My husband and I recently divorced. He got the large-screen TV and I got the herpes. (I asked for the SUV, but he thought I said HSV!) Now I'm ready to start dating again, but am ashamed, scared and confused. How do I handle this delicate situation? I don't want to infect anyone. My doctor said not to worry, but some websites say that HSV-2 is contagious, even with a condom and even when there is no outbreak. I'm worried about having "the talk" with potential suitors and being rejected by men who might even unknowingly be carrying the virus themselves. Are my days of spontaneous, unbridled passion over? Must I have a scarlet "H" tattooed on my bosom, Hester Prynne-style?
— Scarlett With Fever
Yes, your days of spontaneous, unbridled passion are over. They're going to be replaced with preplanned, unbridled passion. And really, when it comes down to it, what's the difference?
Your top priority is to become an expert on herpes. The more competent you are about the information you provide to partners, the more confident you'll come across. And confidence creates calm. Which creates the opportunity for great sex.
First, let's get something out of the way. You have a moral obligation to disclose to your partners before having sex. Do not rob people of the opportunity you were denied: To avoid or minimize the chance of infection by declining sex or using protection.
Here's what you need to know: The herpes virus sets up shop in the nerve cells, where it lies dormant but not dead. At certain times, the virus travels along the nerves up to the surface of the skin. This is called "viral shedding." You are highly contagious during this phase and you can infect people by direct skin-to-skin contact, especially from anal, oral or vaginal sex.
The shedding sometimes produces symptoms (most noticeably the herpes sores or blisters), but it can also occur without them. Hence, the dilemma: It's virtually impossible to tell when you're contagious.
Consequently, the majority of herpes transmission — up to 70 percent — occurs when there are no symptoms. If you do have symptoms (like blisters), you are absolutely contagious and you should avoid skin-to-skin contact in the affected areas.
Bottom line: You are only contagious when you shed. But that's the rub. If shedding can occur without symptoms, how do you know when you're shedding? Scientists believe that shedding occurs between 20 percent to 40 percent of the time in the first six months after initial infection and 5 percent to 20 percent after that.
The good news is that shedding occurs less frequently after the first six months of infection. And the better news is that Valtrex, the medication that MTV warehouses for the cast of "Jersey Shore," substantially lowers the risk of transmission. In fact, it was approved by the FDA to reduce herpes transmission. The operative word being "reduce," not "prevent."
Assuming that you're past the six-month stage and you're on Valtrex, here's how I'd explain your situation to potential partners:
You're not infectious between 80 percent to 95 percent of the time.
You're on Valtrex, which the FDA approved for the prevention of herpes transmission.
You're going to use condoms, which offers added, proven protection.
With all that, your partners have a better chance of getting hit by a MARTA bus on Buford Highway than getting infected by you. But I can't lie, it's still possible.
If you know the facts, keep the issue in perspective and take the necessary precautions, genital herpes can be reduced to a minor inconvenience. It's an error box pop-up, not a complete operating system failure.
For more information about managing herpes, I recommend three resources:
1) Charles Ebel's book, Managing Herpes: How to Live and Love With a Chronic STD. It's highly recommended by experts who deal with the issue every day.
2) The Centers for Disease Control and Prevention's National STD & AIDS Hotline (800-227-8922).
Mike "The Sexorcist" Alvear hosts HBO's "The Sex Inspectors," blogs at mikealvear.com and teaches monthly blogging workshops with Hollis Gillespie. Got a burning or a why-is-it-burning question for the Sexorcist? E-mail him at firstname.lastname@example.org.