Basically, I’m wondering why not everyone on Earth has it. Even if you use a condom and don’t have sex during outbreaks, one can still get it. And like a lot of viruses, symptoms vary between individuals and according to some websites your first outbreak can be years after infection.
Is all of this true? And if so, why isn’t it as common as HPV? Or does everyone have it and no one is saying? I just know a lot of people who have each had a good number of sexual partners (like, maybe around 10) and it seems like no one has it . . .
WAG: It could just have much lower trasmission rates than other STDs. Yes, you can get it even while using a condom, and yes you can get it if someone’s not symptomatic, but neither is very likely.
Looking briefly at Wikipedia, the transmission rate for HSV-2 is about 5% female-male and 10% male-female, annually, using no protection. Antivirals cut that rate in half, and condom use is said to be “highly effective”, though not “completely effective”. Since transmission is certainly higher when someone is symptomatic, and many people will refrain from sex at that time, that would reduce the probability further.
Right. The person has to have a high enough viral load and be actively shedding the virus at the time of contact for spreading to occur. The tricky thing is that the virus is most likely to spread in the handful of days just prior to an outbreak when the person is still largely asymptomatic.
If I recall correctly, the stats are something like 25% of sexually active adults has come into contact the herpes virus. Anyone who was exposed and carries viral antibodies will test positive for HSV with a blood screening, but that doesn’t mean they’ll ever have an outbreak.
As far as “everyone has it and no one is saying”, I think that’s a big part of it. I sort of jokingly say that it’s a good thing I was partnered before being employed at Planned Parenthood, because what I learned from working there is that everybody in the universe has chlamydia, herpes, or both.
Is there anything bad about herpes? Beside skin blemishes? It seems people love to put this stigma around it, except for no reason. Another thing I noticed is that in high school the teacher told us, and the rest of the country, that cold sores are also a type of herpes, and now everyone, it seems, goes around calling cold sores face herpes.
Herpes lesions are unsightly and recurring, you do get some flu-like symptoms, its infectious. And it can travel along the nerves to the brain and cause lesions there, leading to brain damage and maybe death. Fortunately, this is a very rare condition.
Cold sores are generally caused by HSV-1. Genital herpes is generally caused by HSV-2.
The main difference is that HSV-1 establishes itself in or around the trigeminal ganglion (a nerve center by your ear) while HSV-2 establishes in or around the sacral ganglion (nerve center at the base of the spine). Thus, when HSV-1 migrates, it usually ends up around the face, while HSV-2 ends up around the midsection.
HSV-2 is also more likely to cause neonatal herpes (herpes in a foetus or newborn).
In terms of severity of symptoms and so forth they are very similar, despite the stigma.
Hard to find studies covering a wide population that distinguish between both virii, but according to this study, yes, at least in gay males:
You’d expect as much, though; HSV-1 is much more likely to be transmitted through oral contact, while HSV-2 is more likely to be transmitted through genital contact. I don’t have a cite, but I don’t think I need one to suggest that the vast majority of people engage in oral contact (kissing) more frequently than intercourse.
