What is Herpes?

Herpes Simplex Virus (HSV, also referred to as just Herpes) is a common STI that can be transmitted through sexual contact as well as other forms of contact. There are two types of HSV: HSV-1 and HSV-2. HSV-1 is also often referred to as oral herpes as it most commonly appears in and around the mouth. It can also infect the genitals. HSV-2 is less common and only infects the genitals.

For a number of reasons HSV cases are not reported to public health in the same way as most STIs, for this reason we do not have exact numbers on HSV cases in Canada or Nova Scotia. That being said, it is estimated that 90% of the population worldwide has HSV-1, and around 20% of the population worldwide has HSV-2. It is incredibly common, and while it can be painful and uncomfortable it is not dangerous.

Both HSV-1 and -2 appear as small sores (with HSV-2 only appearing around the genitals). The sores can appear as small bumps, blisters, or open sores. They can be painful or uncomfortable, although they aren’t always. Oral herpes can sometimes be confused with canker sores, but are distinct in a few ways. HSV generally appears around the mouth whereas canker sores appear on the inner lip. Canker sores are not contagious.

The first time someone develops HSV symptoms is often the worst, it can be more painful and sometimes be accompanied by fevers and fatigue. People with HSV can have episodes of symptoms and vastly varying frequencies and severities for the rest of their lives. Some people will never show symptoms again, and some may develop sores regularly. A number of factors can influence the development and severity of symptoms including stress, diet, and sleep.

Since HSV is so widespread, and because it is almost impossible to trace HSV transmission back to a single point of contact, Health Canada does not do any contact tracing with known HSV cases.

Herpes and Stigma

Herpes is one of the earliest recorded STIs, and in fact, was so common that it wasn’t considered an STI until the 60s when testing was developed to differentiate between HSV-1 and -2. In the 1970s, a pharmaceutical company developed a drug to treat the sores. They promoted this with an extensive and unprecedented ad campaign. Many people attribute the cultural idea that herpes is ‘gross’ to this campaign.

It is important to understand the risks associated with HSV, how you can treat it, and how you can avoid spreading it, but it is also important to know that first, it is very very rarely dangerous, and second, it is very common.

How can I prevent transmitting Herpes?

Both HSV-1 and -2 can be spread through close contact or exchanging of fluids. HSV-1 is more easily spread as it can be passed through sexual contact, or more casual forms of contact like kissing, or even sharing a drink. HSV-2 is most commonly passed through sexual contact involving genitals, although it can more rarely be passed through sharing unwashed towels, underwear, or bathing suits.

Both HSV-1 and -2 are much more likely to be passed when an active sore is present, while non-symptomatic transmission is possible, it is considerably less common.

It is also important to know that HSV can live in your body without showing symptoms for years, and sometimes even for someone’s entire lifetime. Sometimes, when people develop symptoms years into a monogamous relationship the assumption is that they have cheated, but the appearance of HSV symptoms or an HSV diagnosis does not mean that the virus was contracted any time recently.

In order to prevent passing along or getting HSV we recommend using barrier protection during sex, having open and honest conversations around HSV with sexual partners, and avoiding sexual activities if sores are present and until they have completely healed.

How do I know if I have/get Herpes?

In Nova Scotia, HSV cannot be tested through blood tests, and can only be tested when an active sore is present. You can go to your doctor, the closest sexual health or testing clinic, and some walk-in clinics and ask the doctor to swab a sore that you have. They will then test this swab to see if HSV is present. If you have an open sore we encourage you to let the person you book your appointment with know as many clinics will have priority appointments or lists for people who are actively symptomatic.

If a sexual partner of yours gets diagnosed with HSV you do not need to do anything unless you begin showing sores on/around your mouth and/or genitals. We recommend examining your genitals and throat with a mirror and keeping an eye out for symptoms of HSV. If they appear you should request an urgent appointment to get the sores tested.

Can Herpes be treated?

HSV can never be cured, but its symptoms can be managed. There are topical treatments that folks can get to put on sores when they appear. These treatments can help manage pain/discomfort and help them go away faster. Additionally, people can do things like wear loose fitting clothes and sit in warm baths (avoid bubbles or scented products) to help ease the pain when the sores appear.

For people who get sores a lot, and find that the frequency/severity of the symptoms causes a disruption in their lives there are antiviral medications that people can take daily. These medications help lessen these episodes.

If you are looking for more in depth information on HSV we recommend checking out this guide by the Halifax Sexual Health Centre.

You can learn more about where HEAL NS got this information from at:
https://hshc.ca/wp-content/uploads/2019/01/FAQ-Sheet-HSV-2019.pdf
https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus
https://www.mayoclinic.org/diseases-conditions/genital-herpes/symptoms-causes/syc-20356161
https://www.hopkinsmedicine.org/health/conditions-and-diseases/herpes-hsv1-and-hsv2
https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/herpes-simplex-virus/etiology-epidemiology.html
https://herpes.org.uk/how-herpes-got-its-stigma/#:~:text=The%20history%20of%20the%20genital,barely%20registered%20with%20the%20public
*disclaimer: we do not necessarily endorse all of the information, content, or language used in these references.