why they
never warned him, she replied that I was simply overreacting and that I
should get over it.

I want to know how I can get through this without hating him and his
generally very nice family. He’s a great guy, and he didn’t do it on
purpose (I’ve never met anyone who has), but I’m just so pissed at him
and at myself. I feel dirty, ashamed, and like I should have known

Newly Blistered Sister

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Heather replies:

I was in high school, I was — as I still am now — in the habit of
hugging friends and warmly kissing them on the cheek, the sides of
their mouth or on the mouth entire when greeting them, passing them in
the halls, or just because I loved them and liked to demonstrate my
affection. You can imagine how much everyone loved me during
the week we all found out the hard way that I had mononucleosis and had
spread it to nearly the entire junior class in the span of around
fifteen minutes of kissy-greetings.

I couldn’t have known I had mono, mind you, because I hadn’t had
symptoms yet, and even if I had, I likely wouldn’t have been able to
figure out that’s what it was until I was sick for a week or more,
despite growing up with a healthcare professional. But too, mono is so
common, and chances are good that if it wasn’t me who passed it around,
someone was going to eventually and most of us were going to get it.
It’s very common in young adult populations, it’s highly contagious,
and people who get mono usually don’t know they have until after they
have already been in the most contagious period.

Oral herpes is a lot like this, despite the fact that cold sores or
"fever blisters" are a common symptom and are sometimes present and
visible among those with Herpes. I can’t begin to tell you how many
people in the world don’t know that they have oral Herpes, and don’t
know that cold sores are a symptom of oral herpes. Most people get it
in childhood and have no memory of sores (some won’t have them at all)
back then when they contracted it, and some people will never see a
sore again, even though they have and can possibly transmit Herpes.
Chances are very good this is not even your first exposure to HSV-I:
you’ve probably already been exposed to it many times in your life
before this without even knowing, and for all you know, you already had
it yourself and are only seeing a sore now due to re-exposure. And if
your whole family had it, you might very well have the same attitudes
about it as his do.

Getting mad at laymen about this only makes so much sense to me,
even though I understand your disappointment at contracting a virus you
can’t ditch.

Plenty of doctors will refer to oral herpes as "cold sores,"
and not explain that those sores are Herpes symptoms, and that the
emergence of those sores — and the time just before — also signals
the period of the highest risk of transmission. Plenty of doctors do
not tell people with oral Herpes about potential risks of genital
transmission (in part likely because some really aren’t comfortable
talking to people, especially young people, about oral sex, nor are
many people comfortable talking about sex with their doctors, either).
Of course, for doctors to even have these kinds of responses at all,
they have to either see a sore when a patient has a visit with them or
be asked by a patient about cold sores, so we can only hold doctors so
responsible, too. Often a doctor won’t see active sores or be asked
about them by their patients. But when even healthcare pros and others
in the know don’t pass this information along to laymen, we can only
hold laymen so responsible.

Some of that "Oh, it’s nothing," stuff comes from the fact that oral
Herpes is one of the most common and benign viruses out there. As many
as 80% of people in the U.S. people have it, and most contract it in
childhood from casual, everyday contact. If people act like it’s
normal, it might have to do with the fact that it is normal: more
people have Herpes than not, and it’s pretty safe to say that
all of us have been exposed to it in life, usually multiple times
before we’ve even started being worried about cooties, let alone Herpes.

As a regular reader of Scarleteen, I hope I don’t have to tell you
the this guy’s (lack of) sexual experience, his geekiness or his
religion have squat to do with any of this, and that we can’t figure
someone is somehow free of illness based on things like this. There is
no one kind of person who has — or does not have — Herpes or any
other virus. For sure, it’s sound to figure our risks of, say, Syphilis
are very minimal if we have sex with someone who has never had any kind
of sex with anyone else, because that’s an infection that is often only
sexually transmitted.

But oral Herpes isn’t Syphilis, not when it comes to its epidemiology, and also not when it comes to the possible severity of effects it can have on your life. Heck, for most people even Syphilis isn’t Syphilis anymore in that respect.

Oral herpes really isn’t likely to be that big of a deal when it
comes to your health and the health of others. I swear. Yes, you can
transmit it easily (and often it is passed around in families
nonsexually as happened with this guy and his folks), and yes, there
can be a risk of transmitting oral Herpes genitally. However, that is
relatively uncommon: genital Herpes, or HSV-2, is usually the type of
herpes one gets and transmits genitally.

Let me share some basic information with you from the American Social Health Association on this, as well as what you need to know now so far as protecting yourself and others:

Oral herpes is transmitted through direct contact
between the contagious area and broken skin (a cut or break) and mucous
membrane tissue (such as the mouth or genitals). Herpes can also be
transmitted when there are no symptoms present. There are several days
throughout the year when the virus reactivates yet causes no symptoms
(called asymptomatic shedding, viral shedding, or asymptomatic

If a person is experiencing symptoms orally, we recommend abstaining
from performing oral sex and kissing others directly on the mouth until
signs have healed and the skin looks normal again. Because most adults
have oral herpes, we do not advise that a person stop giving or
receiving affection altogether between outbreaks (when there are no
signs or symptoms) simply because they have oral herpes. However, using
a barrier (such as a dental dam) or condom when performing oral sex
(even though there are no symptoms present around the mouth) can reduce
the risk of contracting genital herpes.

By performing oral sex on someone who has genital herpes, it would
be possible to contract oral herpes – but this is rare. Most cases of
genital herpes are caused by HSV-2, which rarely affects the mouth or
face. Also, and even more importantly, most adults already have oral
HSV-1, contracted as a child through kissing relatives or friends.

(A geeky aside of my own: ASHA, originally called the
American Social Hygiene Association, was the first official sex
education organization in the United States. Around the turn of the
century, despite some profound differences in attitudes around
sexuality and sex ed, the ASHA was basically Scarleteen for Victorians.)

In many ways Herpes really IS no big deal for most people. In
immunosuppressed (in case it’s not obvious, people whose immune systems
are suppressed, or not functioning well) people, Herpes, like many any
virus, can present some serious health risks. Having herpes — though
more often this is about genital herpes, rather than oral — can also
up the risks of us acquiring other infections sometimes. But for the
most part, not only is there nothing dirty about it, there’s not
usually anything dangerous about it either. It’s unlikely to impact
your health or your life, though how you think about it can certainly
have an impact.

You say that you feel dirty and ashamed, despite the fact that the
virus you contracted has nothing to do with cleanliness, and is about
as common as the common cold. It is no more or less dirty than cold
viruses, leukemia, the flu or chicken pox (which is in the same family
as the Herpes virus). I understand why you feel that way, but only
because our culture has stigmatized some viruses rather than others,
often based on all kinds of isms and phobias, and in this case, based
on the fact that Herpes viruses can be sexually or intimately
transmitted, which is the case for a ton of illness including, again,
things like colds and flus. We can probably factor in, too, that
looksism is a factor, as Herpes sores are visible. Sure, it makes sense
in some degree for all of us to want to be healthy, and not have
illnesses, and to view illness as something we want to avoid. But if
you didn’t feel this way if and when you got the chicken pox, and don’t
feel this way when you get the seasonal sniffles, I think your feelings
about this illness probably have more to do with stigmatization coming
from a not-so-great place than with worries about your health. I’m not
wagging fingers at you, by the way: none of us are immune (no pun
intended) from these attitudes, and we do live in a world where we have
to deal with these notions.

I’d implore you to do what you can to diffuse your anger about this:
I’d say those feelings are more likely to bum out your life than a cold
sore now and then, or than letting someone know you’ve got oral Herpes
like most people do. Stress presents more health risks than HSV-I does.
I’d also try to let go of your anger towards him, his family and
yourself. None of you did anything wrong, nor is there anything wrong
with you besides being human and being people who don’t live in a
plastic bubble. We pick up viruses in life, and while there absolutely
are plenty of things we can do to reduce our risks, there really is
nothing we can do to remove those risks completely. This is just the
world we live in, whether we have never kissed anyone before or we
volunteer to run the kissing booth every year without fail.

You say you should have known better, but what I wonder is what you
mean when you say that. How would you have behaved instead? I think
it’s safe to say that most of us don’t ask everyone we kiss, be it
romantically or platonically — and that would include relatives and
friends — if they have ever had a cold sore before we kiss them. We
don’t also tend to give people we’re used to kissing a super-close
inspection of their mouth before we kiss them. And I think we all know
how often a friend will have us taste something they’re drinking, or we
share water bottles, without many of us giving it any thought at all.
Now, if Herpes was very dangerous to us (and again, for some groups of
people it is), it would make sense to do and ask things like that,
though we’d likely also be asking then if they had been sick with
anything else lately, too, if it was safe for us to have that close of
contact at all. But a lot of why we don’t tend to engage in those kinds
of behaviors is because it’s usually not dangerous, because our quality
of life (which includes relaxed affection with people) is also a factor
in the choices we make, and because in a lot of ways, there is just
very little we can do to avoid being exposed to oral Herpes, and we’re
either going to get it or not, which is also often based on pretty
random factors.

My advice to you at this point, beyond trying to adjust your
headspace on this, is just to talk to you own doctor about oral Herpes.
You absolutely can discuss and consider treatments, if you like, which
reduce outbreaks for you. There are also some support groups out and
about on the web for people with either type of Herpes who are having a
tough time adjusting, so if this stays hard for you, you might want to
seek one of those out for yourself.

An etiquette point: I don’t know what "freaking out" is for you, but
when I say I freaked out on someone, I’m usually talking about some
pretty high-key behavior on my part where I am not being particularly
sensitive to the feelings of others. If that’s what it means for you,
too, and it involved any shame or blame to this guy or his family about
their Herpes, I would personally say an apology is likely in order. It
feels pretty crappy to be treated like a leper, even if you have
lepracy, and all the more so when you don’t. I don’t know what your
feelings are per if this is still a relationship you want to pursue,
but whether you do or you don’t, I’d make some peace. After all, you
clearly don’t like how you’re feeling right now, so you can imagine how
they probably don’t like feeling that way, either.

Okay? You’re not dirty, and neither you nor this guy have anything to be ashamed of. Seriously, this will
be okay, and if you let yourself, I think you’ll get okay with it, too,
in fairly short order. I’m going to leave you with a few extra links I
hope can help you get there:

News Politics

Clinton Campaign Announces Tim Kaine as Pick for Vice President

Ally Boguhn

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

The Clinton campaign announced Friday that Sen. Tim Kaine (D-VA) has been selected to join Hillary Clinton’s ticket as her vice presidential candidate.

“I’m thrilled to announce my running mate, @TimKaine, a man who’s devoted his life to fighting for others,” said Clinton in a tweet.

“.@TimKaine is a relentless optimist who believes no problem is unsolvable if you put in the work to solve it,” she added.

The prospect of Kaine’s selection has been criticized by some progressives due to his stances on issues including abortion as well as bank and trade regulation.

Kaine signed two letters this week calling for the regulations on banks to be eased, according to a Wednesday report published by the Huffington Post, thereby ”setting himself up as a figure willing to do battle with the progressive wing of the party.”

Charles Chamberlain, executive director of the progressive political action committee Democracy for America, told the New York Times that Kaine’s selection “could be disastrous for our efforts to defeat Donald Trump in the fall” given the senator’s apparent support of the Trans-Pacific Partnership (TPP). Just before Clinton’s campaign made the official announcement that Kaine had been selected, the senator praised the TPP during an interview with the Intercept, though he signaled he had ultimately not decided how he would vote on the matter.

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Kaine’s record on reproductive rights has also generated controversy as news began to circulate that he was being considered to join Clinton’s ticket. Though Kaine recently argued in favor of providing Planned Parenthood with access to funding to fight the Zika virus and signed on as a co-sponsor of the Women’s Health Protection Act—which would prohibit states and the federal government from enacting restrictions on abortion that aren’t applied to comparable medical services—he has also been vocal about his personal opposition to abortion.

In a June interview on NBC’s Meet the Press, Kaine told host Chuck Todd he was “personally” opposed to abortion. He went on, however, to affirm that he still believed “not just as a matter of politics, but even as a matter of morality, that matters about reproduction and intimacy and relationships and contraception are in the personal realm. They’re moral decisions for individuals to make for themselves. And the last thing we need is government intruding into those personal decisions.”

As Rewire has previously reported, though Kaine may have a 100 percent rating for his time in the Senate from Planned Parenthood Action Fund, the campaign website for his 2005 run for governor of Virginia promised he would “work in good faith to reduce abortions” by enforcing Virginia’s “restrictions on abortion and passing an enforceable ban on partial birth abortion that protects the life and health of the mother.”

As governor, Kaine did support some existing restrictions on abortion, including Virginia’s parental consent law and a so-called informed consent law. He also signed a 2009 measure that created “Choose Life” license plates in the state, and gave a percentage of the proceeds to a crisis pregnancy network.

Regardless of Clinton’s vice president pick, the “center of gravity in the Democratic Party has shifted in a bold, populist, progressive direction,” said Stephanie Taylor, co-founder of the Progressive Change Campaign Committee, in an emailed statement. “It’s now more important than ever that Hillary Clinton run an aggressive campaign on core economic ideas like expanding Social Security, debt-free college, Wall Street reform, and yes, stopping the TPP. It’s the best way to unite the Democratic Party, and stop Republicans from winning over swing voters on bread-and-butter issues.”

CORRECTION: A previous version of this article included a typo that misidentified Sen. Tim Kaine as a Republican. We regret this error.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.