Nerve Classics

A Plague on Both Your Houses

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I will not admit to having herpes just to win an argument in a bar, but my coworker was spreading total fallacy and had to be stopped.

“You can’t get it just because someone has a cold sore and they go down on you. Oral and genital herpes are different.” Jeff said with that relaxed, confident air common to men under the age of twenty-four, and irritating to women over twenty-seven.

“That is so not true!” I protested, feeling a sudden panic.

Jeff looked at me through his new-media glasses and cocked his elfin face at a stubborn angle. The others in our happy-hour gang waited with interest, and sipped their drinks.

“How do you know?” He wasn’t being overly confrontational. As web programmers, this was how we debated everything from cab routes to php code.

Because that’s exactly how my ex-boyfriend gave me herpes! He was your age, and as otherwise clever as you are! I couldn’t say this out loud, of course. Instead, I applied a poker face.

“Dude,” I pronounced, “My stepdad was a gynecologist. I grew up reading his medical journals, like The Female Patient.” This was not a lie, but I really only learned most of what I know because I had to learn firsthand.

Like an Encyclopedia Herpetica, I went on, unwilling to be vague. “There is herpes simplex 1 and herpes simplex 2, but you can absolutely get one from the other. The main difference is just where it lives in the body, the same as crabs are just lice in your pubic hair.” Talking fast, trying to push down the passion that might have made me sound defensive, I wanted to sound matter-of-fact, because I knew these were facts.

My posse of programmer boys listened. To my relief, one replied, “Wow, I didn’t know that.”

I’m a member of a silent army, one the National Herpes Resource Center estimates to include at least 80 percent of the population. Scared of telling people, and afraid of transmitting the virus, we often live in a state of denial. However, the things we fear can be addressed and prevented not just with all there is to learn, but with how we can learn to be.

Most people don’t have a practical understanding of how herpes is spread. It doesn’t have to look like anything, and it’s commonly transmitted when it’s “silent.” Many people consider oral sex to be a safer, less intimate activity than intercourse, according to a recent comprehensive study by the National Center for Health Statistics. But oral herpes — simplex virus Type 1 (HSV-1) — is carried by more than 70 percent of people worldwide.

For the record: a cold sore is herpes simplex one. Kissing with a cold sore, or performing oral sex when you have one, can pass the virus to either mouth or genitals, where it lives happily ever after as HSV-1 and/or HSV-2, respectively.

The first infection, physically the most painful, is also medically recognized to bring with it a depressive malaise, not only because you now have a lifelong virus that will cause pain, embarrassment, and create some degree of mess in your personal life. The day of my diagnosis, I couldn’t lean on anyone for support. Instead, I cried a lot in the bathroom, then went to Tae Kwon Do class anyway, where each kick felt like my flesh was being pulled off with hot pokers. I’m shocked it didn’t leave scars.

My ex-boyfriend gave me herpes after we were together for a year and a half. He claimed he didn’t know he had it. I didn’t believe him. In hindsight, getting herpes from him seemed so avoidable. I noticed that his bottom lip looked chapped, but didn’t know much about cold sores. It was late winter, when dry lips are the norm.

“Did you split your lip or something?” I asked him outright.

“Yeah, I guess so,” is all he said. It didn’t occur to me to worry about it.

Three days later my clitoris, having been the focal point of much contact with the questionable lip, felt painfully tender and raw. Then a few other spots developed and became the sores you hear about, and the image you dread to Google. I found more on my gums, under my tongue. It was Old Testament punishment, and my body was Egypt. It felt like God was smiting my heretofore beautiful ladyflower.

I was raised Catholic. I’d even wanted to become a nun until I was about nine and started to wonder about sex, imagining Sleeping Beauty-style scenarios where dashing young heroes sought to wake a slightly older, more womanly version of myself. Midway through college, I was proud that I’d remained disease free. I sought to maintain my track record by becoming a serial monogamist.

The long-term boyfriend who gave me herpes was by most accounts a squeaky-clean, intelligent young man. I was serious about Will, even considered him a potential husband. I felt that we were together on a path, right up until he “somehow” gave me herpes. My doctor explained that people can have it for years without knowing it. It didn’t mean he had been unfaithful, but his immature attitude was as big a disappointment.

If I tried to talk about the physical or emotional aspects of having the virus, Will would cut me off, saying it made him feel guilty. It seemed unfair that I had to protect his feelings while trying to keep mine falsely positive. I stayed with him for a good long while, even though I sensed other incompatibilities. Fear I would never be able to find acceptance with a new person — and of passing the virus along — cowed me. The Flaming Lips played on perpetual repeat. The knowledge that the responsible way to enter a relationship is to tell your prospective new beau that you have herpes does nothing to make you want to try a fresh start. Until I told my current boyfriend.

Mark had been my friend for a few years and was also in a relationship, so I felt insulated from the ramifications of telling him. One day over instant messenger, he admitted he was struggling with an attraction toward me. With nothing to lose, I typed, “Well, maybe this will help turn you off. Will gave me herpes six months ago.”

“Thank you for telling me that,” he immediately responded. “I’m so sorry. I have HPV. You know, genital warts? I had them treated, but I hate how gross I feel — like I can ruin anything I touch.”

Mark was the first person I ever told. I couldn’t believe my relief at his empathy. Suddenly I felt desirable again. I broke up with Will that week. When Mark and I started seeing each other six months later, there was no need for the dreadful “I have to tell you something” conversation. It’s extremely difficult to do this under normal circumstances. To open yourself up to the any possible reaction rarely seems worth it. Negotiating the space between Will and Mark led to some interesting moments. Once, after kissing a guy, I had a private panic attack but only told him I didn’t want get romantic, so we went no further. I told another guy my status before we got intimate; he confessed to having been treated for gonorrhea a couple months before. In general, guys had an easier time accepting a virus than rejection, and most wanted to hook up anyway.

When my relationship with Mark became physical, we used condoms but understood that the viruses couldn’t be prevented totally. As our relationship developed a sense of permanence, we took a pragmatic approach, mentally preparing to eventually contract each other’s diseases. The chances of passing herpes to my partner — if I have no outbreaks, am not on suppression medication and do not use condoms — are two to four percent over the course of a year. Abstaining from kissing and sexual activity during an outbreak is the best prevention. A partner with no symptoms can get a blood test to check for the antibodies of HPV-2, but the results are often inconclusive. Researchers at the Louisiana State University Health Sciences Center performed a study in which 98% of participants shed HSV-1 DNA in their tears. Dr. Herbert Kaufman, leader of the study, says this shows the virus is everywhere and practically unavoidable.

When I first contracted herpes, I took the suppression medication Valtrex. Because I didn’t have recurring outbreaks and my doctor believed my body was handling the virus well, I stopped. More than two years passed before I had a second outbreak. My doctor and I believed stress was the trigger. My job had been demanding; Mark and I were experiencing relationship growing pains. I wasn’t sleeping well and felt depressed; I believed everything important was in jeopardy. Then my body started breaking down.

Embarrassingly, I didn’t recognize the outbreak for what it was. First, I thought it was a yeast infection. Then I thought I had contracted HPV. I made my boyfriend answer a million questions. Over-the-counter yeast-infection creams made the pain worse. Even though I knew what herpes looked like, I wasn’t able to recognize its later manifestations. This, I learned, is common.

Mark insisted I see my doctor. He stayed calm and rational, sending me text messages to ask how I was feeling and gently reiterating his belief that I was having an outbreak. I was scared, irritable, even made him swear that he hadn’t been unfaithful. I told him I felt ruined.

“Even if, God forbid, we don’t end up together we still have the most common STDs out there,” Mark said. “It doesn’t mean we’re hopeless and unlovable; we just have to be adults about it.”

Today, I dread the idea of not being with him, but not because I’m afraid of telling people anymore. We’ve have been together for about three years now, have more sex in more ways than anyone we know, and are both still free of each other’s viruses. I’ve had two mild, almost invisible outbreaks since my initial infection over four years ago. I get regular Paps and the full gamut of tests. We want to marry, maybe have a kid. We have talked about herpes and risks to the baby at childbirth, and HPV’s link to cervical cancer. Sometimes, we don’t think about any of it, until we’re reminded.

Lately, in addition to the increasingly common TV ads for Valtrex, we’re bombarded with ads for the HPV vaccine and news of the surrounding controversy. Merck, the maker of Gardasil, notes that the vaccine is only approved for girls and women aged nine to twenty-six. At thirty-two, I’m outside that range. According to my gynecologist, the drug researchers have presumed I’ve gotten married. Still, she thinks I could benefit from the vaccine. Each of the three shots in the series costs $500, and she encouraged me to see if insurance might cover it, though in her experience they don’t. “Use condoms,” she says at the end of our conversations.

Statistically, women become more sexually conservative after their mid-twenties, and medical science reports that most women build up an immunity to the HPV virus and break it down over time. The risk is that, five to ten percent of the time, the virus incorporates itself into the genetic structure of cervical cells and eventually becomes precancerous. “Great, ” Mark said once, after watching the Gardasil commercial, “It feels so good to know I can give a woman cancer.”

I wanted to tell him that what he’s given me is confidence, and a feeling of partnership I hadn’t thought possible. Instead, I kissed him on the neck and said, “I know. It’s all right.” Mark looked at me and put his hand out, palm up. I low-fived him in a gesture of solidarity, then held his hand and fast-forwarded through the rest of the commercial. Safety is a relative concept, but I’m glad it’s one that can be personally constructed, and mutually enjoyed.

This article originally appeared in Nerve’s Personal Essays.