Clearing the confusion over herpes types 1 and 2

Dear Alice,

You say that others quite possibly might have antibodies built up from childhood exposure to Herpes Simplex 1. Is that true regardless of where you have the virus (genitals, face)? I had it on my face often as a kid, and now genitally... Am I less likely to give it to someone, genitally, who has had it on their face at one time or other, because of a build up of antibodies?

Scared and depressed in Oregon

Dear Scared and depressed in Oregon,

To begin and to shed light on the distinction between strains a bit further: herpes simplex virus 1 (HSV-1) is more likely to appear on the face, whereas herpes simplex virus 2 (HSV-2) is more likely to appear on the genitals. That being said, either virus can cause outbreaks anywhere on the body. When people are exposed to or infected by a particular virus, their body’s immune systems respond by developing antibodies to fight it off. Antibodies to herpes form regardless of where the symptoms occur on the body (i.e., lips, mouth, or genitals), which is often where the virus first enters the body. Unfortunately though, a build-up of antibodies on your part, doesn’t necessarily prevent or reduce the likelihood of transmission to another person who doesn’t have the same strain of herpes. But, as the virus stays in the body for the long-term despite intermittent outbreaks, there are some strategies you can employ on your own and with your partner(s) to reduce their risk.

First, have you been officially diagnosed? It can be difficult to determine whether or not you or a partner have herpes because many people are often asymptomatic or they have mild signs that go unnoticed. The signs and symptoms associated with each strain of the herpes virus can vary. The only way to know is to get a confirmatory blood test to determine the specific strain. Unfortunately, at this time, this type of test is not routine. If you’ve previously received a herpes diagnosis by way of a health care provider’s visual exam you may fall into one of the scenarios in which the Centers for Disease Control and Prevention (CDC) recommends screening via bloodwork (i.e., being a patient with a positive diagnosis, but with no laboratory confirmation). Per the CDC’s recommended screening scenarios, your partner(s) would likely be candidates for the blood test as well.

To address your second question regarding the likelihood of transmitting the virus genitally to a partner: if you know for sure that you only have HSV-1 — and both you and your partner already have it, then transmitting that strain is less of a concern. The symptoms may be non-existent or intermittent, but both people still have the virus. However, if you have both HSV-1 and HSV-2, and your partner only has one type of herpes, then you could transmit the other strain to them. Skin-to-skin contact is the primary way to transmit either of the viral strains, whether sores are visible or not. The good news is that the virus won’t survive long on surfaces and can’t be passed through sharing objects as both strains quickly die outside the body.

The primary concern associated with herpes is the active outbreaks, when there are noticeable symptoms causing irritation or discomfort; during this time, there may be a higher likelihood of passing on the virus to others (though because of viral shedding that occurs even when symptoms aren’t present, it could be passed on at other times as well). For more detailed information about herpes, check out some of the Q&As in the Herpes section of the Go Ask Alice! archive.

Though what you’ve been dealing with may be caused by herpes, it’s good to know that you don’t have to stop being sexual; here are some tips for minimizing the risk of herpes transmission:

  • Regularly use barriers methods of contraception, such as condoms (internal and external) and dams, which minimize skin-to-skin contact.
  • Take care of yourself when you have an outbreak of either strain: practice proper hygiene, get enough sleep, and eat nutritious foods.
  • Focus on non-sexual fun with your partner(s) while you wait for sores to heal completely.
  • Foster healthy communication and keep your partner(s) informed of your herpes status.

Scared and depressed in Oregon, know that you aren’t alone in how you feel about having herpes (as your signature suggests). Many people are worried about the impact a positive diagnosis may have on current or future relationships or they believe that their time and opportunities for sexual expression are over. Fortunately, that doesn’t have to be true! Herpes is pretty common and the condition can be managed. After time and perhaps treatment with suppressive medication, the symptoms of each outbreak typically becomes less intense and outbreaks all together become less frequent. Being kind to yourself and having good communication with your partner(s) can make having herpes simply just a part of a larger, happy life. Some may also find it helpful to talk to a health care provider or counselor to work through some of the feelings that a positive diagnosis may bring up. Knowing about the virus and how to manage it can be helpful in learning to live and love with herpes. For additional support or to get more information, you can also check out the American Sexual Health Association website.

Last updated Oct 21, 2016
Originally published Jun 25, 2004

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