Answering your questions, man to man.

Q: I've been seeing this girl and we've really been hitting it off. And then last night, she tells me she has herpes. Now, I'm freaking out. My head tells me to handle this like a mature gentleman. But my gut reaction is to ghost and never look back—I don't want herpes! What should I do? – Jason, San Antonio

A: Finding out your partner has herpes can be a bombshell at any point in the relationship. If you’ve been physically intimate, freaking out was probably your first reaction (Do I now have herpes?). Then come the other questions:

Is herpes a deal breaker?

Are you stupid to continue a relationship with someone who has herpes?

Or are you stupid for breaking it off?

I won’t bullshit you. This isn’t an enviable situation. But it is not nearly as unique or earth-shattering as you think it is.

Walk with me.

Freaking out? Read this first. No one wants herpes. But at the same time, it's not the end of the world. Not even close. Consider this: Herpes is more common than you think. Over 1 in 6 Americans have HSV-2 and even more have HSV-1. Herpes does last forever, but most people see no symptoms for years, decades or ever at all. Having herpes doesn't mean your partner is or ever was a cheater or a slut. A herpes infection can go undetected for decades, which means you might even be the one who introduced it into the relationship without knowing it. The worst part of herpes is the stigma. From a medical standpoint, it’s extremely manageable and suppressible. Many people with herpes never have symptoms or outbreaks. For those that do, anti-herpes medications, such as Valtrex, Zovirax, and Famvir, can prevent or shorten outbreaks. A relationship doesn’t have to end because of herpes. You can still stay together, you can still have freaky sex, you can get married and have kids, whatever. But if you do choose to break it off because of herpes, that’s okay, too.

I know there a lot of thoughts and anxieties swirling in your head—about your partner’s health, about your health, about your partner’s fidelity, about your future (or lack thereof) with your partner—and we’ll get to all that.

But first, let’s get straight on what herpes is and what it isn’t.

What causes herpes?

There are two viruses that people talk about when they talk about herpes: Herpes Simplex Virus 1 and Herpes Simplex Virus 2, or HSV-1 and HSV-2. HSV-1 is the one that usually causes cold sores around your mouth and lips. HSV-2 is the one usually responsible for genital herpes. Both HSV-1 and HSV-2 can cause infections anywhere on your body, and both HSV-1 and HSV-2 are more common than you think. And yes, herpes is forever.

How common is herpes?

The prevalent statistics you encounter in drug commercials, sex ed, and PSAs are inconsistent and often confusing. That’s because herpes infections are much more complicated than we paint them in our SNL sketches and stand-up routines.

Here’s the best statistic I’ve seen. It’s from ProjectAccept.org:

Around 75% of Americans carry HSV 1 or HSV 2 somewhere on their body. That virus can (but may not) be transmitted to any surface of someone else’s body, via physical contact. If it does transmit, there’s an ~80% chance that they won’t recognize any symptoms from the infection. However they, too, will retain the virus for life and be contagious.

That’s a lot to parse, but boil it down to this: far more than 1 in 6 Americans between the age of 14 and 49 have HSV-2. 1 in 6 means that if you’ve had three sexual partners in your life, then there’s a 50:50 chance that one of them has had herpes and an even greater chance that one of them has had a partner with herpes.

So, when I tell you that your partner disclosing to you that she—and therefore maybe you—have herpes, I really mean that it’s not that earth-shattering. Not just compared to everyone you know, but compared to your own life up to this point. What’s unique about this situation is that one of you knows and is talking about it openly.

Herpes: The Stigma Herpes is the modern day leprosy. The shaming of the “unclean” and the fear loom far larger than the actual health risks to the population. We have a long tradition of shaming, ridicule, and misconception to thank for that. From Shakespeare and South Park to sex ed and parodies of Valtrex commercials, herpes has been treated unfairly by mass society. That’s a sad reality that you and your partner will have to face. But you don’t have to bring that shit directly into your relationship. This is between you and your girlfriend, fiance, wife, boyfriend, husband, life partner or whatever. You have the opportunity to be open-minded about this. So, let’s process some baggage. First, is your partner a slut? Is she cheating on you? I mean, that’s how you get herpes, right? By sleeping around and having unprotected sex? The answer: Probably not. According to the CDC, most herpes transmissions occur when the infected person shows no symptoms and may not even know they are infected. Remember, over 1 in 6 people have HSV-2. And many don’t even know about it. That two people might hook up–be it a third date or a long committed relationship–and one or both of them has herpes and doesn’t know it is hardly far fetched. After all, isn’t this essentially what just happened to you? Isn’t this why you’re reading this right now? “Unless you actually have reason to suspect they're cheating, a herpes diagnosis in the middle of a relationship does not mean they have been cheating.” Jenelle Marie Davis, the founder of The STD Project, explained to Primer. “Most STI panels do not test for herpes, most people are asymptomatic (meaning they do not have signs or symptoms or experience outbreaks), and even the tests that are out there often return false negatives if someone was recently exposed or does not have a high enough concentration of the virus or the antibodies for the virus (depending on the type of test).” Dwelling on how someone got herpes is wasted mental and emotional energy, when really, you should be focusing on the next steps for your relationship in the here and now. “When thinking about herpes diagnosis as an indicator someone has cheated, let me pose this question: When you catch a cold or the flu, do you look for the culprit? Do you search back in your memory for which doorknob you touched that might have been infected or which person sneezed in your vicinity?” says Davis. “No, you don't – at least, most of you don't. And that's because there's no stigma and shame associated with catching the cold or the flu. So, blame and origin is irrelevant, because those things are seen as unfortunate but part of being human – our bodies are resilient but not infallible, and the potential for infection and risk is present in almost everything we do. The only reason we care about who gave it to us and when is because we shame people for how they got it – by having sex or engaging in sexual activities. When we take that away, we stop freaking out.”

How is herpes contracted?

Herpes is contracted through skin-to-skin contact and through sexual contact, including oral, anal, and vaginal. It’s most contagious during an outbreak (when there are visible sores), but HSV can shed viruses when a person is asymptomatic as well.

So, yes, you can contract herpes from someone whether or not they are having an outbreak.

How likely is it that I’ll get herpes from my partner?

Staying in a relationship where you are negative and they are positive seems like playing with fire.

But there’s something to be said for someone who knows they have herpes and knows how to manage it versus someone who has herpes and doesn’t know and has never been tested.

Eric M. Garrison, a clinical sexologist, told Primer: “When a person living with herpes knows everything about herpes and can comfort themselves and educate their partners, when they can know their prodrome and understand what that means, when they are aware of what can trigger their outbreaks, then sex with them can be (and often is!) less risky than sex with a partner who may or may not know their status.”

A herpes prodrome are signs that an outbreak is about to happen. Herpes prodrome include itchiness, tingling, burning, numbness, aches, shooting pains, and other sensations and can appear 30 minutes to a couple of days before an outbreak. When prodrome is present, it means the virus is active and the chances of transmission are high.

Is the risk higher than being in a relationship with someone who is confirmed negative? Obviously yes.

But is it realistic to only be in relationships with people who have been recently tested for herpes? No. Wise? Yes. Likely? No.

That being said, you'll never reduce your risk of contracting herpes from a partner down to zero. But you can get it pretty damn close.

There are three ways to reduce the risk of transmission.

Abstain from sex during outbreaks. For many people, outbreaks can be entirely prevented by paying attention to prodrome (early indications of an oncoming outbreak) and taking medication when they appear. After an outbreak, you should abstain from sex for about 2 to 3 days.

For many people, outbreaks can be entirely prevented by paying attention to prodrome (early indications of an oncoming outbreak) and taking medication when they appear. After an outbreak, you should abstain from sex for about 2 to 3 days. Manage asymptomatic shedding. This is when the virus is contagious, but there are no symptoms of a herpes outbreak. Asymptomatic shedding greatly decreases after the first year of infection, especially with the use of suppressive medication. The idea of a person being contagious without knowing it sounds scary, but studies show that for those who have herpes and never have outbreaks, they shed about 1 out of 10 days and for those who do have outbreaks, they shed about 2 out of 10 days. About 49% of people shed for 12 hours or less, while 24% shed for 6 hours or less. That's a pretty small window, even if you're frisky enough to go at it every day of the year. Plus, anti-viral medication greatly reduces asymptomatic shedding.

This is when the virus is contagious, but there are no symptoms of a herpes outbreak. Asymptomatic shedding greatly decreases after the first year of infection, especially with the use of suppressive medication. The idea of a person being contagious without knowing it sounds scary, but studies show that for those who have herpes and never have outbreaks, they shed about 1 out of 10 days and for those who do have outbreaks, they shed about 2 out of 10 days. About 49% of people shed for 12 hours or less, while 24% shed for 6 hours or less. That's a pretty small window, even if you're frisky enough to go at it every day of the year. Plus, anti-viral medication greatly reduces asymptomatic shedding. Wear a condom. If your partner is asymptomatic and taking daily medication, then the chances of transmission are already low. Condoms take it down even lower.

If nothing else, dating someone with herpes can seem like an inconvenience. The need to always wear protection and be aware of outbreaks and prodromal symptoms is certainly unique. But on the grand scale of things, herpes might be less of a challenge than celiac’s disease or severe nut allergies or even a monthly menstrual cycle.

For most people, herpes outbreaks happen less and less frequently as time goes on. There are medications that can shorten or prevent outbreaks and reduce the chances of transmitting herpes to another person. Coupled with a good understanding of herpes and a frank and open discussion with your partner, this can mean a very manageable relationship with herpes.

Bottom-line: Is a long term relationship with someone with herpes a life sentence for protected sex? Or is contracting herpes from your partner going to be an inevitability—not a matter of if, but when?

That can't be answered definitively. I'm not going to sit here and guarantee that you'll never get herpes, either from your long term girlfriend or from a random hookup. But know this: many, many couples find a way to make it work. And they all sort of do it in their own way.

In a long term relationship where there is open communication, maybe even a little professional counseling (people like Eric Garrison, or someone your doctor refers), you find your rhythm. You find the lifestyle and sex life that fits your comfort level. In the same way that no birth control method reduces the chances of pregnancy to zero, couples eventually find the right balance between caution and calculated risk. Some couples have sex with condoms every time, others only wear protection during outbreaks or simply avoid contact with the areas where the virus is transmittable. Sores can appear around the mouth, on the genitals, on the thighs, or buttocks, etc. The recurrence of herpes outbreaks is variable—but they always reappear in the same site.

Getting tested. You can get herpes tested by a primary care physician or at a health clinic. Herpes can be tested by taking a sample from a sore, or by taking a blood test to check for HSV antibodies. The incubation period for herpes is usually 1 to 7 days but may incubate for longer, even weeks, before showing any symptoms. Here's an infographic that explains the herpes testing process.

Is it okay to break up with someone because they have herpes?

Yes, of course it is. It’s okay to break up with someone for any reason. You can break up with someone because their mother is awful or because of the weird way they eat ice cream or because they have different job and family aspirations than you. You’ve got free will here.

But…

Consider that you might be walking away from a relationship that’s worth the added complication of herpes. People are not defined by their sexually transmitted infections and neither are relationships. If what you have with that person is something special, then letting herpes end it is something you’ll regret.

The reason: it’s just so incredibly possible to be dating, or living with, or married to someone who has herpes. For the vast majority of the days in your lives, herpes will be a non-issue.

Don’t run scared because of the stigma of herpes.

Chances are, attitudes about herpes will change in the coming decades. As a kid, I remember reading in the Bible about the way lepers were treated and thinking how foolish it was that these people were marginalized because they were (wrongly) believed to be unclean and contagious. Are the conditions we stigmatize today much different?

While it’s naive to say that we’ve completely overcome the negative light shed on illnesses like HIV, breast cancer, post traumatic stress disorder, colon cancer, HPV, anxiety, and depression, when you consider how our cultural stance on these conditions has changed, it suggests a trend towards acceptance and understanding. Thirty years in the future, you might judge yourself differently for recoiling from herpes in ignorance.

But, like I said, if this is something you don't feel calibrated to take on, or to take on with this specific partner, then you don't need to feel guilty about ending things. Maybe you were already on the fence and then you got this news. If you're still not sure how to handle things, try giving it some time to mull it over. Maybe even hang out with her again – maybe you'll realize she's actually a terrible listener and not what you're looking for in a partner anyway.

If you do decide to go separate ways because of herpes, my suggestion is to be as respectful as possible.

What does that mean? Don't ghost her. You think she's never seen a guy drop off the planet before after she – very responsibly – told you this incredibly intimate situation? Be one of the good guys, talk to her.

Learn about HSV. Talk about HSV with your partner. Come to terms with it with an informed perspective.

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