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Genital Herpes: Intimate Conversations

with Terri Warren, RN, ANP

This blog has been retired.

Friday, September 7, 2007

Herpes Stigma

So there’s good news and bad news about the social stigma associated with herpes. In a recent phone survey of about 2,000 people in the US, 3/4 without herpes and 1/4 with herpes, a slight majority of both groups felt that the topic of genital herpes was not taboo. But when ranking the social stigma associated with any STD, herpes ranked only behind HIV – but hey, let’s face it, there is stigma associated with any STD – it does involve genitals, after all, and we, as a society just aren’t comfortable about our genitals.

Another piece of good news was that for people who had herpes, the biggest issue was bothersome symptoms of herpes outbreaks. That was listed way ahead of being bothered by stigma. Outbreaks can be treated or mostly prevented with medicine but there’s no prescription for feeling stigmatized by your herpes.

The bad news is that a majority of people who didn’t have herpes said they would avoid having a relationship with someone with herpes or break up with a partner who had herpes. Now that is truly stunning to me. This is 2007, folks! Of all of the things that can go wrong in a relationship, herpes is so far down the list, its almost not detectable. I’ll bet if you surveyed discordant married couples – that is, couples where one person has herpes and the other doesn’t, they would tell you that sex, money, in-laws, household chores and inability to talk to each other cause way more problems than herpes ever could.

It makes my heart very sad to think of the wonderful, quality people that I know, and know really well, who have been turned down for relationships because they have herpes. I used to think that people who did that were scumbags, that they didn’t have a good sense of ethics or of what’s important in life or that they would be unreliable in future hard situations. But I think a bit differently about that now. Now, I think that often they are just unreasonably afraid, that they know too little about the real experience of herpes, that they are just afraid of the reputation, not the actual disease and that they will never be able to know the “real” herpes.

I also think that people who count a lot on their sexuality for their identity are less likely to take any risk of getting herpes. It’s like if you are a pianist, you take extra care with your hands or if your job is to model toenail polish, you take extra care with your feet. If much of your identity is tied up in your ability to be sexual, then you will be less willing to take risks with that part of you. And lest you are thinking, “yea, see, they are scumbags, they are oversexed weirdos”, I would say that isn’t necessarily true. They just may feel good about the way they look or the things they can do sexually and may not have built up their confidence about themselves in other areas at the same rate as the sexual confidence. We all feel strong in some areas, but not in others, right?

Another group of people who just can’t seem to deal with herpes in a partner is people with obsessive compulsive disorder, and this is more common than you night think. And it comes in mild, moderate and severe cases. The severe case is the person who comes into my office and won’t touch the doorknobs – they wait for someone else to walk into our suite to let them in, then we have to open and close the exam room and bathroom doors for them because they cannot touch the knobs.

The moderate is the person who is unreasonably fearful about transmitting or getting STDs – like “if my daughter digs through my laundry basket for her pink socks can she get herpes on her hands if I had a pair of jeans in there that she touches” (undies would always be kept separate, of course, and never within reach of the daughter). The moderate might also do lots of hand washing, far more than necessary.

The milder is the person who asks lots and lots of questions about germs and presents several scenarios about getting an STD – like “so if I touch a guy’s penis through his jeans, but there is a little wetness from pre-cum on his jeans and I do it without gloves on, can I get herpes under my fingernails?” True, lots of people ask questions about transmission, but if someone leans toward OCD tendencies, the questions have a different feel, are more “out there”, are more troubling for the asker.

Another reason someone might not take the risk of getting herpes is simply that they don’t know the person who has herpes well enough to take that risk, and that is completely understandable. That’s why, when you have herpes, and you meet someone at a party, you don’t say, “Hi, I’m Terri, and I have genital herpes.” You wait until they know you better, have more invested in you, have more reason to be willing to take some risk. But this discussion must happen before having sex, of course, so they have an opportunity to make the decision about risk for themselves.

The survey also deals with the fact that many people with herpes admit to NOT disclosing their herpes status to sexual partners. But that’s another blog.

I’m sure you can think of more reasons why people are reluctant to take the risk of getting herpes, but think of this: do you think it is in one’s best interest to chose or not chose a life partner based on whether they have a virus on their genitals that can be well controlled with medicine and causes infrequent symptoms that can also be successfully and easily treated? Are there not more important qualities for a partner to have or not have that will sustain a relationship over time? I think the answer is quite clear. The trick is having people think it through carefully and being brave and sensing what is truly important in a partner.


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Posted by: Terri Warren, RN, ANP at 10:50 am