I was skimming through some of the more active old threads and ran across this one. I didn't want to resurrect the old thread, but there is so much misinformation there, I felt compelled to post. As guys who go out chasing tail, we should be armed with some knowledge of the risks. Credit to oldnemesis in that old thread - he gave some accurate facts.
Here are a whole bunch of herpes facts:
- HPV is not herpes. Herpes is HSV - herpes simplex virus
- Unlike HPV, HSV is for life. There is no cure and no vaccine (yet; and maybe never - it's a whole lot more profitable to keep people on antivirals than it is to sell a lot of one-time vaccines)
- HSV is part of the human herpes virus (HHV) family
- But don't be fooled by people who tell you that chickenpox is 'herpes', and thus everyone has herpes. Chickenpox is caused by VZV, another HHV, and yes, pretty much everyone has VZV (like HSV, it never goes away, and if it reactivates, it's called shingles). When people say 'herpes', they are referring to herpes simplex.
- There are 2 types of HSV - HSV1 and HSV2.
- Either type can infect the oral or genital area. And yes, transmission can occur via oral sex.
- Cold sores (oral herpes) are usually caused by HSV1 (most infected persons got it when they were little kids, from parents or other relatives kissing them), but oral HSV2 infection can happen.
- It used to be that genital herpes was almost always caused by HSV2. This is not the case anymore. Lots of new genital herpes cases are caused by HSV1 (typically, the person gets it from receptive oral sex).
- Condoms are no guarantee against herpes because it is a skin to skin infection. As someone pointed out in the old thread, men and women shaving their genital area is a bad idea because it creates more skin to skin friction. Evolution put hair there for a reason.
- The best data on condom effectiveness against HSV transmission indicates that the risk reduction is only 30%. Yes, you're reading that correctly - it reduces the risk of transmission by a mere 30%. Compare that to fluid-borne STDs, where condoms reduce risk by >99%.
- Asymptomatic viral shedding is not a mere guess, as was alleged in that old thread. We know it happens because we can pick up virus off intact (non-outbreak) skin. There are lots of shedding studies out there.
- We know how prevalent herpes is b/c there are studies that blood test for HSV antibodies.
- Here's the data from a study published in JAMA in 2006 (I'll post the link if anyone wants to see it). This is US data:
- Overall HSV2 infection rate is 17% (this is for people aged 14-49, the rate goes up for each older age bracket, so for 40-49, it's 26%).
- For males, it is 11% (again, males aged 14-49).
- For females, it is 23%. And remember this is HSV2 only. Most HSV2 is genital. There is a lot of HSV1 that is genital. So the overall rate of genital herpes (genital HSV1 + genital HSV2) amongst women is higher than 23%.
- For whites (male and female): 13%. White females: 19%. For blacks (male and female): 42%. Black females: 46%
- Most of the people with genital herpes are unaware they have it. I've seen different estimates for this, but it's usually 80-90%. So for all the people who have genital herpes, only 10-20% know they have it.
- The biggest behavioral risk factor for genital herpes is . . . number of sex partners. So guess which guys are at the highest risk? You got it - players - natural or self-made. Sucks, but it is what it is. Now that you know, you can take steps to protect yourself.
- A couple of posters in the old thread mentioned that the women they knew with genital herpes were pretty attractive. This doesn't surprise me in the least. The hottest chicks go for the most alpha guys. And the alpha guys (race-adjusted), should be most likely to have herpes. Google 'Derek Jeter herpes tree'.
- OK, on to HSV1:
- Overall HSV1 infection rate (people aged 14-49): 58%
- Males: 56%. Females: 60%.
- Whites: 50%. Blacks: 68%.
- Back to viral shedding. So this happens in two ways – one is the classic outbreak. Lots of virus there. So sex is a bad idea if you or your partner has an outbreak. Problem for the pussy sleuths is that most outbreaks are not of the medical textbook horrorshow variety. And if it was a really, really bad outbreak, she wouldn’t be having sex with you anyway because her vag would be in too much pain. The other way shedding happens is asymptomatically – i.e., virus is being shed through unbroken skin. So there’s no way you’re going to detect this unless you have a lab in your home. And the infection can be spread via this asymptomatic viral shedding.
- It’s not all bad news. The reason most people with genital herpes don’t know they have it is because they don’t get outbreaks or only get very minor outbreaks that are easily mistaken for other things, like ingrowns or razor burns or cuts. And while infection can occur during asymptomatic shedding, infected persons are not always shedding. High levels of asymptomatic shedding happen during a small percentage of days. And the odds of getting herpes even from an infected partner are fairly low on a per sex act basis (I’d have to look this up to recall accurate figures) – the problem is you never know when your number will come up.
- Someone made a point in the old thread about herpes being overhyped because if it was so widespread, many more women would be having c-section deliveries. The baby typically only gets infected if the mother is having an internal outbreak that the baby would come in contact with during delivery. So there is no inconsistency between the HSV prevalence data and the relatively low number of c-sections. And by the way, if they know the mother has herpes, they will usually put her on antivirals during the last several weeks of pregnancy. It’s really no big deal, which is why there are so few cases of neonatal herpes.
- Another issue from the old thread. If someone knows he/she has herpes and infects someone else, is that actionable? Yes, it is. Ask Ron Mexico, aka Michael Vick.
- Testing: Most clinics and physicians won’t test you for herpes unless you show up with symptoms OR you specifically ask to get tested for it. Even saying ‘test me for everything doc!’ will NOT get you tested for HSV. Yeah, the system is that fucked up. If you want to get tested for it (and are not having any symptoms), ask for HSV type-specific IgG antibody testing (the older IgM test is nearly worthless). And make sure you see HSV1 and HSV2 listed on your lab results. If those buggers aren’t listed in the lab report, you didn’t get tested for it. Note - this is for the US. Outside the US, you may find it even harder to test for HSV.
- This is why when a girl tells me she is 'clean', it means nothing to me and doesn't change in the least the precautions I take. Even if she did get tested for STDs recently (unlikely), the odds that she knew enough to get tested for HSV are close to zero.
- Precautions. You can read the usual medical info on this (wear a condom, don’t have sex if you or your partner is having an outbreak, etc.). Here’s what I do: I trim, but never shave. I always always always wear a condom. I liberally apply lube to the areas that won’t be covered by the condom – base of penis, pubes, balls, inner thighs. The idea is to reduce friction. When taking her underwear off, I’ll try to get a whiff of the vag. If it stinks even a little, I won’t give oral (of course, smell doesn’t mean herpes, but it might mean something is happening down there, and I don’t want to take any chances, whether it’s an STD, a yeast infection or a mild non-STD bacterial infection). I try to visually inspect the vag before oral or penetration. If I see sores, I’ll get a blowjob and finish that way. And I always shower after sex. Of course, none of this is any guarantee, but there are no guarantees (short of total abstinence including no kissing or oral sex) and all you can do is try to reduce risk in ways that don’t take all the joy out of sex for you.
Here are a whole bunch of herpes facts:
- HPV is not herpes. Herpes is HSV - herpes simplex virus
- Unlike HPV, HSV is for life. There is no cure and no vaccine (yet; and maybe never - it's a whole lot more profitable to keep people on antivirals than it is to sell a lot of one-time vaccines)
- HSV is part of the human herpes virus (HHV) family
- But don't be fooled by people who tell you that chickenpox is 'herpes', and thus everyone has herpes. Chickenpox is caused by VZV, another HHV, and yes, pretty much everyone has VZV (like HSV, it never goes away, and if it reactivates, it's called shingles). When people say 'herpes', they are referring to herpes simplex.
- There are 2 types of HSV - HSV1 and HSV2.
- Either type can infect the oral or genital area. And yes, transmission can occur via oral sex.
- Cold sores (oral herpes) are usually caused by HSV1 (most infected persons got it when they were little kids, from parents or other relatives kissing them), but oral HSV2 infection can happen.
- It used to be that genital herpes was almost always caused by HSV2. This is not the case anymore. Lots of new genital herpes cases are caused by HSV1 (typically, the person gets it from receptive oral sex).
- Condoms are no guarantee against herpes because it is a skin to skin infection. As someone pointed out in the old thread, men and women shaving their genital area is a bad idea because it creates more skin to skin friction. Evolution put hair there for a reason.
- The best data on condom effectiveness against HSV transmission indicates that the risk reduction is only 30%. Yes, you're reading that correctly - it reduces the risk of transmission by a mere 30%. Compare that to fluid-borne STDs, where condoms reduce risk by >99%.
- Asymptomatic viral shedding is not a mere guess, as was alleged in that old thread. We know it happens because we can pick up virus off intact (non-outbreak) skin. There are lots of shedding studies out there.
- We know how prevalent herpes is b/c there are studies that blood test for HSV antibodies.
- Here's the data from a study published in JAMA in 2006 (I'll post the link if anyone wants to see it). This is US data:
- Overall HSV2 infection rate is 17% (this is for people aged 14-49, the rate goes up for each older age bracket, so for 40-49, it's 26%).
- For males, it is 11% (again, males aged 14-49).
- For females, it is 23%. And remember this is HSV2 only. Most HSV2 is genital. There is a lot of HSV1 that is genital. So the overall rate of genital herpes (genital HSV1 + genital HSV2) amongst women is higher than 23%.
- For whites (male and female): 13%. White females: 19%. For blacks (male and female): 42%. Black females: 46%
- Most of the people with genital herpes are unaware they have it. I've seen different estimates for this, but it's usually 80-90%. So for all the people who have genital herpes, only 10-20% know they have it.
- The biggest behavioral risk factor for genital herpes is . . . number of sex partners. So guess which guys are at the highest risk? You got it - players - natural or self-made. Sucks, but it is what it is. Now that you know, you can take steps to protect yourself.
- A couple of posters in the old thread mentioned that the women they knew with genital herpes were pretty attractive. This doesn't surprise me in the least. The hottest chicks go for the most alpha guys. And the alpha guys (race-adjusted), should be most likely to have herpes. Google 'Derek Jeter herpes tree'.
- OK, on to HSV1:
- Overall HSV1 infection rate (people aged 14-49): 58%
- Males: 56%. Females: 60%.
- Whites: 50%. Blacks: 68%.
- Back to viral shedding. So this happens in two ways – one is the classic outbreak. Lots of virus there. So sex is a bad idea if you or your partner has an outbreak. Problem for the pussy sleuths is that most outbreaks are not of the medical textbook horrorshow variety. And if it was a really, really bad outbreak, she wouldn’t be having sex with you anyway because her vag would be in too much pain. The other way shedding happens is asymptomatically – i.e., virus is being shed through unbroken skin. So there’s no way you’re going to detect this unless you have a lab in your home. And the infection can be spread via this asymptomatic viral shedding.
- It’s not all bad news. The reason most people with genital herpes don’t know they have it is because they don’t get outbreaks or only get very minor outbreaks that are easily mistaken for other things, like ingrowns or razor burns or cuts. And while infection can occur during asymptomatic shedding, infected persons are not always shedding. High levels of asymptomatic shedding happen during a small percentage of days. And the odds of getting herpes even from an infected partner are fairly low on a per sex act basis (I’d have to look this up to recall accurate figures) – the problem is you never know when your number will come up.
- Someone made a point in the old thread about herpes being overhyped because if it was so widespread, many more women would be having c-section deliveries. The baby typically only gets infected if the mother is having an internal outbreak that the baby would come in contact with during delivery. So there is no inconsistency between the HSV prevalence data and the relatively low number of c-sections. And by the way, if they know the mother has herpes, they will usually put her on antivirals during the last several weeks of pregnancy. It’s really no big deal, which is why there are so few cases of neonatal herpes.
- Another issue from the old thread. If someone knows he/she has herpes and infects someone else, is that actionable? Yes, it is. Ask Ron Mexico, aka Michael Vick.
- Testing: Most clinics and physicians won’t test you for herpes unless you show up with symptoms OR you specifically ask to get tested for it. Even saying ‘test me for everything doc!’ will NOT get you tested for HSV. Yeah, the system is that fucked up. If you want to get tested for it (and are not having any symptoms), ask for HSV type-specific IgG antibody testing (the older IgM test is nearly worthless). And make sure you see HSV1 and HSV2 listed on your lab results. If those buggers aren’t listed in the lab report, you didn’t get tested for it. Note - this is for the US. Outside the US, you may find it even harder to test for HSV.
- This is why when a girl tells me she is 'clean', it means nothing to me and doesn't change in the least the precautions I take. Even if she did get tested for STDs recently (unlikely), the odds that she knew enough to get tested for HSV are close to zero.
- Precautions. You can read the usual medical info on this (wear a condom, don’t have sex if you or your partner is having an outbreak, etc.). Here’s what I do: I trim, but never shave. I always always always wear a condom. I liberally apply lube to the areas that won’t be covered by the condom – base of penis, pubes, balls, inner thighs. The idea is to reduce friction. When taking her underwear off, I’ll try to get a whiff of the vag. If it stinks even a little, I won’t give oral (of course, smell doesn’t mean herpes, but it might mean something is happening down there, and I don’t want to take any chances, whether it’s an STD, a yeast infection or a mild non-STD bacterial infection). I try to visually inspect the vag before oral or penetration. If I see sores, I’ll get a blowjob and finish that way. And I always shower after sex. Of course, none of this is any guarantee, but there are no guarantees (short of total abstinence including no kissing or oral sex) and all you can do is try to reduce risk in ways that don’t take all the joy out of sex for you.
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