Does Everyone Have Herpes?

Sex educators often repeat the statement that “most people have herpes.” They say this, in part, in an attempt to reduce the massive stigma that surrounds genital herpes. However, while many people have various strains of herpes, most people do not have genital herpes. Because the statement is a bit misleading, it can result in more confusion and fear because of the stigma that exists around genital herpes.

One of the most vivid memories I have from my first formal training as a sex educator was learning that 80% of people have herpes. The training was in an old mansion-turned-office-space and us trainees were all seated in a circle in some sort of living room, expectantly facing an instructor with a flip chart. Our instructor wrote in large black print that 80% of people have herpes and that 90% of those people didn’t know they had it. At the time, I remember being shocked by that number and wondering how it could possibly be true. I was honestly also a bit scared because that meant I probably had herpes.

Herpes basics

Looking back, my fear reaction was due to my own beliefs of the stigma surrounding herpes. So, let’s start with some basic info about herpes. When most people think about herpes they are thinking about genital herpes, which usually looks like blisters or sores on and around penis, vagina, and anus. There are multiple strains of herpes in the Herpesviridae family that affect humans, but here I am referring to herpes simplex virus, often abbreviated HSV[1]. Herpes simplex virus consists of two strains, called HSV-1 and HSV-2. Historically, HSV-1 is found mostly above the waist, most often on or around the mouth in the form of cold sores. HSV-2 is mostly in the genital region. More recently there has been increasing evidence that HSV-1 infections are presenting themselves both on the mouth and genitals. (Review of much of the details about HSV can be found in the Sex Information and Education Research Council of Canada Sexual Health Issue Brief on the topic (PDF here).  

We mostly talk HSV about it in terms of cold sores and genital herpes, but it can occur on any part of your body. Common locations include eyes and fingers. Herpes on your fingers is called herpetic witlow. Wrestlers and other contact sport players can also get herpes on various parts of their bodies from being in close contact and rubbing on one another with. Because it is common in wrestlers, this form is called herpes gladitorum! It’s just HSV-1, usually on the torso or arms, but it has this extra exciting name. I guess to distinguish it from less cool forms of herpes, perhaps?

Herpes stats

Data from a recent (2015-16), large study in the U.S. at the Centres for Disease Control (CDC) showed that 48% of their sample tested positive for HSV-1 and 12% tested positive for HSV-2. In Canada, a large study in 2009-2011 that only looked for HSV-2 estimated that 13% of the population has HSV-2. Even more interesting was that 94% of those who tested positive did not know they had HSV-2. A global study, commissioned by the World Health Organization reviewed 111 studies from many countries to estimate a global incidence of HSV-2. The statistical model they came up with estimated a global incidence of 11% for HSV-2.  

I am reporting on the HSV-2 stats because that is the most common form of genital herpes, but more and more genital herpes outbreaks are being linked to HSV-1. Either strain of herpes can be present at the genitals.

Herpes stigma

Herpes as a virus, is just not that big of a deal. Yes, it is a lifelong infection, but the primary effects are some annoying blisters on your body every so often. There is a risk of harm during childbirth if there is an active genital outbreak, but this can be deal with using preventative measures. However, stigma around herpes is massive, and it causes harm to people with herpes.

Because of sex negativity, stigma around sexually transmitted infections is very high. This has been documented in many studies. For example, people have much harsher judgments of people with STIs compared to cancer diagnoses because they feel the people with STIs made a choice to have sex in ways that put them at risk. People believe this without knowing anything about the ways in which a person contracted the STI!

Another study had participants read one of several paragraphs about someone who wasn’t feeling well but went to a party. Depending on the paragraph the person read, they were told the person gave either chlamydia or swine flu to someone else. The paragraphs also varied in severity. Some people read about a low level of complication due to either swine flu or chlamydia, and one paragraph about swine flu even said the person who got it died.

Participants read one of these paragraphs and then ranked the people infecting other people on how risky their behaviour was, how selfish they were, and how smart they were. The rankings showed that people who read the paragraph about the mild chlamydia outcome ranked the person as taking more risks, being more selfish, and being more stupid than the person who infected someone with swine flu that resulted in death! Giving someone chlamydia is seen as WORSE than causing someone’s death via swine flu!!!

There is so, so, so much stigma about STIs. And this stigma is part of the reason we often know so little about STIs. Herpes is particularly stigmatizing because it is something people have for life, as opposed to chlamydia, gonorrhea, and syphilis that can be treated if people get tested and know they have them. We also have way more stigma about genital herpes than oral herpes. Yes, oral herpes can be embarrassing when they are on your face, but there is nowhere near the level of stigma compared to genital herpes.

Conclusion

So, while genital herpes virus is common as far as STIs go, genital herpes isn’t everywhere, as some people might say. If you do have genital herpes, it helps to get to know your body cycles and be able to detect when an outbreak is coming on. Using protection and being aware of impending outbreaks can help prevent spreading it to a partner. But no protection is fool proof, especially since herpes is transferred from skin-to-skin contact. There are also medications that some people with HSV take to reduce outbreaks. That helps reduce the pain and discomfort of an outbreak, and the risk of transmitting it. Overall, it’s pretty easy to live with the virus. For many people, the most difficult part is dealing with the stigma.

For lots more info on herpes, you can hear more on the Do We Know Things? podcast, episode 3.

[1] Others include varicella zoster virus (chicken pox and shingles), Epstein-Barr virus, cytomegalovirus (mononucleosis). There are 8 Human Herpes Viruses (HHV), including HSV 1 & 2.