Today is World Herpes Awareness Day. The day is designed to raise awareness around the causes, risks, and treatment specifically for genital herpes. Though herpes is a common STI, with one out of six people currently living with the virus, there is still plenty of stigma and misinformation associated with a herpes diagnosis.
In order to remove some of that stigma, we spoke to Dr. Jessica Shepherd, OB/GYN about the social stigma, transmission, and preventing the spread. Check out our interview below.
MadameNoire: What is the reason or cause for the stigma behind herpes?
Dr. Shepherd: It really is attributed to social stigmatization by the public. The public perception of what it is, what it might mean if you have that diagnosis. And it’s a lot of misinformation. A lot of it is stemmed and rooted in sexuality. We have a very bad culture of sexuality here. So anything that can trigger promiscuity or something that’s a negative impact of sexual health then those are all things that lead to why it gets that label.
MN: I would also say that stigma prevents people from disclosing the fact that they’ve received a herpes diagnosis. Can you speak to why it’s important people share when they’ve been diagnosed with herpes or any other STI?
Dr. Shepherd: I think that is something that should be shared. But the problem is the stigmatization precedes the diagnosis. So that makes people hesitant or anxious to share that information with partners, even though it should be shared.
And whether it’s herpes or any other STI, many people are not very open when they share that part of their sexual history with current partners, future partners. And that’s why we still have so many undiagnosed cases and spreading of disease. One, people might not know they have it and two, if they do have it, they’re very reluctant to share the information.
MN: How soon do you think someone should broach the topic of their diagnosis with a new or potential partner?
Dr. Shepherd: I think obviously there are moments in a relationship where people know they’re more serious or getting to a point where they’re going to be more intimate. I think that is the time for an appropriate discussion and I think it’s one that should be brought up very candidly, without any assumption of what their diagnosis might mean or what their history might mean.
But it’s easier to be transparent about those things, if it’s brought up without judgement.
MN: In terms of stigma, I think a lot of it comes from what it means when someone has herpes. What type of life can people life with herpes?
Dr. Shepherd: Oh my gosh! They can lead a completely normal, good life, having good sex. Able to have children, minimize their outbreaks. I mean everything. I’m trying to list all the reasons why people think it’s so terrible to have. And I’m trying to give people reassurance that they can have a normal life. I think that’s where most people’s issues lie. They believe I’m now shunned. I can’t do abc, which might mean have sex, be with a partner, have babies or be healthy, or not be deemed as a social misfit.
All of those things can still occur, even with a diagnosis of herpes. And the reason I know this is because if you look at the numbers. One in six people have it. Clearly, the population is out here living their best life, as they should. And they can do that even with a diagnosis of herpes.
MN: Does herpes affect someone’s ability to breastfeed?
Dr. Shepherd: No! Not at all. The only way that would impact someone’s ability to breastfeed is if they had an actual lesion on their nipple. Because it’s translated through skin to skin contact.
MN: Someone said we don’t associate shame with someone catching a cold. But with any STI there’s shame attached to it because we feel like perhaps it’s a punishment for sexual behavior. Do you have thoughts about that?
Dr. Shepherd: That’s the whole social stigmatization. It’s something so completely horrible, you’ve done something wrong to have it. And that was the punishment. When really it is just a virus. And I say that not loosely like it’s not a big deal. But clinically, as a physician, when someone gets a virus, our main thing is not how you got it, when you got it, how many people you’ve slept with. That does not cross our mind. What we’re trying to do is minimize the amount of outbreaks that you have. Viruses are chickenpox, HIV, HPV, coronavirus. The reason we treat viruses is because we want to suppress their ability to be active in your system.
And with herpes, it’s the activity that causes an outbreak. Just like when someone gets shingles later on in life, it’s a chickenpox virus.
We’re just trying to minimize your symptoms. And that’s what we can do through management, through over the counter therapy just as Femiclear—which allows you to have minimal symptoms and when you have symptoms, decrease the pain you might have with that. Outside of that, there really isn’t any other thing that we’re concerned with.
And we also want to decrease the risk of transmission, which is why we give parameters like if you have an outbreak, you either want to use a barrier method—such as a condom—to cover that lesion. Or practice abstinence so you can really minimize the risk of transmitting.
Also, when you’re having an outbreak, take the medication so it can decrease the viral load and shorten the duration of the outbreak and then using femiclear to decrease the pain of the lesions.
MN: Why is herpes more prevalent in women than men?
Dr. Shepherd: Yeah, that has to do a lot with anatomy. Anatomically because women have shorter genital tract in terms of areas of exposure, it’s easier for women to have the symptoms than men. Men have more of an external exposure of genitalia. There’s more surface area for lesions to be. The other thing is that women are typically more body aware. So if there’s a change, a woman is more likely to say, ‘something is wrong.’ Let me go to the doctor.
Whereas males typically might have a symptom and they may or may not pay attention to it. And then the second part is about getting to a healthcare provider to seek an answer.
MN: Is there something that causes someone to experience more outbreaks than others? What is it that causes outbreaks?
Dr. Shepherd: Stress is a big thing, because you’re suppressing your immune system. When you’re stressed, the immune system can’t fight it to keep it suppressed. Also If someone is immunocompromised or in an immunocompromised state like on cancer treatment or has HIV. It takes a toll on your immune system and you’re more likely to have an outbreak.
Pregnancy. Pregnancy doesn’t mean you’re going to have an outbreak. It just means if you do have one, we definitely want to know so we can give you the medication that you need. So that if you are close to delivery, there’s less risk of transmission to the baby.