Q: About two weeks ago I met a great guy who "fits" me. Tall, dark and very handsome, makes me laugh, good job, cool apartment right in my neighborhood, etc. He's a total package ... except that earlier this week he told me he has -- bum-bum-bum -- genital herpes. He said he wanted to get it out in the open before we got closer, which I appreciate, but I'm not sure how I feel about this. I've seen the Valtrex commercials but I'd rather not risk having to take a pill the rest of my life. Also, we have done plenty of making out on his couch. Am I at risk for getting infected from kissing? If we have sex, how can I protect myself? I haven't really asked him any questions as far as outbreaks or how he got it.
A: First the bad news: You are at risk of contracting genital herpes during sexual contact, no matter how well you protect yourself. (Well, unless you're really into latex and manage to completely cover every inch of yourself in a rubber suit, but that seems a little bold for your first time with a new partner.) Herpes is contracted via skin-to-skin contact, and newer research shows that shedding of the virus occurs constantly, not just during outbreaks. Actually, the most contagious periods are the week before and the week after an outbreak. Since there's no way to know when an outbreak will happen, there's no way to know when you're at the highest risk of infection.
It's important to note that there are two types of herpes: Herpes simplex 1 (HSV-1) is the type that thrives in the oral area; herpes simplex 2 (HSV-2) thrives in the genital area. It is possible to transmit HSV-1 to the genitals and HSV-2 to the mouth, however. You can't catch his genital herpes just from kissing him on the mouth, but you can contract type-2 herpes on your mouth from giving your man a blow job, although it's rare. Scientists are working on improving testing methods for HSV-2 (which can be inconclusive), since recent findings have linked it to the spread of HIV.
Which brings me to the good news: People with herpes usually don't know they have it, yay! Wait, what? According to the Centers for Disease Control, while 50 to 80 percent of U.S. adults have HSV-1 and around 16 percent have HSV-2, the majority of these cases are asymptomatic. As in, they never have a single outbreak. The fact that there is no cure for herpes is no cause to clamp your vagina shut for the rest of your life -- just be responsible and practice safe sex. Condom use is shown to reduce transmission by up to 50 percent. Antiviral treatment (such as Valtrex and its cheaper, generic equivalent) can also reduce transmission by 50 percent and keep outbreaks at bay. Now, 50 plus 50 doesn't equal 100 in this case, but combining the two measures significantly decreases your risk of infection.
Herpes rarely causes health problems beyond temporary skin lesions. In fact, society didn't much distinguish between the two types until pharmaceutical company Burroughs Wellcome launched a marketing campaign in the 1970s that stigmatized HSV-2, effectively making those carrying it feel like depraved lepers. The No. 1 symptom of genital herpes is depression, followed by anxiety over having to share the information with others.
Your gentleman friend was courageous enough to share with you now, so that you can make a decision about the future of the relationship. Hopefully you feel a little better informed to do that.