STD Information: Herpes

Herpes infections are caused by the herpes simplex viruses (HSV-2 and HSV-1). Transmission can occur even when lesions are not present (in fact, probably most transmission actually occurs in the absence of skin ulcers or breakdown, which is why 90% of persons infected with HSV-2 don't know they're infected).  See our Links for several excellent resources on this common infection.

  • Symptoms: small blisters on the vulva, often painful, are classic, but at least 90% of people infected with HSV-2, which causes the majority of genital herpes, do not know they are infected. Itching is a common symptom. In the initial episode of HSV, symptoms can include painful/difficult urination, fever, swollen lymph nodes, and flu-like symptoms.
  • Treatment: three antiviral medications (acyclovir, famciclovir, valacyclovir) are now available & all work equally well. Antivirals are also recommended for recurrences and suppression when there are more than 6 recurrences a year. Antivirals help the symptoms of HSV and speed healing; they do not cure the virus.  They also reduce the likelihood that HSV is shed in the absence of outbreaks.
  • Transmission WTW: very likely occurs, but data on specific prevalence and risks is very limited. In particular, oral-genital contact (oral sex) can transmit HSV-1 from the mouth to the genital area, especially when one partner has a cold sore.  
  • Precautions: because transmission can occur even when no lesions are present, any genital-genital contact should involve latex barriers 100% of the time; couples should abstain from sex during outbreaks, until the skin is fully healed.  

Please note that for the purpose of our web site we are focusing primarily on woman to woman transmission (WTW) and only providing a general overview of the infections themselves. You may want to check out our Bibliography and Links sections for more in depth information or contact us with specific questions through STD Q&A's.