From the Hangover to glitter, herpes jokes are everywhere in pop culture. Lazy, ignorant, and just plain mean, they poke fun at an incredibly common STI that anyone can catch. While technically not everyone has herpes, a whole lot of people do. In the U.S., around one in two people ages 14-49 have oral herpes, and around one in six people have genital herpes. According to the CDC, around 776,000 people in the U.S. get genital herpes infections each year.
Herpes is caused by the herpes simplex virus (HSV). There are two types of this virus: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Either type can cause either oral or genital herpes.
The most common symptom of genital herpes is a herpes outbreak. When this happens, someone develops painful or itchy blisters on or around the genitals, inner thighs, or butt, and these blisters can break and turn into painful sores. They may also experience other symptoms, including a fever, headache, swollen glands, pain when urinating, and genital pain. Symptoms are usually worse during a person’s first outbreak than during later outbreaks. However, some people with genital herpes never have an outbreak and may not know they have herpes. The most common symptom of oral herpes is developing cold sores around or inside the lips and mouth. These cold sores can also, more rarely, appear on or in the nose, chin, or cheek.
Genital herpes is spread through skin-to-skin sexual contact with someone who has herpes, including but not limited to vaginal, anal, and oral sex. It’s rare and preventable, but possible, for someone with genital herpes to transmit it to their child when giving birth. Oral herpes is spread through direct skin-to-skin contact between the contagious area and broken skin and mucous membrane tissue, such as kissing someone who is having an outbreak. You can also develop oral herpes by giving oral sex to someone who has genital herpes, but this is rare.
Herpes can’t be cured, but taking an antiviral can help reduce outbreaks, make the outbreaks that do occur less severe, and reduce the risk of transmission. Using a barrier method, such as condoms and dental dams, can also reduce the risk of transmission, as can avoiding skin-to-skin contact with the affected area during an outbreak. Taking action to reduce triggers, such as practicing stress reduction methods, can also help prevent outbreaks.
So, if herpes is so common, why is it so stigmatized? Project Accept, a non-profit advocating for those affected by HSV and HPV, points to a pharmaceutical marketing campaign by Burroughs Wellcome Co. for an antiviral drug called Zovirax. Launched in the late ‘70s, the marketing campaign really took off in the ‘80s. According to Salon, it was one of the first prescription drug campaigns to be marketed to the public, rather than to doctors. As Project Accept writes, “The campaign appears to have successfully created the stigma which has clung to genital herpes ever since."
The stigma around herpes leaves many people feel isolated and alone after a diagnosis. One 2009 study of women who had recently been diagnosed with herpes found that 34% developed clinical depression and 64% experienced anxiety after their diagnosis. The majority also reported feeling ashamed about their diagnosis and were worried about having an outbreak or transmitting herpes to a partner.
"We have this idea that only a certain type of people get herpes, and that's largely based on our sex education,” sex educator Emily Depasse tells Refinery29. “Most of us weren’t fortunate enough to have a comprehensive sex ed class, and even if we did have a class, they likely just brushed over STIs: this is what it is, these are the symptoms, don’t get them. You’ve probably heard or made a herpes joke, and some of our shame originates there. But a lot of our shame originates from knowing how to have conversations about safe sex." If we do learn how to have conversations about safe sex and STIs, without stigmatizing the many, many people who have them, our approach to sex as a society will get a whole lot better.