Not So Simplex: The Complicated World of Herpes

Illustration by Mimi Shang

Illustration by Mimi Shang

Herpes, a common sexually transmitted diseases, is incurable and can be tough to prevent. The virus can be transmitted through vaginal, oral and anal sex, through open sores on the genitals and the mouth, and through skin-to-skin contact. Despite its high prevalence, many people don’t understand the symptoms of herpes or how it can be transmitted. Fortunately, herpes is not life-threatening and most people don’t show any symptoms—but this also means that herpes is usually transmitted by people who don’t even know that they have the disease.

All of this can sound scary, and if you’re like the average WUSTL student, you probably aren’t totally sure of what herpes is or what the symptoms are. There are two types of herpes, oral and genital.The virus HSV-1 usually causes oral herpes but can also cause genital herpes, and the closely related virus HSV-2 causes most cases of genital herpes. Over half of Americans have oral herpes, which can sometimes manifest as cold sores around the mouth. Around 15 percent of Americans have genital herpes, which can cause sores in the genital area. Sores usually look like ulcers, but can resemble pimples or ingrown hairs. Since the disease is often asymptomatic and its symptoms can be misleading when they present, it is difficult for students to gauge the risk of herpes.

In a survey of 63 Washington University in St. Louis (WUSTL) students, only 19 percent of students said they were confident that they could understand and recognize herpes symptoms. Of those surveyed, the students that were sexually active had a slightly higher level of confidence at 24 percent. The survey also revealed that many students were confused about oral herpes. Though having a cold sore or blister around the mouth is a symptom of oral herpes, 42 percent of students reported that they did not have oral herpes despite getting cold sores around the mouth. Oral herpes can cause genital herpes if transmitted through oral sex, so it’s worrisome that students are unaware that their cold sores are caused by the herpes virus.

Asia Brown, a graduate student who leads Student Health Services’ Peer Sexual Health Educator team, says that herpes is an issue for WUSTL students. Though HSV-2 infection is uncommon in the WUSTL student population, HSV-1 is prevalent, and Brown says many students present to Student Health with genital herpes that they have acquired through oral sex with someone who has oral herpes.

The disease may be asymptomatic in many cases, but Brown says that should not stop students from taking steps to prevent it. The best way to minimize the risk of HSV-1 genital infection, according to Brown, is by using condoms and dental dams during oral sex. For students who suspect they have genital herpes, the fact that it is a chronic illness should not discourage them from seeking treatment. As Brown points out, symptoms and viral load can be managed with treatment, so contacting a healthcare provider is important for your health as well as the health of your sexual partners.



Urvi is a sophomore from Pineville, NC. She can be reached at urvisinha@go.wustl.edu


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