When it comes to how to disclose a herpes diagnosis, opinions are split. People like sex columnist and podcaster Dan Savage argue that herpes infection is so common and so minor a health issue for most people that they should not be required to tell a new partner about their status. On the other hand, there are those in the medical and activist communities who argue that the only ethical way to care for future partners is to disclose, despite the outsized stigma and reaction disclosure of a herpes diagnosis might carry. And, in some states, it's actually illegal to not disclose.
“Someone’s personal information about their health, their body, and particularly their genitals is all their own,” Pierce says. “And they’re under no obligation to tell anyone — until sexuality is on the table.”
Pierce says that some people choose to disclose their status from the get-go, even putting it in their dating profiles. Others may choose to wait until they’ve gotten to know someone a little bit better, with the hope that the potential partner will be more receptive if they know them better.
The stigma, on the other hand, is massive.
Jessica Horwitz, certified nurse practitioner (MSN FNP-C) and vice president of clinical services at the telemedicine company Nurx, tells Bustle that while she encourages all of her patients to talk about their STI history — including any herpes diagnosis — she’s not comfortable saying that anyone should “always” disclose.
“There is the reality that a lot of people may have had herpes and they may never have an outbreak again or for many, many months or years,” Horwitz says. “Those are situations where I don’t think that someone always needs to disclose.”
For the majority of people carrying the herpes virus, the actual effects of the infection can be minor to none. (While there are two herpes viruses — HSV-1 and HSV-2 — both can cause sores on your genitals. That's what we're talking about here: Genital herpes, regardless of which version of the virus caused it.) The herpes virus is transmitted via skin-to-skin contact with an infected area, usually through activities like anal, vaginal, and oral sex, as well as kissing. The majority of people who contract it have some slight irritation or blistering, so minor that they mistake it for something else, or one outbreak and then nothing for the rest of their life. And people who have been diagnosed with herpes can take ongoing suppressive therapy, which greatly reduces the risk of transmitting it to a partner.
The stigma, on the other hand, is massive. Herpes started being tagged as “sexual leprosy” in the 1970s. Before that, it was mostly treated like what it was — a minor skin irritant — but after the sexual revolution, the seeds were sown for herpes hysteria to run rampant for another 50 years. Many people internalize this stigma; some even believe that they’ll never be able to have sex again after a diagnosis, which isn't true.
It’s much about you disclosing to a partner so that the partner feels comfortable as it’s about you seeing how that partner responds to make you comfortable.
For those who do want to disclose, Pierce recommends bringing it up in a matter-of-fact way. If you’re unemotional and clear, she says, it’s much more likely that the person you’re telling will be as well. And don’t feel the need to over-explain if you don’t want to.
“You’re only required to disclose as much about your personal and sexual history as you feel comfortable,” Pierce says. “Simply stating you have herpes is the max required. Anything else from there is up to you.”
A person learning that you have herpes might want to know how many partners you’ve had, or how you got it. That kind of information is fine to share, if you feel comfortable doing so, but your potential partner doesn’t have a right to it. Pierce also suggests sharing information about whether or not you’re taking suppressive therapy and the ways you work to reduce risk of transmission, but “that’s not necessarily required.”
And while it can feel like there’s a power imbalance between the person disclosing a herpes diagnosis and the person hearing about it, Horwitz says that having this discussion is powerful for both parties.
“It’s much about you disclosing to a partner so that the partner feels comfortable as it’s about you seeing how that partner responds to make you comfortable,” Horwitz says. “It can actually be an equal power dynamic in a situation that a lot of people see as not an equal power dynamic: the person disclosing oftentimes feels powerless and the one they’re disclosing to feels like they have power.”
Pierce suggests having resources on hand that you can recommend to your potential partner. Because there’s so much misinformation about herpes, you might not want your partner googling on their own. (Look up the “blue waffle” myth and you’ll see what she means.)
Pierce recommends having some fact-based, stigma-free sources to share, like the American Sexual Health Association, as well as some sources that share personal stories, like her own site, The STI Project. Both Horwitz and Pierce both suggest making sure you’re prepared to answer any questions — and know that your partner’s initial reaction may differ from their ultimate feelings about your disclosure.
“Allow them a little time to consider and do some of their own research,” Pierce says. “Their immediate response and reaction might be different than a little more thoughtful and educated a response after they’ve had some time.”
Finally, while it’s easy to get down on yourself if you’re rejected after disclosing, Pierce wants everyone to know that another person’s decision about whether or not to continue with a relationship based on a herpes diagnosis doesn't say anything who you are as a person.
“Understand that everyone has the right to decide whether or not that’s going to be a good fit for them and it usually has nothing to do with whether or not you’re an amazing person," Pierce says. “It’s important to do your best to mentally give yourself the mantra that you’re not going to take it personally."
Jessica Horwitz, certified nurse practitioner (MSN FNP-C) and vice president of clinical services at the telemedicine company Nurx