Jennifer Frazier
Nicole Oelkers

Herpes Simplex and Sexuality- Transmission and Prevention



Table of Contents
  • Main Info
    • What is it?
    • Population percentages
    • Differences between HSV-1 and HSV-2
    • Is is dangerous?
  • Transmission
    • Ways of contracting the viruses
    • Skin to Skin
    • Behaviors that put you at risk
  • Infection
    • Signs and Symptoms
    • Where does the virus live?
    • Where do you get outbreaks?
    • What to expect if infected
    • Diagnosis and Testing
  • Treatments
    • Is there a cure?
    • Possible vaccine
    • Viral management
  • Prevention
    • Barrier methods
    • Review of medications and vaccine

Main Info
Herpes Simplex is part of the human herpes virus family, and contains two of the eight strains of the virus. The two strains belonging to the Simplex category are Herpes Simplex Type 1 (HSV-1), and Herpes Simplex Type 2 (HSV-2). The other six strains of human herpes viruses are all caused by separate viruses than Simplex, and are commonly
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Common HSV outbreak on the mouth
not thought to be a form of herpes. Some examples of other human herpes viruses are Chickenpox (caused by varicella zoster virus, or VZV) and Mononucleosis (caused by Epstein-Barr virus, or EBV). The rest of this article will be discussing the Simplex viruses (1).

HSV-1 is commonly associated with “cold sores,” and most forms of oral and facial herpes. It is estimated to be found in at least 60% of adults in the United States, with some sources estimating anywhere between 60-80% of the population being infected with the virus (1).
HSV-2 is frequently called “genital herpes,” but is usually referred to as just “herpes,” and is usually associated with sores on the genitals, mons pubis, anus, and sometimes inner thighs. Anywhere from 20-25% of the population in the United States will test positive for HSV-2. Most recent quotes say 22% of the population is infected with this strain (1).
Herpes Simplex is not a life threatening virus, nor a virus which negatively affects fertility, or increases rates of cancers. Though a permanent diagnosis, it can be referred to as the “friendliest” sexually transmitted disease, because it only causes painful blisters when one is having an outbreak (2). At times when the virus is dormant, there is no discomfort experienced by an infected individual, though the virus can still be transmitted to others. Long-term effects of the virus can include the rare instance of scarring on the urethra, making urination difficult or uncomfortable, and the open lesions can potentially create an easier route for other infections (such as HIV) to enter the body (1).
Transmission
Herpes HSV 1 and HSV 2 can be spread through skin to skin contact, while traces of the virus can be found in the bodily fluids that also come into contact with infected skin (such as saliva, semen, fluid in the female vagina canal and through fluid from a sore) (5). The virus can be spread any time the virus is active or during an outbreak. A person has a 75% chance of contracting herpes when the virus is active, or shedding (6). Shedding refers to when the virus is replicating itself without causing symptoms. Herpes also has a time period when it is not contagious, during the latent period. This is when the virus lies in your nerve cells at the root. However, there is no way to tell if a person’s infection is in the latent or shedding period, so there is no way to tell when a person is contagious (5).
Oral herpes, or HSV 1, is the most common and easily spread strand of herpes. Most people contract this form during their preschool years because of the close contact. Oral herpes can be spread through kissing, close skin contact, or even sharing a tooth brush. Oral herpes can also be transmitted to the genital area through oral sex (6).
Genital herpes, or HSV 2 is most often transmitted through sexual intercourse. Like oral herpes, genital herpes can infect the mouth region through oral sex. About one third of genital herpes is transmitted during a shedding time, so the person might not know they are spreading it (6).
There are many activities that can increase your chances of contracting oral or genital herpes. Do not kiss anyone who has an oral sore or share anything with them that has oral contact with them. Do not perform any oral sex on someone who is exhibiting a genital sore. There are contraceptive foams that kill the herpes virus in test tubes that you can use along with condoms during intercourse that will decrease your odds of contracting herpes. If you’re using a foam make sure it has nonoxynol-9 as an active ingredient to fight against the herpes virus. Lastly, the more sexual partners you have, the more at risk you are for contracting genital herpes (6).
Infection
Both HSV-1 and HSV-2 are most commonly asymptomatic. As many as 90% of people infected with HSV-2 do not know they are infected because their symptoms were so mild that they did not notice them, or they did not experience symptoms at all (1). The body’s immune systems works to keep the virus suppressed, but cannot rid the body of the virus because both HSV-1 and 2 live in the body’s nervous system, where fighter cells cannot reach to attack it (3).
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HSV sores on the penis
The following specifics on the infection are speaking in general terms; meaning that HSV-1 will refer to oral/facial herpes, and HSV-2 will refer to genital herpes. It is important to keep in mind that, though less common, the two strains can be interchangeable, meaning it is entirely possible to get HSV-2 on one’s oral cavity, and HSV-1 on the genitals (1).
The HSV-1 strain will usually enter the body through the oral mucus membranes, through skin to skin contact with an infected person (1). The virus will then live on the ganglion located behind the cheekbone, and cause recurrent outbreaks on and inside the lips or mouth (3).

HSV-2 will typically enter the body through the genital mucus membranes, via skin to skin contact (1). This strain of the virus will live in the ganglion located toward the base of the spinal cord, and cause recurrent outbreaks on and inside the genitals, or surrounding areas (ie: the anus) (3).
While it is possible to become infected with both strains of the Simplex virus, it is rare to spread the same strain of the virus from one part of the body to another. This transferring of sores caused by the same strain from one part of the body to another (ie: oral cavity to the eyes) is called autoinoculation. This most commonly happens during the initial outbreak, because the body has not yet built up antibodies against the virus. Ways to prevent this is to wash your hands after touching lesions (1).
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HSV sores on the vulva
Symptoms experienced by a newly acquired infection will involve sensations all over the body. One may experience headaches, a fever, aching, and flu-like symptoms. It can also be noted that the lymph nodes will be enlarged during initial infection, which is a positive reaction because it indicates that the body is building up a powerful response to the virus. Common symptoms which accompany recurrent outbreaks are a tingling or numb sensation around the infected area, unusual discharge for females, and painful urination (1).
There are two most common types of testing for the HSV viruses: swab cultures and blood tests. A herpes culture is done when someone has sores, which may or may not be caused by HSV. A health professional will thoroughly swab the sore, sometimes breaking open the lesion to gather as much viral material as possible. The swab is then in a preserving liquid and sent to the lab for testing. Blood tests involve taking a blood sample and testing it for HSV antibodies. Blood tests are traditionally more reliable because they do not allow for as much error in collecting a sample; this is demonstrated by the lower false-positive and false-negative rates blood tests have (1). You can also get tested for herpes even when you do not think you are infected, but it has been noted that herpes tests are only incorporated into routine STD testing a little more than 50% of the time (4).

Treatments
There is no current cure for herpes, but there are many products and steps you can take that help reduce the frequency and length of outbreaks. Some doctors recommend that you keep the area as clean and dry as possible to help your body’s natural healing process. You can also try taking a warm shower and drying out the infected areas delicately. It is recommended that you do not wear tight fitting underwear during a genital herpes outbreak to prevent irritation and chaffing. Another way to aid your body in the healing process is to take vitamins, eat healthy, and if it’s an oral herpes case, avoid acidic foods (6).
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Currently there is no vaccine for oral or genital herpes. Scientists are researching ways to diagnose and treat recurring genital herpes. It is also believed that in 3-5 years there will be a vaccine to prevent herpes in people who have not already contracted it. Other vaccines have been tested on herpes that have worked on herpes related infections like small pox or Polio, but none show any effects (6). There is a new drug being tested called Aciclovir which has decreased the shedding the herpes virus which is a big step in decreasing transmission between couples and from mother to fetus (10).

A few of the supplements and prescriptions available to take for herpes includes Red Marine Algae, Valtrex, and Zovirax. Red Marine Algae is a natural option
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for the treatment of herpes. This supplement assists your immune system to lower your number and the duration of your outbreaks (8). Valtrex is a highly publicized treatment for herpes. Valtrex is a prescribed treatment that decreases the number and duration of your outbreaks, which decrease the possibility of herpes transmission, though you still need to wear protection during sexual activity (9). Zovirax is intended for slowing the growth and spread of herpes so that your body’s immune system has a chance to fight it off. Zovirax is available in pill form and two cream forms, one for genital or oral outbreaks and one for ocular herpes, which is a breakout in the eye (7).


Prevention
Barrier methods are one easy way to reduce your chances of getting herpes, though they only work if the infected area is going to be covered up during sexual activity. For instance, if a sore is located outside of the condom area it is likely to spread. Anti-viral medications are not 100% effective, they only lessen your chances of contracting herpes by reducing the outbreaks and the duration of the outbreaks. As talked about before, there is yet a vaccine for preventing herpes, but there may be one on the way (6).
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References
  1. Warren, Terri, and Ricks Warren. The Updated Herpes Handbook. Portland: The Portland Press, 2005. Print.
  2. Berry, Rebeckah. "Contraception and Sexually Transmitted Infections." Central Oregon Community College. Bend, OR. 27 Oct 2011.
  3. Cooney, Jeff. Personal interview. 24 Oct 2011.
  4. Smith, P. Davis, and Craig M. Roberts. "American College Health Association Annual Pap Test And Sexually Transmitted Infection Survey: 2006." Journal Of American College Health 57.4 (2009): 389-394. Academic Search Premier. Web. 2 Nov. 2011.
  5. “Transmission.” Herpes: You are Not Alone. 2008-2011. Herpes.com. RetrievedNovember 3, 2011 http://www.herpes.com/Transmission.shtml
  6. “Herpes Simplex: Medications and Transmission.” Health Central. 2005-2011. Health Center Network, Inc. Retrieved November 3, 2011 http://www.healthcentral.com/genitalherpes/introduction-000052_9-145_2.html
  7. “Zovirax.” Herpes: You are Not Alone. 2008-2011. Herpes.com. Retrieved November 3, 2011 http://www.herpes.com/zovirax.shtml
  8. “Red Marine Algae.” Herpes: You are Not Alone. 2008-2011. Herpes.com. Retrieved November 3, 2011 http://www.herpes.com/redmarinealgae.shtml
  9. “Take Charge.” Valtrex. 1997-2011. Glaxo Smith Kline. Retrieved November 3, 2011 http://www.valtrex.com/
  10. Leflore, Stephani. Anderson, Peter, and Fletcher, Courtney. “ A Risk-Benefit Evaluation of Aciclovir for the Treatment and Prophylaxis of Herpes Siplex Virus Infections.” Review Article. August 23, 2000. Adis International Limited.