Herpes Virus

The herpes simplex virus (HSV) comes in two strains, type 1 and type 2. Both are easily transmitted by skin-to-skin contact.

Genital herpes is caused by type 1 and type 2 HSV. It is a chronic condition because the virus can lie dormant in your body before becoming active again and causing further outbreaks. Most people experience four to five outbreaks in the first two years after infection. Outbreaks become less frequent and less severe over time.

It is estimated that 1 in 8 Australians have genital herpes, with around 85% of people carrying type 1 and 20% carrying type 2.

Australian adult women are twice as likely to have genital herpes as men. The infection is most prevalent in women aged 35-44.

Genital herpes is more prevalent in adults who live in metropolitan areas than rural areas. Indigenous Australians are more likely to have genital herpes than non-Indigenous Australians.

For many people, it can take months or even years to experience symptoms after being exposed to HSV. This means that there are large numbers of people living with the virus without knowing it.

Others will experience symptoms shortly after infection, usually four to seven days after exposure. The first outbreak is generally the most severe than subsequent bouts.

During the first outbreak you may notice:

• Small blisters that turn into open sores around genitals, rectum, thighs and buttocks
• Blisters and ulcers on cervix
• Vaginal discharge
• Pain when passing urine
• General malaise (discomfort)

You may experience these symptoms for up to 20 days. Sores will scab and heal without leaving scars. During recurrent outbreaks you may experience:

• Tingling and burning in your genitals or leg before blisters form
• Painful blisters that burst and leave sores
• Blisters and ulcers on the cervix

Symptoms usually last for less time during recurrent outbreaks.

Genital herpes is caused by both type 1 and type 2 HSV. It can be spread through skin-to-skin contact, including during anal, vaginal or oral sex.

• When HSV is present on your skin you can pass it on to a sexual partner. It is easily transmitted through the moist skin around your genitals, mouth and anus.
• In other cases, transmission happens due to contact with other areas that can be affected by HSV including the skin and eyes. For example, if you have oral sex with someone with a cold sore, you can get genital herpes.
• It is also possible to catch HSV from sex toys, although transmission is not possible from towels, cutlery or cups.
• It is easier to catch HSV when there are open sores, but it can be transmitted at any time.

Recurrent outbreaks can also occur at any time. Doctors don't fully understand why recurrent outbreaks occur when they do, but it is thought that possible triggers could include:

• Stress
• Excessive alcohol consumption
• Being ill (when your immune system is down)
• Exposure to ultraviolet light, such as sunbeds
• Surgery on the genital area
• A weakened immune system

If you think that you have genital herpes, it is important to get a sexual health check-up. You can do so with your doctor or at a sexual health clinic. For a first outbreak, it is best to see a sexual health specialist at your local clinic.

It is easier to diagnose genital herpes when the infection is active. With this in mind, you should get a check-up as soon as you experience symptoms.

During the check-up you will be asked a series of questions, including:

• Have you had similar symptoms in the past?
• Have you ever had a cold sore?
• Have ever had a sexually transmitted infection (STI)?
• What your sexual history is like

The medical professional will then use a swab to collect a fluid sample from a blister. This will be sent to a laboratory to test for HSV.

Even if the swab comes back negative for HSV, you may still have the infection. In this case, a diagnosis will be confirmed by future outbreaks.

If you have unprotected sex with a new or casual sexual partner, or unprotected sex with a partner that you think may have had other sexual partners, you should get a test for other STIs. Sadly you can only get tested for herpes IF you show symptoms but many other STIs do not so it's important to get a full check-up.

If a sexual partner tells you that they have been diagnosed with genital herpes or any other STI, it is important to get a test.

In the event of a diagnosis of genital herpes you will be recommended treatment. The type of treatment depends on whether you have experienced symptoms for the first time or if they have been repeated.

For first-time outbreaks you will likely be prescribed antiviral tablets, which are usually taken daily to stop HSV from multiplying. They include the active ingredients famciclovir, acyclovir, and valaciclovir.

For recurrent outbreaks that are mild in severity you may not be given tablets. You can ease your symptoms by cleaning the affected area, applying an ice pack, using anaesthetic creams, drinking lots of water, and wearing light clothing.

It is important to refrain from sex when you have open blisters.

Preventing herpes

• Do not have sex if you have any open blisters or sores. Always use a condom to help prevent infection, and avoid sharing sex toys.
• Do not kiss anyone if you have a cold sore around your mouth.
• You can also use other barrier protection methods such as male condoms, female condoms (used separately) or dental dams to cut the risk of transmission.
• You can reduce your risk of exposure by limiting the number of sexual partners that you have. If you have multiple sexual partners you are at higher risk of getting an STI.
• Take responsibility for your sexual health. Protect yourself, get regular tests, and tell your partners if you are diagnosed.

If everyone monitors their sexual health on a regular basis, infection rates should drop and health issues caused by untreated STIs should be reduced.