Dear Alice -

I have been diagnosed with herpes simplex 2. Not fun. I am afraid, now, to consider having sex with anyone who does not have it. From the research I have done so far, I have come to the conclusion that it is unsafe to have sex, even with a condom and with no sores. I really don't look forward to being alone, or sexless, for the rest of my life, but I am unwilling to convey the disease to someone that I care for enough to have sex with. Is anyone doing research on a cure for herpes? Can you recommend reading material? Something technical that describes the viral and immunological aspects of the disease?

Hopeless in NY

Dear Hopeless in NY,

Herpes simplex is a common virus that is spread by direct skin-to-skin contact. Symptoms of genital herpes usually develop within two to twenty days after contact with the virus, although it may take far longer. For some people, the first attack is so mild that it goes unnoticed. For others, the first attack causes visible sores and flulike symptoms. In either case, the virus eventually retreats to the nervous system and lies dormant there.

Some people have frequent recurrences, while others rarely do; and, for many, this number decreases with time. With each recurrence, your body is more prepared to fight off the infection, so there are usually fewer sores, they heal faster, and the outbreak is less painful. The flulike symptoms of the first outbreak are seldom present during subsequent outbreaks.

Herpes affects each person differently. The following factors could bring on an episode: surgery, illness, stress, fatigue, skin irritation (such as sunburn), diet, menstruation, or excessive friction during intercourse.

Your worries about transmission are understandable. Sexual contact poses a risk for transmitting herpes from the time the first symptoms of itching, tingling, or other skin sensations are noticeable, until the area is completely healed. Sexual contact during times when no symptoms are present (asymptomatic) is less likely to cause infection. However, people tend to have sex more often when they have no sores, which can increase the risk of transmission.

The virus can become active and transmitted without any detectable symptoms. During this time, the virus travels along the nerves to skin and mucous membrane sites. The presence of the virus at the surface of the skin is referred to as viral shedding, or asymptomatic shedding. The herpes virus can be transmitted during viral shedding. There is really no way to tell when viral shedding is occurring. Your body gives you no warning, such as minor pain, discomfort, or a tingling sensation in the skin where the shedding is going on.

There's good news where prevention is concerned. Laboratory results have shown that the herpes virus does not pass through latex condoms. A recent clinical study of women has shown that herpes simplex 2 infection rates are much lower among condom users. Keep in mind that herpes is spread by skin-to-skin contact; the virus can be transmitted by contact with infected areas not covered by a condom or dam.

If you're concerned about the long-term— a lasting relationship and possibly having children — don't despair. Couples come to different kinds of peace with herpes. Many women and men with herpes have had several partners, have gotten married, and/or have had healthy children, some by C-section and some by vaginal delivery. Your obstetrician and midwife can monitor you during pregnancy and labor.

Lastly, give yourself the best possible chance to avoid recurrences by maintaining general good health and keeping your stress levels to a minimum. Eat well, sleep, and try to keep a healthy perspective on life.

For more information, call the National Herpes Hotline, operated by the American Social Health Association. In addition, you can contact the Herpes Resource Center at 1.800.230.6039. Both of these organizations will have the most recent research regarding herpes, and potential treatments and cures.

Take care,


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