Why Don't People Talk About Cold Sores The Same Way As Genital Herpes?

Young woman touching lips
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Back in the spring of 2011, I tweeted a link to this fabulous essay on the different importance assigned to HSV-1 and HSV-2 disclosure. It inspired a young gender and sex educator to tweet back:

"I have HSV-1 and I disclose to all partners before even kissing, let alone sex. #BeingResponsible."

My response? "Being responsible is sexy!" It really is. Trust is an important component to having a good sexual relationship.

Responsibility goes a long way towards building that trust.

The point of the original article is that people are frequently lambasted for not disclosing a genital herpes infection. However, there is no pressure to disclose an oral herpes infection - i.e. cold sores. That's true even though a growing number of genital herpes cases are thought to be from transmission during oral sex. In fact, scientists estimate that more than half of new genital herpes infections in the U.S. and the rest of the developed world are caused by the "cold sore virus" instead of the "genital herpes virus"

From a logical standpoint, therefore, the fact that people don't feel the need to disclose cold sores is more than a little ridiculous. However, I suspect that a lot of it comes back to three points:

  1. People don't think of cold sores as being herpes
  2. People don't know that cold sores can be transmitted to the genitals
  1. People don't know that you can transmit herpes even when there's no outbreak

Ignorance, therefore, denies people the motivation to disclose. This is true even though, in theory, talking to a potential partner about the fact that you get cold sores shouldn't be that big of a deal. At least, it should be much less stressful than it is to disclose the (irrationally) far more stigmatized genital variety.

After all, cold sores are extremely common, and many people have been infected with the virus that causes them since childhood.

The ways that social stigma affect STD disclosures can be profound. It can be much less difficult to risk infecting someone than to talk about the possibility and risk rejection. Stigma can even be so severe that people avoid getting tested. They're so afraid of finding out they might have something wrong with them, that they don't want to know. Sometimes, that's even true when people have symptoms. If they don't know for certain that they have an STD, they don't need to talk about it. The desire for plausible deniability is a powerful thing. 

Gupta R, Warren T, Wald A. Genital herpes. Lancet. 2007 Dec 22;370(9605):2127-37.

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