“Just because you don’t understand it doesn’t mean it isn’t so”
Lemony Snicket
One of the most avoided truths is that the majority of people have herpes.
Cold Sores vs. Genital Herpes
I have HSV-1(G) because of HSV-1 oral transmission. I’m subject to judgement, stigmatization, and assumptions that someone with a cold sore isn’t. The location is different, and so is the perception.
There’s a massive lack of awareness surrounding the connection between cold sores and herpes. Stigma and misconceptions of HSV are often fueled by misinformation, fear, and perception of STIs. One of the biggest differences between cold sores and genital herpes is that HSV-2 is associated with sexual activity. Cold sores, oral herpes (HSV-1), is often perceived as more common, less severe, and not always/necessarily sexually transmitted. Because of poor education, many people are unaware that cold sores are caused by the herpes simplex virus and it can be transmitted through oral contact. Because of the genuine lack of awareness, many individuals with cold sores don’t realize the importance of disclosing their oral herpes to partners which directly leads to the unintentional transmission of the virus during oral sex. So, to be clear, cold sores (HSV-1) are herpes.
In my last semester of undergrad, I designed and conducted a study aimed to investigate if individuals who have been exposed to comprehensive sex education emphasizing safe sex practices and STI awareness hold less stigmatizing attitudes towards sexually transmitted infections. I did this study to further the point that even with comprehensive sex education, STIs are heavily stigmatized. While I’d like to think we could change the culture of sexual health, I’m doubtful it’s possible.
Results
Of the 85% of participants who had “comprehensive” sex education, topics varied yet included STIs, contraceptives, anatomy, protection, safe sex, and healthy relationships. Some responses suggested less comprehensive education, one participant noted “We didn’t really talk about safe sex, just not to have it,” while many others said they were simply taught abstinence. While indicating attitudes towards STIs, 60% of participants agree that STIs are a source of shame and embarrassment and 89% agree that STIs are a dealbreaker for them in sexual relations. Risk perception regarding the likelihood of contracting an STI given various scenarios offers insight into sex-related decision-making. 98 % believe that it is low risk to engage in sexual activity within a committed, monogamous relationship. 89% perceive using condoms consistently and correctly during sexual activities to prevent STI transmission as low risk. 37% of participants said they were unlikely to get STI tested while experiencing symptoms commonly associated with STIs and 73% are unlikely to get tested if they have a new sexual partner with an unknown STI status. The majority would get tested if it was recommended as part of a routine health check-up, even with the absence of symptoms. Six people would not get tested if they were informed that they were in contact with someone who tested positive. 78% of participants know someone who has had an STI, and everyone said they would be supportive of a friend telling them they were positive.
So What Now?
We have to start talking about cold sores and herpes. Doctors and nurses need to education patients about the virus and sex education must improve. 50-80% of Americans have HSV-1, so why don’t we start talking about it? I have to carry a burden because people aren’t ready for this conversation.
Have you ever had a cold sore? Have you ever been with someone who gets them?
And yes, you can pass the virus without an outbreak.
Living with Herpes 
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