News • Blog
Sexual health and LGBT population
Living with HIV
Post-exposure prophylaxis (PEP)
Genital herpes is transmitted through sexual contact. It is not an infection that is passed along on shared ustensils, towels or soaps - albeit this is a frequent question in our clinic. Herpes may be transmitted through simple skin-to-skin contact (genital to genital) or through contact with contaminated genital secretions. This implies a risk associated with sexual penetration; vaginal, anal or oral as well as direct contact without penetration. After exposure to the virus, a 2 to 20 day incubation period ensues followed by the primary genital herpes outbreak. Unfortunately, approximately half or 50 % of individuals infected will not develop symptoms and thus remain unaware of their herpes status.
The greatest risk of transmitting or acquiring genital herpes is when you or your infected partner are suffering from an outbreak. It is felt that this increased risk period likely includes the 12 to 24 hours prior to the visual appearance of skin lesions (when the virus is reproducing in the nerve cells). Many individuals who experience recurrences of their genital herpes are able to identify the imminent onset of an outbreak because of their "prodrome". A prodrome may include odd neural sensations such as localized itching, burning, tingling or numbness, and this in the region where the lesions tend to occur. High risk begins at this point and persists until the lesions have "crusted over" - meaning that there are scabs on the surface.
The risk of transmission is diminished in the absence of lesions, although is not considered to be "no risk" . In the past it was believed that if there were no skin lesions, then there was no risk. Studies have documented that individuals infected with genital herpes may in fact occasionally excrete herpes virus from the nerve and through the skin, and this even in the absence of an episode. Rates of asymptomatic excretion vary greatly from one person to another, and from one study to another. It is felt that there is approximately one day in ten when such excretion occurs...obviously it is impossible to know which day (outside of research techniques). This is typically frustrating for patients and couples living with herpes (we will discuss living with herpes later).