President’s Corner: Dr. Freda M. Bush

Genital Herpes

My father was a Baptist preacher, and he used to quote Scripture to us often to teach us life lessons. All nine of us had one memorized from his mouth, and that was Proverbs 22:6: “Train up a child in the way he should go; and when he is old, he will not depart from it.” Then he would sometimes elaborate and say that meant we were to be “God fearing, law abiding and independent of him.” He taught us many things, including to be studious, courteous, respectful and hard working. Sometimes when he felt it necessary to make a point, he would use hand gestures or enlist the “rod of correction.” My mother gave us the conversations about sex, and they were short. “If you get pregnant, or get a girl pregnant, you will get married. So don’t date anyone you wouldn’t want to marry.” I do not ever recall our having a conversation about sexually transmitted infections, although there were only two back then: gonorrhea and syphilis.

As the parents of three daughters and one son, my husband and I were very interested in raising our children with the same principles and work ethics. We too taught them how to have healthy relationships with adults and their peers. But our conversation had to expand to include avoiding more problems associated with sexual activity and the more than 25 STD s.

Last month MI’s science article focused on genital herpes which is caused by the herpes simplex virus: HSV-1 or HSV-2. HSV-1 has traditionally been considered the cause of oral herpes, also known as “fever blisters” or “cold sores.” HSV-2 has traditionally been considered the cause of genital herpes. Recent research, however, has shown that both types can, and frequently do, cause genital herpes. In the past, physicians were not too concerned about patients having “fever blisters” on their lips. But now that we know HSV-1 can also infect the genital region, physicians are concerned about “fever blisters” causing a genital herpes infection on the person receiving the oral sex.

Herpes infection is so common for two reasons: 1) There is no cure; therefore, once people are infected they are infected for life. Yes, certain medicines can help reduce the length of the outbreaks of genital ulcers or limit the number of outbreaks, but the virus itself remains in the body. 2) Often the virus is spread before and without the infected person even being aware of it.

A person who becomes infected can feel that a sexual partner has violated a trust. “The person who infected me must have known he had herpes but didn’t bother to tell me.” Actually, this may or may not be true. Some infected people do not know they are infected, though, of course, many do. Even so, infected people must deal with the fact that they can infect any future sexual partners, including any “hookups,” but they can also infect their spouses or children.

In my gynecology practice it is not uncommon to obtain the history of many young patients that includes prior sexually transmitted infections (STIs) of chlamydia, gonorrhea, HPV and herpes. Upon inquiry they respond nonchalantly as if it’s just a fact of occurrence. But many women, when they learned they had HSV, felt that their partners didn’t warn them or give them the option to decide whether to take the risk of having sex with them. They immediately express anger and hurt and disappointment. Often they say, “He should have told me and given me the choice of whether to take the risk or not.” When they calm down and we begin to plan or discuss their future sexual activity with HSV, there is a strained silence as they ask themselves: Would I have said yes to sex with him with or without a condom? Was our relationship without sex that meaningful? Was sex with him that valuable?

Ultimately they generally say, “I would think I would treat someone the way I would have wanted to be treated—even at the risk that the relationship would end.” It also lets you know how valuable you are to the person if they say, “Let’s wait for sex,” but they want to continue dating.

Fortunately today there is hope for future relationships with suppressive medications and a change in lifestyle. You don’t have to end a relationship because someone has an STI. I say the person inside the body is the one you should love or care about. Get to know the person inside the body and determine over time whether the relationship should continue or progress deeper to a commitment in marriage; then get married before becoming sexually intimate. Even a young person who has previously engaged in sexual activity can change their behavior and return to a lifestyle of avoiding sexual risks. A life free of the burden of sexual consequences is worth the wait!

 

 

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