You might have herpes – and don’t even know it
A lot of Kiwis are unknowingly walking around with oral or genital herpes. Behind the stigma is a medically mostly insignificant skin condition that’s basically the same whether it’s on your face or your bits.
If you’ve ever had an STI test, and it came back clear, you might think you don’t have herpes. You could be wrong.
Testing for herpes isn’t part of the standard sexual health screening. Most people have mild or no symptoms, so don’t know they have the virus.
A little pimple, a crack in the skin that comes and goes, a bump you presume is an ingrown hair – all of those things can be signs of genital herpes.
If a person is symptomatic, a doctor can swab for a PCR test. Blood tests for virus antibodies have a high false positive and false negative rate and won’t indicate its location, so they’re not often used as a diagnostic tool.
There are two strains of herpes: HSV-1 and HSV-2 (the HSV stands for herpes simplex virus).
For a long time, the strains were thought of in terms of ‘upstairs’, (HSV-1, commonly known as ‘cold sores’) and ‘downstairs’ (HSV-2, commonly known as ‘herpes’). Now it’s understood HSV-1 also causes genital herpes, passed on mainly through oral-genital sex. HSV-2 is mostly transmitted through genital-genital sex.
According to a 2020 study by the World Health Organisation, 80% of the world’s population under 50 have herpes: 67% HSV-1 and 13% HSV-2.
Because herpes is so often asymptomatic and undiagnosed, you may not know whether you or your partner has it.
Research carried out as part of the Dunedin Study – which began following 1037 children in 1975 – reveals how common it is in New Zealand. The participants were invited to be tested for HSV-2 at ages 21, 26, 32 and 38. By age 38, 17.3% of men and 26.8% of women had HSV-2 antibodies in their blood.
That’s an average of 22% of the population with genital herpes caused by HSV-2.
But we know HSV-1 also causes genital herpes – 30 to 40% of cases, according to a Waikato study that looked at 10 years of data.
When you do the maths, that means 34% of New Zealand’s adult population, or about a third, will have genital herpes.
For most people, it is so mild and asymptomatic it is never diagnosed. The first outbreak is usually the most severe, and can include flu-like symptoms and aches, which may be followed by an outbreak of herpes sores or blisters on or around the genitals. For those who do experience recurrent outbreaks, oral antivirals can reduce or stop recurrences, lower the risk of passing the virus on and speed up healing.
Reporting disclosure statement: This post was written with expert advice from Claire Hurst, nurse and Herpes Foundation manager. For information and support visit herpes. org.nz. It was reviewed by The Whole Truth: Te Māramatanga expert panel member Dr Rawiri Jansen.