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Disclosing to my partner that I live with herpes: How to do it?
By Carol-Ann Morier (Intern 2019-2020)
Disclosing herpes to a partner can be a very stressful event. However, we believe that the fears that may accompany the disclosure should not prevent you from meeting partners and having a healthy and fulfilling sex life. Here are some tips that may help you with your disclosure.
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Determine your boundaries about what you want to share with your partner. It's important to set these boundaries because during a disclosure, your partner may have many questions, some of which are intrusive. You have the right to keep certain information about your experience with the virus to yourself.
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Educate yourself about the virus. It is important for you to learn about the virus for your own sake, but also to be able to answer some of your partner's questions. When you disclose, your partner is likely to have questions. However, do not hesitate to refer them to Info-Herpes if you do not have the answers to their questions or if you do not wish to answer them. We can then provide him/her with up-to-date and reliable information about the virus.
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Identify a time and place that makes you feel comfortable. During a disclosure, it is important that you feel as comfortable as possible. You may want to identify a time when you feel comfortable disclosing (before sex, in the morning or evening, etc.). It is also a good idea to identify a place where you feel safe to say it (at home, at your partner's house, in a public place, remotely, etc.). This then allows you to control the context in which you confide in your partner about this.
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De-dramatize the virus. It is helpful to play down the virus when disclosing because it can help reassure your partner. You can do this by normalizing the virus with statistics about the prevalence of herpes in the Canadian population. You can also choose the right words. For example, you can use the word "episode" instead of "attack" and say "I live with herpes" instead of "I have herpes". Using words that are less pejorative will not only help to make the situation less dramatic, but will also make you feel less culpable.
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Name and explain the methods you use to prevent transmission of the virus to your partner. It is important to protect your partners from possible transmission. You can explain the methods you use (condoms, suppressive therapy, adapting sexual relations depending on recurrence, etc.). By explaining this to him or her, you are helping to reassure them. It also opens up a discussion about the methods you want to use together.
Whatever way you decide to disclose to your partner is up to you. The important thing is that you feel as comfortable as possible. Don't hesitate to use our services (brochure, website, frequently asked questions, remote support, etc.) to help with your disclosure. We are here to support you in your efforts!
Source : Info-Herpès (2015). Formation Herpès 101 (5ème version) [Formation]. Montréal : CAPAHC et PVSQ
Coachella Music Festival warns of alleged rise in herpes cases
By Ludovick Ouellet-Harvey (Intern 2018-2019)
Perhaps you've heard of the Coachella music festival? In the last few days, several media outlets have been covering the event. One story about the festival caught our attention. We're talking about articles about the rise in herpes cases on the first day of this festival.
The information used by journalists was taken from the gossip website TMZ and the website HerpAlert. The HerpAlert website is run by a team of doctors who analyze photos sent in by concerned individuals to make visual diagnoses of herpes. According to the TMZ website, HerpAlert doctors diagnose around 12 people a day, but by the first day of the Coachella festival, hundreds of people were dealing with the site. A total of 1,105 cases were reported in Indio, the Palm Springs desert, the Coachella Valley, Los Angeles and San Diego. These are the places where most festival-goers stay during this musical event.
Now that we've brought you the version reported by the media, let's talk about the facts and what to keep in mind when reading this news. First of all, there are two types of herpes. Type 1, often called "cold sores", is found mainly around the mouth, but can also be found on the genitals. Type 2, on the other hand, is found almost exclusively in the genital area, and very rarely in the mouth. It's worth noting that in 2017, the World Health Organization estimated that 67% of the world's population under the age of 50 were carriers of herpes type 1, and that 11% of people under the age of 50 were carriers of herpes type 2. This represents a significant proportion of the population. It's also important to remember that some people can be carriers of the virus without knowing it.
Secondly, two very important pieces of information have been left out of these articles. Firstly, the visual diagnosis of herpes is not included in Canadian screening guidelines. This method does not identify the type of herpes. Currently, the only two recognized ways to screen for herpes are by taking a swab from the lesion (pimple) or by taking a blood sample to detect antibodies. The data used to describe the "explosion of herpes cases" comes from a website that makes visual diagnoses from photographs. While we recognize the initiative and expertise of these doctors, visual diagnosis is not recommended in Canada. The data presented here should therefore be taken with a grain of salt.
Secondly, it's important to talk about the incubation period. This is the time between transmission of the virus and the appearance of the first symptoms. The incubation period for herpes is around 6 days. It's not possible for people to catch the virus and immediately develop symptoms. Those who do develop symptoms and actually carry the virus had it long before the festival. Moreover, the first symptoms do not mean that that's when the herpes was transmitted. A person can be a carrier for several months or years without showing any symptoms. Certain factors can encourage recurrence, such as fatigue, diet, stress, prolonged exposure to the sun or any other factor that weakens the immune system. At a festival in the desert, many of these factors may be present.
Finally, there are around 1105 reported cases. However, it is not specified whether these are official diagnoses, which would have to be confirmed by blood test or swab, or whether they are simply the number of requests from concerned individuals on HerpAlert. It's important to remember that herpes is not a dangerous virus. It causes uncomfortable, painful pimples (called "cold sores" when they're on the mouth), but they don't lead to chronic illness or health problems. It's one of the most common sexually transmitted and blood-borne infections (STBBIs), and everyone will come into contact with the virus at some point in their lives.
When it comes to herpes, the stigma associated with it often hurts more than the infection itself. The publication of sensationalist articles reinforces this stigma while spreading myths about herpes. A concern frequently mentioned by people who contact the Info-Herpes project is to protect others from the virus. This type of article can increase feelings of guilt about living with the virus, and fear of entering into relationships with others. Around 67% of the world's population are carriers of herpes type 1 and 11% of type 2. This represents a significant number of people who may experience discrimination when such statements are made in the media. That's why it's important to remain critical when reading this kind of news.
Sources
Agence de santé publique du Canada. (2016). Lignes directrices canadiennes sur les infections transmissibles sexuellement. Section 5 : Prise en charge et traitement d’infections. Infections génitales au virus Herpès simplex (VHS). Repéré à https://www.canada.ca/fr/sante-publique/services/maladies-infectieuses/sante-sexuelle-infections-transmissibles-sexuellement/lignes-directrices-canadiennes/infections-transmissibles-sexuellement/lignes-directrices-canadiennes-infections-transmissibles-sexuellement-32.html
Organisation mondiale de la Santé. (2017). Herpès (virus de l’herpès). Repéré à https://www.who.int/fr/news-room/fact-sheets/detail/herpes-simplex-virus
Does herpes really cause Alzheimer's?
By Ludovick Ouellet-Harvey (Intern 2018-2019)
In recent years, researchers have observed a link between herpes type 1 and Alzheimer's disease. According to the Alzheimer Society of Canada website, Alzheimer's is "an irreversible disease that destroys brain cells and causes thinking and memory problems. Alzheimer's disease is not a normal part of aging" (Alzheimer Society Canada, 2018). In this article, you'll find the results of some research that has been very recently published.
Results
A link has been demonstrated between herpes type 1 and Alzheimer's disease. According to the researchers, the virus moves into the brain, where it becomes dormant (inactive). With aging, the virus reactivates, causing damage to the brain. The accumulation of this damage would eventually lead to the development of Alzheimer's disease.
This theory was developed because herpes type 1 DNA was found specifically in the plaques causing Alzheimer's in some patients who had developed the disease. After further study, it was determined that the presence of herpes type 1 AND a genetic mutation (APOE4) increases the probability of developing Alzheimer's disease. A person living with herpes type 1 has, after 10 years, a 2.5-fold increased risk of developing dementia.
Following these observations, researchers explored the effect of antiviral treatments for herpes on the development of the disease. One study shows that Alzheimer's cases are 2 times higher in patients not taking antivirals (Itzhaki, 2018). In another study, researchers observed that, in patients infected with herpes type 1, 28% of untreated patients had developed a neurodegenerative disease by the end of their study, compared with 5.8% of patients taking antivirals (Richeux and Anderson, 2018). Another study explored the protective effect of treatment. The researchers observed that the protective effect of antivirals is greater the longer the treatment is taken. They compared taking medication for more than 30 days to taking it for less than 30 days. In both cases, the effect is notable, but they do not yet understand the mechanism of action of antivirals. To hope for an effect of antiviral treatment of herpes on the development of Alzheimer's, the authors suggest that treatment be taken before the age of 50. They also suggest targeting those at higher risk, such as those with the APOE4 genetic mutation (Itzhaki, 2018).
Important points to consider
Let me reassure you, when it comes to research on the impact of herpes type 1 on the development of Alzheimer's, although the link is being taken more and more seriously, the research is still in its early stages.
There are a few points to bear in mind when reading these results.
The main point is that, while the link between herpes type 1 and Alzheimer's has been scientifically demonstrated and supported, the cause-and-effect relationship has yet to be proven. It is therefore possible to see an association between the two, but it has not yet been demonstrated that herpes type 1 causes or triggers the development of Alzheimer's disease. Furthermore, it has not been demonstrated that the herpes virus alone causes Alzheimer's disease. Indeed, the results indicate that both herpes AND the genetic mutation (APOE4) increase the likelihood of developing the disease.
Another element not explained in the studies is how the virus travels to the brain. Generally speaking, the virus settles in one place and stays there. The studies do not explain how the virus migrates to the brain.
Another very important element to consider when reading these studies is the virus itself. The herpes virus is a member of the herpes virus family, which comprises 8 viruses (including varicella/zoster, mononucleosis, roseola, etc.). Some studies link herpes viruses to Alzheimer's disease, but do not specify which type. Some research is being carried out on shingles (herpes virus type 3) and not on herpes type 1 (present in the mouth and genital area). Current research focuses on rare, severe cases of type 1 herpes (oral or genital) and shingles. Research specifically studying the link between herpes type 1 and Alzheimer's disease is being carried out on a population aged over 50 who have recently been diagnosed with herpes.
Finally, there are no results demonstrating the effect of antiviral treatments on people who have carried the virus for several years. The studies were carried out on people in their fifties who were newly carriers of the virus.
