A few months ago, I returned home from an overnight reporting trip to New York with an unwelcome souvenir: what looked like a pimple forming along my upper lip. "What is that?" my boyfriend asked. I hadn't even noticed it beyond a mild annoyance, but after examining it over the next few days and frantically Googling, we both concluded it must be a cold sore. It seemed to meet the criteria for how one develops. WebMD told me cold sores, caused by herpes simplex virus (HSV), "are groups of small blisters on the lip and around the mouth. The skin around the blisters is often red, swollen, and sore."
I'd never had even a hint of a cold sore before, but given my sexual history of sometimes sleeping with people without asking their STI history, it wasn't that surprising. What did shock me was my reaction: I felt ashamed. What if I passed along HSV to my boyfriend? What if we had to abstain from kissing and oral sex? Instead of focusing on the matter at hand, I thought back to all the random, often drunken nights I wished I could take back. The nights I was less careful about whom I went home with, the months I didn't ask to exchange STI tests with people I dated, had come back to haunt me.
According to further internet research, "Cold sores are contagious even if you don't see the sores." I didn't want to take any chances. We rushed to the nearest pharmacy and got Abreva, an over the counter cream, which I began dutifully applying five times a day. While the redness around my mouth started to ease, my stress over this health development didn't.
I've been an erotica writer and sex columnist for over a decade, and have built both my career and my personal identity around being open, honest and non-judgmental about sex. In April, for STI Awareness Month, I profiled herpes activists who were doing everything they could, including launching the Twitter hashtag #ShoutYourStatus to dismantle the stigma I now felt entangled by, as if I'd suddenly put on a cloak of sluthood I couldn't take off. It didn't matter that I had interviewed Ella Dawson, who told me herpes made her sex life better; I felt ashamed of whatever I'd done to bring the condition on...and ashamed of my own shame. How could I front to the world that I was sex positive when I was judging myself so harshly?
In search of company in my misery, I contacted Sheila Loanzon, author of Yes, I Have Herpes: A Gynecologist's Perspective In and Out of the Stirrups. Loanzon was diagnosed at age 20. The adjustment to her new reality didn't happen overnight, she told me, adding, "I had to work through 15 years of internal angst to get to where I am today." She said that while herpes stigma affects everyone, women and men often respond differently in her experience. "I have discovered that there are as many herpes-positive men who have been turned down while dating as there are women," she said. "But it seems that women often have the emotional component—feeling worthless, dirty, hurt, and unloved—while men generally have more anger around having herpes."
In contrast to my reaction, my boyfriend was calm and totally practical about helping me take care of my health. He didn't ask where I might have gotten said cold sore, nor did he make even a hint of judgment about it. Sure, we both knew the rough outlines of each other's sexual histories, but beyond a few wild stories and the times our exes crop up in conversation, we'd never gone into depth about each and every lover and whether we'd used protection with them. Thankfully, he didn't seem to consider this a time to backtrack. Every time I tried to apologize for not giving him a goodnight kiss or engaging in oral sex, he assured me it wasn't my fault. "Cold sores are totally common," he said, as if I were talking about a headache or stomach bug.
Over the course of that first week, I actually started to believe him. Seeing the same statistics pop up over and over again online helped too. The Centers for Disease Control and Prevention (CDC) even points out at the top of its genital herpes page how widespread it is, noting, "one out of every six people aged 14 to 49 years have genital herpes." Even more common was my ailment: Johns Hopkins Medicine estimates that 50 to 80 percent of US adults have oral herpes.
Loanzon elaborated on these numbers: "Currently," she said, "it is estimated that 80 percent of the US population has either herpes simplex 1 or 2 and is unaware." In other words, having herpes is far more common than not having herpes.
Yet I somehow didn't even know these basics—or had chosen to ignore them in my shame spiral. I also hadn't known that oral herpes and cold sores are generally caused by herpes simplex virus 1, or HSV-1. Genital herpes is caused by HSV-1 or HSV-2. Loanzon explained that, "If person A has oral herpes and gives person B oral sex, person B can get genital herpes." That's how she acquired it, in fact. "Person B can now transfer genital herpes to any future partners, as well as oral herpes, if they receive oral sex. Person A can also give person B oral herpes through kissing." It's that easy to pass it on. "When a person has a history of cold sores or HSV-1, regardless of whether an outbreak is present or not, the herpes virus can be spread to sexual partners to the genital area through oral sex," Loanzon said. "Taking the antiviral medication at the first sign of symptoms (skin outbreak, tingling, itch in the area) decreases the length of time, viral shedding, and pain of the outbreak."
What could I have done differently, I wondered? Loanzon only recommended breathing and taking a moment to mourn. It's okay to be sad about the loss of some sexual freedom (since it's best to have protected sex with condoms or antiviral meds), and to feel fear and confusion about what happens next. That's part of the healing process, she told me comfortingly.
After two months of trying to accept my new fate, I learned something surprising: What I thought was a cold sore actually wasn't. My new dermatologist concluded that all my upset had been over simple skin irritation. But it wasn't all for naught: Going through this process showed me that I'm as susceptible to the shame around STIs as anyone else. I know that there could be a next time with a different result. I hope if there is, I'll approach it with a lot more compassion for myself.