STD Information: Herpes

Herpes infections are caused by the herpes simplex viruses (HSV-2 and HSV-1). Transmission can occur even when lesions are not present (in fact, probably most transmission actually occurs in the absence of skin ulcers or breakdown, which is why 90% of persons infected with HSV-2 don't know they're infected).  See our Links for several excellent resources on this common infection.

  • Symptoms: small blisters on the vulva, often painful, are classic, but at least 90% of people infected with HSV-2, which causes the majority of genital herpes, do not know they are infected. Itching is a common symptom. In the initial episode of HSV, symptoms can include painful/difficult urination, fever, swollen lymph nodes, and flu-like symptoms.
  • Treatment: three antiviral medications (acyclovir, famciclovir, valacyclovir) are now available & all work equally well. Antivirals are also recommended for recurrences and suppression when there are more than 6 recurrences a year. Antivirals help the symptoms of HSV and speed healing; they do not cure the virus.  They also reduce the likelihood that HSV is shed in the absence of outbreaks.
  • Transmission WTW: very likely occurs, but data on specific prevalence and risks is very limited. In particular, oral-genital contact (oral sex) can transmit HSV-1 from the mouth to the genital area, especially when one partner has a cold sore.  
  • Precautions: because transmission can occur even when no lesions are present, any genital-genital contact should involve latex barriers 100% of the time; couples should abstain from sex during outbreaks, until the skin is fully healed.  
