Just in time for Halloween, the World Health Organization published a frightening report on the prevalence of genital and oral herpes.
According to the WHO's study, which pooled data from existing reports on the STD dating back to 2005, two-thirds of earth's population under 50 lives with HSV-1, the strain of herpes that can be transmitted without penetrative sex. When symptoms of HSV-1 manifest orally, they are commonly referred to as cold sores—but HSV-1 can also cause genital herpes through oral sex. Although HSV-2 is the more demonized strain of the two, they are genetically similar, and up to 40 percent of cases of genital herpes are caused by HSV-1.
"There's such a disconnect between cold sores and genital herpes," herpes activist Jenelle Marie Davis explains to Broadly. "There's a polarizing difference in the perception of the two, but when you look at the virus itself, they behave very similarly. People think one is the good herpes and one is the bad herpes, but that's not true." According to Davis, and many other experts, both types of herpes are actually pretty chill.
I would love for everybody to look at [herpes] in a much more practical way.
Davis is the founder of the STD Project, an organization that aims to encourage awareness and provide non-sensationalized information about STDs. She was diagnosed with herpes when she experienced her first outbreak at 16.
"[When I was diagnosed] I was actually stigmatized by my practitioner and treated very poorly," she says. "He also said it was 'the worst case he's ever seen'. It was horrible. I was 16 years old, I was just confirmed that I had an STD, and now I was being told that I have the worst case of herpes ever."
Because of this stigmatization, she launched the STD project in 2012 to help assure young people and adults with sexually transmitted diseases that herpes isn't a cause for panic. Herpes is infectious and incurable, but relief from the disease won't come from ostracizing those who have it—especially as that demographic increasingly includes everyone. Davis's mission is to combine preventative education about STDs with the message that when prevention fails, there's no reason to be ashamed.
"No one is ever going to want an infection. However, our bodies aren't infallible," Davis says. A diagnosis of herpes can be managed by suppressive therapies and abstaining from sex during an outbreak.
"More people have a strain of herpes than not. But most people with herpes don't transmit the disease to their partners," Davis says. "Male-to-female transmission is about 10 percent per year—that's if you're not using barriers or on suppressive therapy—and female-to-male is about four percent. It's very possible to reduce the risk of contracting herpes to a minimum, but when you do contract something, it's not the end of the world.
"I would love for everybody to look at [herpes] in a much more practical way," she continues.
People think one is the good herpes and one is the bad herpes, but that's not true.
The WHO's data shows that 3.7 billion people have herpes simplex virus type 1 and an additional 417 million people have herpes simplex virus type 2. In most cases, herpes presents very mild symptoms or none at all, so some people with the STD aren't even aware they have it. Currently, however, the CDC does not recommend routine screening for herpes in patients without symptoms since the STD is so common. The CDC states that because "the diagnosis may have adverse psychological or effects for some people, widespread testing for HSV is not currently recommended." Davis argues this attitude contributes to the disease's stigmatization.
"In order to determine if someone [without symptoms] has herpes, you have to do a blood test, and the blood test will say whether or not you're positive for HSV-1 or HSV-2," Davis says. "But the test doesn't tell you where the disease is located. So the current CDC recommendations do not suggest to blood test everyone for herpes because patients go into a tail-spin if they test positive and don't know if they have oral or genital herpes. The reality is, however, that they're both equally simple to manage.
"So many people are asymptomatic," Davis says. "They're carrying around the virus and are still able to transmit it. They don't know that they have it, they don't know where they have it, they don't know how they're transmitting it, and they're not getting tested. It's a quadruple whammy. Knowledge is power, and we're doing folks a disservice by not providing the information they need to make decisions and be mindful and thoughtful with their partners. Once people realize the true statistics behind how many people actually have the disease, it will become a much more normalized conversation."