STDs: Talk STDs with Sue (cont.)

MEMBER QUESTION:
I thought there was no cure for genital herpes?

JOHANSON:
There is no cure for genital herpes, but there is suppressive medication, which can reduce the number and severity and duration of an outbreak.

MODERATOR:
What is involved in suppressive therapy?

JOHANSON:
Suppressive therapy is a prescribed medication taken daily by mouth, which curtails a flare-up of genital herpes. It is a prescription from your family doctor. If you have any concerns, please get it checked out immediately, and ask about suppressive therapy.

MEMBER QUESTION:
Hopefully you can answer this question for me: How much of a risk is my partner at even if I don't have an outbreak at the time?

JOHANSON:
That is something we really do not know. Some herpes patients are shedders. Even if they do not have an outbreak, old dead skin cells can slough off and in some cases contact could trigger an infection with your partner.

MEMBER QUESTION:
How do you know if you're a shedder?

JOHANSON:
At this point we have no guaranteed way to tell. So we go on the assumption that everybody could possibly be a shedder and must be aware of that.

MEMBER QUESTION:
Aside from the meds, what else should I be doing?

JOHANSON:
Be aware of the prodromal signs and symptoms, such as a painful bump that tingles, itches, or burns, followed by a lesion or blister that may be very painful. This will last up to 10 to 14 days, then will heal without leaving a scar.

Prevention is condoms, safer sex every time, all the time. Please do not use condoms lubricated with nonoxynol-9. Be open and honest with your partner if you suspect an outbreak is impending. Avoid any sexual contact at that time.

MEMBER QUESTION:
How do I get a potential lover to get tested before we do anything? Any advice?

JOHANSON:
Talk to your partner. Tell your partner you are concerned for their health and you are concerned for your health. So in both your interests, why don't we go together to see the family doctor or a sexual health clinic and be tested for the possibility of all sexually transmitted diseases (STDs) including genital herpes.

Talk to your partner openly and honestly. Tell them you enjoy being with them, you have great fun together, and you find this partner very attractive and interesting, and you hope that this might develop into an ongoing relationship.

If you have a history of diagnosed genital herpes, you wait until there is an opportune moment when you are alone, when there are no distractions, and you can talk on a personal level. Then you say, "I find this very embarrassing, but when I was in college, I picked up an infection. It does not bother me and I take medication so that it is pretty well under control."

Then go and say, "Do you know about cold sores, the ones you get on your lip? Instead of getting them on my lip, I get them below the waist."

At this point your partner will probably say, "What is it?" And you can say, "It's called herpes. I don't have an outbreak too often, and I take ongoing medication to help control it."

Then I would go on to say, "I promise you I would always tell you in advance whenever I feel I am aware of the prodromal symptoms, because I want to protect both of us."

MODERATOR:
You need to be honest about outbreaks not only to protect your partner, but also to protect yourself.

JOHANSON:
Because if you have a herpes lesion and your partner is HIV positive, you could be infected with the HIV virus through that open lesion. That is why suppressive medication is so beneficial.

MODERATOR:
And if you can't talk to a sexual partner about these things, maybe you shouldn't be having sex with them?

JOHANSON:
If you are too embarrassed or too ashamed to talk to your partner about the possibility of a transmission of any of the sexually transmitted diseases, then perhaps it would be advisable to postpone any sexual contact until the relationship is well established and the intimacy and trust level are at a level that you can be comfortable talking about the possibility of sexually transmitted diseases.

MEMBER QUESTION:
Can herpes of the mouth such as a cold sore be transmitted to the genitals?

JOHANSON:
Yes. Generally, herpes of the mouth is herpes simplex virus 1 (HSV-1), but with oral genital sex it could be transmitted to your partner's genitals.

Conversely, if your partner has genital herpes, (generally herpes simplex 2 or HSV-2)) it could be transmitted to you by oral genital sex. That's why it is essential that you talk to your partner well in advance about such intimate details.

MEMBER QUESTION:
Are there any side effects from taking the medications?

JOHANSON:
For some people on suppressive medication, there may be some side effects, such as nausea, vomiting, upset stomach, or diarrhea. Talk to your family physician.

MEMBER QUESTION:
What do you think of the attention HPV has received lately and how prevalent it seems to have become suddenly with new testing and such?