How to Disclose You Have Herpes: A Therapist’s Guide
By Grace Crawford-Smith
Communicating clearly about sexual health is a skill most of us aren’t taught, which is unsurprising given we aren’t taught how to talk about sex at all.
Living with a sexually transmitted infection (STI) like the herpes virus (HSV1 or HSV2), which is treatable but not curable, can bring up feelings of shame due to cultural stigma, lack of education and fear of rejection in some way.
However, the more comfortable we get talking about sex, including disclosing our sexual health information with others, the more we can normalise and de-shame this incredibly common experience. The more accurate information we have, the easier it becomes to dispel myths and misunderstandings about conditions such as herpes, which for many people is just a part of their everyday life.
What is herpes?
Genital herpes is an extremely common STI, caused by herpes simplex virus (HSV).
There are two types of HSV that can lead to genital outbreaks: HSV1 and HSV2. HSV1 normally occurs around the lips and mouth and presents as cold sores, whereas HSV2 commonly affects the genitals and around the anus.
HSV1 and HSV2 can both occur on lips, mouth, genital or anal areas, and people can be infected with both types of the virus.
The prevalence of HSV1 is estimated to be 70-80% of the population, while the prevalence of HSV2 is estimated between 12-15% of the population.
Prevention and Protection
The virus can lie inactive for years beneath the skin, so many people live with the virus without symptoms as it’s difficult to test unless an outbreak is visible on the skin. This means herpes cases are often undiagnosed and under-reported.
HSV is transmitted through skin to skin contact with a person actively experiencing an HSV1 or HSV2 outbreak. Spreading normally occurs when a person has active blisters, however the virus can still be spread when a person isn’t showing any symptoms.
HSV can be treated. However because it is a virus, it cannot be cured. Treatment can include anti-viral medication, self-care, condom use and avoiding skin to skin contact during an outbreak.
Using condoms definitely reduces the chance of spreading, however it does not eliminate the chance of spreading as condoms don’t cover all the areas of skin on the body where the HSV virus may be. Condoms are still highly recommended for prevention of spreading, as well as protection against other potential STI’s and/ or unwanted pregnancy if applicable.
What acts can potentially spread HSV?
Oral sex, vaginal sex, anal sex, kissing... lots of things! For this reason, it’s best to let people know straight away, before play, that you have the virus.
How do I disclose that I have herpes?
Let’s talk about how to communicate with potential sexual partners when you have a herpes diagnosis.
This blog is not about how to treat or manage herpes, however there will be some resources linked at the bottom of this piece to support you with treatment options.
Choose the right time to speak.
Oral sex, vaginal sex, anal sex, and kissing are all ways that HSV1 or HSV2 can shed to another person from an infected area. For this reason, it’s best to let people know straight away, before play, that you have the virus.
A good rule of thumb is to disclose after a sense of connection and attraction seems to be established, but before pants have come off. Also, avoid kissing if you have an outbreak (cold sores) on your lips.
I always recommend conversations about sex happen outside of the bedroom, and outside the heat of the moment. This eliminates the “trying to keep it sexy/ romantic” urge, and reduces the chance of avoiding the conversation or making hasty decisions.
When we are really aroused, our judgement can be slightly clouded, and it is possible to make decisions we later regret when the surge of arousal has passed. This is why it’s important for everyone to chat in a time where you’re both feeling quite calm and connected.
2. Keep it direct yet relaxed.
This is not a dramatic confessional! Herpes and STIs are a normal part of life.
Disclosing is a chance to have a conversation about sexual health for two (or more) people to discuss how they are going to navigate touch safely.
Think of the sexual health conversation as an ongoing one between sexual partners. I’ve provided some example scripts below.
3. Know your stuff!
Provide key information points, and perhaps have a few links ready to go to share in case someone would like to do their own research. Knowledge is power.
Resist the urge to convince when providing information, as people are entitled to be as cautious or un-cautious as they would like to be, as long as everyone is consenting and aware of risks.
Remember, you’re not responsible for providing a scientific lecture, if someone wants to educate themselves then help them make a start, but let them take responsibility for their own learning as well.
A helpful graphic with key points of information will be provided at the bottom of this blog that can be sent to support or follow up disclosing.
4. Respect a no, a maybe or a yes.
Don’t put people on the spot, instead give them the time to process and come to their own decision.
Allow people the space they need to make their own choices. Transparency about STI’s is a part of consent, so people know what they are choosing to participate (or not participate) in.
Allow yourself the space you need to support yourself if you hear a no. Rejection sucks, yet it is also a part of life.
Remember, the right person for you will be okay with your diagnosis. You didn’t choose to have herpes, but herpes is now a part of your path. Therefore, the right people on your path will accept this experience. We aren’t aiming to attract everyone on Earth!
Self-regulate, co-regulate, talk to a friend, find a therapist if navigating sex, dating and/or relationships is feeling difficult or isolating with herpes. There will be helplines listed below.
5. Find community.
There are plenty of support groups and even dating apps for people with a positive HSV status. However, knowing how to disclose and respect other’s decisions means you can relate to different people, regardless of their current sexual health situation.
Let Them Know is a free notification service to let sexual partners know they might be at risk of contracting an STI after play. Partners can be notified via text or email, with your contact details or anonymously. This is useful if you receive a diagnosis after having already had sexual contact with a person.
What are some sample scripts?
Here are some ideas of what you might actually say during a disclosure conversation:
“I’m enjoying spending time with you and I feel really attracted to you. Before we potentially get naked or have sex, I wanted to talk about sexual health. I wanted to let you know I have herpes. I know a lot about it, and I’m happy to answer any questions you have if I can, and send some links I’ve found really helpful. If you need time to think or research, just let me know when you’re ready to revisit this chat”.
“I’m really attracted to you and I would love to sleep with you if you feel the same way. Before we potentially take things further, I need to give you a heads up that I have HSV1/ HSV2. It’s more of an inconvenience at this stage, and I have a lot of information about it. I am happy to send you some resources to help you decide if you’re open to continuing, with this in mind. If you have questions, let me know.”
“Hey, can we talk about sexual health for a moment? I am open to being physically intimate with you as I’m feeling a good connection. If you’re interested in that as well, before pants come off, I wanted to let you know I have herpes. It’s super common and it’s treatable, but not curable, so please take the time you need to think about it or ask me any questions, then we can chat about how you’re feeling when you’re ready”.
Resources
Information to send after disclosing:
https://www.stoptherise.initiatives.qld.gov.au/stis/herpes#section__how-herpes-is-transmitted
https://www.health.gov.au/sti?
Think you might have herpes or an STI?
Call Healthdirect (Australia wide) - 1800 022 222 or use symptom checker:
Who can I call if I am feeling distressed about an STI?
NSW Sexual Health Info Link - 1800 451 624
Family Planning Australia’s Talkline - 1300 658 886
Lifeline - 13 11 14