Dear Alice,

The question I have is very important. A friend of mine contracted herpes through her first boyfriend. Well, first sexual boyfriend and he says he doesn't have it. Yet where did she get it? She was defending him and blaming herself. I tried telling her that they don't call it an STD for nothing. Now she swears she got it from a tanning bed. I personally don't believe it. Could this be true? If so, why haven't I heard anything on it?

Worried Friend

Dear Worried Friend,

You're right, genital herpes isn't classified as a sexually transmitted infection (STI, the new term for sexually transmitted disease, or STD) for nothing! The most likely way to get the strains of herpes that typically affect the genitals is through direct skin-to-skin contact, which often happens during sexual contact. Herpes usually manifests as blisters, or painful, fluid-filled sores on and around the genital area, mouth, and sometimes even on the thighs and buttocks. It’s transmitted through contact with the sores of an infected person, not from their bodily fluids (e.g., vaginal fluid, semen, breastmilk, blood). The newly infected person's sores usually show up in the same area as the point of contact during the transmission of herpes. Additionally, herpes may be transmitted when a person is asymptomatic or when herpes simplex virus type 1 (commonly known as cold sores) come in contact with the genitals (more on these in a bit). Research indicates that transmission doesn’t occur through contact with shared surfaces, so it’s highly unlikely that she got it after using a tanning bed. 

So to go deeper, how the heck did your friend get herpes? If your friend has had close sexual contact with a person besides the boyfriend you mentioned, it’s possible that she got the herpes virus from this other person. Bear in mind, though, that the incubation period for herpes is 2 to 20 days (but it can last longer). The other scenario is that her boyfriend does have herpes, but just doesn't know it. Her boyfriend could also have an asymptomatic case of herpes; that is, he carries the virus but doesn’t experience any symptoms of the disease. Asymptomatic cases of herpes will shed several days a year, meaning that the virus comes up to the skin's surface and can be transmitted to another person during that time. Additionally, the first time that someone experiences symptoms may not be the first time they were infected. It’s possible that your friend was infected previously after activity with another person, and she’s only experiencing an outbreak now. Another possibility is your friend's boyfriend had direct contact with someone who had fever blisters or cold sores, and contracted herpes that way. His cold sores — herpes simplex virus type 1 (HSV-1) — could have led to a genital infection for her if his mouth was on her genitals.

Ultimately, she may never know where this infection originated, as the origin of transmission and outbreak of herpes isn’t always clear. What is more clear is that although there is no cure for herpes, it’s certainly more manageable with antiviral treatment that can shorten or suppress outbreaks. These medications may be taken after the initial outbreak, and some people find that taking low doses regularly helps to suppress further outbreaks. 

It may take a while for your friend to accept and learn to live with herpes. Regular check-ins with a health care provider, getting treatment as necessary, utilizing safer sex practices with sexual partners, and seeking out support to cope with a herpes diagnosis are some ways that your friend may manage moving forward. Perhaps you can read the some of the related Q&As, which provide information and address strategies for living with herpes. If you feel comfortable, you could even share these resources with your friend.

Alice!

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