According to one recent survey, a non-negligible number of Americans erroneously believe that genital herpes are literally lethal. Even people who don’t may think of the sexually transmitted infection as a social death sentence. Hell, advice columns and forum discussions breaking down whether it’s possible for someone with herpes to have an active sex life are basically their own genre by now. Herpes took on this grim social aura thanks to irresponsible and sensationalist mid-20th century reporting that focused on its incurability and linked its spread to promiscuity and supposed social decay. In truth, rather than an insurmountably grave condition, herpes is usually a minor nuisance, even at its worst.
The Centers for Disease Control and Prevention (CDC) estimate that at least one in six people between ages of 14 and 49 have HSV-2, the strain of herpes virus that usually affects genitals. Additionally, up to two thirds of all people have HSV-1, which usually causes cold sores on lips and in mouths but can also be transmitted to people’s genitals, typically via oral sex. The vast majority of people with either form of herpes never develop symptoms—usually an itch or pain, and sometimes flu-like symptoms, often followed by the appearance of irritating red bumps on or around the genitals. (Both HSV-1 and HSV-2 create similar symptoms in the genitals.) Sometimes these symptoms are so mild that people mistake them for something else, like ingrown hairs.
In many cases, people only get one major and maybe a few minor herpes symptom outbreaks in their lives. Even particularly bad symptoms usually become less common and severe over time as people’s immune systems adapt to fight back against herpes. The virus only causes serious issues in impossibly rare cases—like when a parent spreads the virus to a vulnerable newborn. (This is one of the few contexts in which the virus can potentially be deadly.) The CDC doesn’t even recommend testing for it regularly—and few care providers do—because the costs of tests, and of social stigma, don’t match the public health benefits of screening.
So, how does herpes actually affect a person’s ability to have sex? Although its impact isn’t as big as it’s frequently made out to be, symptomatic genital herpes can impose a few limitations: Most sexual health experts recommend avoiding sex during outbreaks—that’s when transmissions to uninfected partners are most likely. It’s also easier to contract other STIs during an outbreak, when exposed to them, thanks to the openings sores create for other infections, and in some casts to the effects the virus has on the immune system. (Transmission of the herpes virus is still possible when people are asymptomatic, and even when they use barriers like condoms, as herpes can shed off of uncovered skin. But good management and precautions can keep transmission risks exceedingly low.) The social stigmas around herpes also lead to plenty of stress and anxiety, which can interfere with people’s ability to get turned on or enjoy sex—and can ironically increase the risk of experiencing an outbreak.
In recent years, activists like Ella Dawson have started pushing back on herpes stigma, and a few support groups and sexual health outfits have started to publish comprehensive guides on how to navigate the condition during sex. However, they often focus on how people with herpes can approach disclosing their status to prospective partners, minimize transmission risks, and work through the psychological aspects of the condition. Few offer nuts-and-bolts insights on how partners explore the intersection of sex and herpes together. For insights on this, VICE spoke to Robin, who has symptomatic HSV-1 genital herpes, and her partner, Miles, about their sex life.
This article has been edited for length and clarity, and Miles and Robin’s names have been altered to protect their privacy.
Robin: I didn’t know much about herpes before I got diagnosed, other than what you learn in high school sex education: That you can get it through intercourse or oral sex, and that it’s incurable. I vaguely remember teachers showing pictures of what the worst cases of herpes look like, and those slides were… not pleasant. I also picked up a lot of social stigmas about how, if you get herpes, you must be promiscuous—and if you’re a woman, you must be a slut or a whore.
In 2019, about five days after I had sex with a partner, I started urinating frequently, and it burned—and I saw bumps on my genitals. I thought I had a UTI, but I slowly realized it was probably an STI. I hoped it was something curable, like chlamydia or gonorrhea. When I confided in a family member, she disclosed to me that she had herpes, and it sounded like that might be what I had. By the time I saw a doctor, that had started to sink in, and I cried in the waiting room. Everyone was staring at me; it was terrible. I felt like I was sitting on social death row. When I got my results, I started grieving for what I thought was the death of my dating and sex life. I felt too ashamed to even try dating, because I’d have to disclose my status as someone with herpes.
My doctors also told me that I shouldn’t have sex during an outbreak, which sounded reasonable. But early on, I had frequent outbreaks—sometimes, once every week. I felt like, even if someone would want to date me, I wouldn’t actually be able to have sex ever again. Who was going to be OK with not being able to have sex for a month or more at a time? I really worried that I was never going to have a normal sex life.
Once I got on Valtrex, [a drug that many people with symptomatic herpes take daily to reduce the number and severity of outbreaks, and transmissibility], my outbreaks got better. Now, I haven’t had an outbreak in months.
I realized that I really wanted to have a monogamous sexual partner in my life. So, I started seeing a therapist who helped me build up my confidence and develop ideas for how to approach dating again. I went back on dating apps, and a few months after my diagnosis, I went on my first date. It didn’t go well. We got smoothies and this guy tipped his cup towards me to ask if I wanted to try some of his. I said no, and he asked why. I thought, Oh, no—here it goes. I explained that this is a condition I have—and he ghosted me after that date. I asked if my disclosure had anything to do with that, and he never replied to that message. That was pretty discouraging.
But I had better experiences later, both with people who were OK with the fact that I have herpes, and with people who weren’t, but communicated that to me in a respectful way I felt OK about. In the spring of 2019, I met Miles.
Miles: I knew a bit about STIs before we met—including the fact that there are a ton of different types of herpes viruses. I definitely knew people stigmatized herpes; I grew up hearing people laugh about it, like it’s something to be embarrassed about. But it never occurred to me to look at someone in a negative light because they caught something. I knew that herpes wasn’t going to be detrimental to my health if I ever did get it. I think a lot of people don’t really have information about herpes, so they think about it as something that lowers a person’s social status without even thinking.
Robin: When did I end up disclosing my status to you?
Miles: After our second or third date, I think.
Robin: I set him a long text explaining my status, because I feel the urge to be honest about this as soon as possible. It was in the evening. I sat by my phone for a long time waiting for a response, thinking about every possible outcome, and trying to convince myself, Well, if he’s not OK with this, it says more about him than me, and it’s good that he’s showing his true colors early on. If he can’t accept something as small as herpes, what else won’t he accept?
Then I got a text in the morning saying, “I am so sorry, I was already asleep when you sent your message! I’m OK with this. I like you for who you are, and I want to see where things go, so we can talk more about this, but I’m not leaving because of it.”
Miles: We had just really connected. To me, herpes is no big deal. There are ways to be safe about it. It wasn’t going to stop me from pursuing a potential relationship.
Robin: The next time we met, I explained my symptoms and treatment and what I thought we needed to do to be safe during sex. At the time, I thought I had to use a condom every time I had penetrative sex, so I told him that was non-negotiable because I didn’t want to put him at risk. Beyond that, I said, “I want you to trust me to tell you when I’m having an outbreak, and we won’t have sex during those times. I want to keep that line of communication open, and for you to know that I’m putting your health and safety first. I want to do everything that I can to avoid passing this on to you.” I didn’t want him to experience what I’d gone through.
Miles: I’ve always been big on using protection—not because of STIs; because I never wanted to have an accidental pregnancy. I’d only ever had sex without a condom two times before this relationship, and both times, it kind of freaked me out. Going a couple days or weeks without sex has never bothered me in a relationship. I want the person I’m with to feel comfortable, at the end of the day, so if they’re not comfortable having sex for any reason, neither am I. I told Robin that I trust her on her health, and I wasn’t seriously concerned about getting herpes.
Robin: Oral sex also felt tricky because people often don’t use barriers during it. Receiving oral sex seemed out of the question. I didn’t know how I’d approach it safely; I thought maybe I just wouldn’t receive it ever again.
I didn’t think giving oral sex would be a problem until an earlier partner accused me of transmitting herpes to him that way. He didn’t have any evidence I was the one who transmitted it to him, or that it was oral sex that did it, but I was still scared.
Eventually, we agreed that we’d do oral sex, and do it without condoms, as long as I was communicating regularly about outbreaks and I was on my medication. We stopped using condoms during penetrative sex after a while, too.
Miles: When we started having sex without protection, at first Robin asked me every time if I was sure I wanted to do that, and reminded me of the risks. I’d say, “Hey, you’re on your medication to reduce the risks. I know you’re not in an outbreak. I’m not worried about this.”
Robin: When you deconstruct herpes, and just evaluate it medically and physically, it’s essentially the equivalent of having a pimple on your mouth or genitals. It’s not going to rock your health. The psychological and social effects are really the biggest and most impactful parts of it.
Early on after my diagnosis, I struggled not to feel like a giant, walking virus. I’ve always taken pride in my ability to explain the risks to people, so that they can make a good, informed decision about having sex, and if they do get herpes, I know that I’ve done everything I can. Even then, sometimes during sex the fear of transmitting to someone else—Oh no, was the start of a sore I saw earlier? Am I at the start of an outbreak? Maybe I missed a sign?—can get stuck in my head. It gets so overwhelming that I can’t stay in the moment during sex, even if I try to focus on the sensations of the moment rather than the thoughts, and I just have to stop altogether.
Even now, I still get stuck on that thought sometimes. Miles is very good at reassuring me that my herpes doesn’t affect the way he sees me sexually, which helps me think less about it the next time we have sex. But when I can’t perform in the moment, it’s just not possible for me to get back into sex.
Miles: I definitely pick up on it when Robin’s in that mindset. I can feel her entire body tense up, like she’s very stressed, and I see her eyes start to look around at other things. I always stop, check in, and reassure her that I wouldn’t hold a transmission against her, or leave her over it.
Robin: Even with my herpes under control, there are still times when we can’t have sex because of occasional outbreaks. But oral and penetrative sex aren’t the only ways people can derive pleasure from each other. Many people do things like mutual masturbation when other types of sex are off the table, but for us being physically close—like cuddling—is usually enough.
Miles: Yeah, I actually believe that those moments when we can’t have sex because of outbreaks make our relationship stronger. It reaffirms that we can be intimate through more than sex.
Robin: At the beginning of our relationship, I felt inhuman and undeserving of sex. Being with Miles has helped me to trust that other people can be accepting of this condition. There are some days when I don’t even think about the fact that I have herpes. It’s one of the least severe problems in my life.