I have herpes and I don’t think I need to tell people
By: Ellen Beale
Tags: Stigma, Sexual Health, Disclosure, Herpes, Acceptance

I am not telling you these things to create hysteria around how easy it is to get herpes. This is not a drive to discourage consensual adults from going down on other consensual adults. Oh god, please no. I am telling you these things to put into perspective how much of a non-issue it is to have genital herpes, and by implication, how it’s just wild that we hold people morally accountable for disclosing that they have genital herpes when we never, ever expect people with HSV-1 (which is, like, basically everyone) to disclose this fact before having oral sex. Even though you can fully get genital herpes in this way. We just don’t care. And we shouldn’t.

If that seems callous and/or sexually irresponsible, allow me a little story about why standard STI screenings don’t screen for herpes. Yes, that’s right. If you’ve ever had an STI screening and the doctor said, “Good news, you’re all clear,” you may still have herpes.

How is this possible? Okay, are you ready for it? This is gonna flip your lid.

That herpes screening isn’t included in standard STI screenings is one of the first things I found out after my diagnosis. I tried to found out why and surprise! I found a lot of what I now know to be misinformation. The worst of these is the often-cited bullshit that there’s no blood test for herpes. According to the myth, a herpes diagnosis requires testing swabs from actual herpes sores. Which implies only people who’ve had an outbreak can get tested for herpes. The same source will go on to tell you that only about 40% of people who have herpes will get an outbreak. Wait a minute. Question: How do we know that if we can’t detect asymptomatic herpes? Answer: There is a blood test for herpes. You can absolutely, 100% get diagnosed with herpes even if you’ve never had an outbreak. Confused? Me, too. If there’s a blood test for herpes, why isn’t it included in standard STI screenings?

It turns out there’s a difference between STI testing and STI screening. Testing is done when you have symptoms, while screening is done in the absence of symptoms. Doctors screen for STI’s like chlamydia and gonorrhoea even when the patient has no symptoms because these infections can cause serious health complications.

Herpes? Not so much. Here is the rationale behind the decision to not screen for herpes from Christine Johnson, M.D., an associate professor and herpes researcher at the University of Washington:

Pause. Did you get that? The mother effing U.S. Preventative [Services] Task Force, a “panel of national experts in disease prevention and evidence-based medicine” (my emphasis) came together, all these doctors whose literal JOBS are to prevent the spread of diseases, sat at a table and said, “Yeah, you know what, telling someone they have HSV is just not worth the psychological trauma.”

I’m sure there was a doctor in that room, let’s call him Doctor Stigma, who said, “Hold on a minute, that seems extremely irresponsible. If patients don’t know they have herpes, they could unknowingly pass it on to their sexual partners.”

And then a different doctor, Doctor Logic, must have said, “That’s true, but we’ve done the calculations and we have come to the conclusion that the negative psychological effects of a positive herpes diagnosis far outweigh the potential negative effects of an asymptomatic herpes patient transmitting the disease.”

And then Doctor Stigma (remember this is Doctor Stigma who’s sitting on a panel of national experts on disease prevention) must have said, “You’re telling me it’s worse for someone to find out they have herpes than it is for that person to pass on the disease to the potential myriad of sexual partners they’ll have in their lifetime, and the potential myriad of sexual partners those people might have?”

To which Doctor Logic, who is also an expert on a panel of doctors who specialise in disease prevention, must have replied, “That is correct.”

And that, ladies and gentlemen, is how doctors feel about the importance of finding out if you have herpes. A literal panel of doctors sat together and came to the conclusion that the actual health effects associated with herpes that may affect potentially millions of people were smaller than the psychological effects of one person finding out they have herpes.

I know what you’re thinking. If medical professionals feel this way about herpes, if they consider it ethical to not screen for herpes, why on god’s precious earth is it unethical of me to not disclose my herpes to a sexual partner? Why am I expected to risk my psychological wellbeing as well as the quality of my romantic relationships with a herpes disclosure when experts in disease control have LITERALLY ruled that not knowing is better than knowing?