NCBI Reasons for Not Testing and Treating the Population for Herpes

For those who want to understand the thinking of the CDC .... :(

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687913/

Does this mean that there are even more people out there who have herpes than the current numbers suggest, or do the numbers we know already take into consideration these people?

The numbers are accurate as far as we know ... there were studies of the population done at some point where people were swabbed (and their research swabs are more sensitive than the ones that are used for diagnosis) and each person also filled out info about their knowledge (or not) of their Herpes status.

That said, I saw a recent study that suggests that in women 50 and above who are unmarried (ie, not in monogamous relationships) that 50% of us have genital herpes ..all studies have been up to 49 with all ages combined .. which makes sense that more of the population will have it as we get older ... but that's still a pretty darned big number :(

Sorry for the late reply but I think I have a relevant comment.

I recently saw a similar study that said 55.3% of unmarried women in the 45-49 age range are infected with HSV-2 and only 5.8% of women in that same demographic are aware of their positive status. That doesn't include unmarried women in that age range with GHSV1.

As someone in that age range, knowing the majority of my demographic is infected, I find it frustrating that doctors do not take a more proactive stance through either education or testing. When I received my positive tests results, most of the information I received from my gyn was at odds with what I have read about preventing transmission.

If the frickin CDC would include it in testing, genital herpes would be viewed as common and not as a big deal, like oral herpes. I absolutely do believe that more people have genital herpes, than what the CDC states. The reason I do believe this, is because they tend to find 40% of cadavers have latent HSV 2 in the sacral ganglia and only 5% had knowledge or Medical records, being aware of the infection.

http://archneur.jamanetwork.com/mobile/article.aspx?articleid=795486

It's also my understanding that 25-30% of pregnant women have genital herpes and only 5% of those women are aware of their positive status. So yes, seems very common, even among younger women. And though I haven't seen studies for women over 50, I would assume the rates continue to increase with age. I wonder if there may even be greater risk of contracting herpes after menopause due to dryness.

I will admit, until being diagnosed and then researching all this myself, I was completely ignorant of all this. I had no idea so many people, especially women, were infected and asymptomatic. I was clueless about exact methods of transmission and the incomplete protection provided by condoms. I had no idea 80-90% of those infected with HSV-2 are unaware but infecting others in absence of symptoms.

I also didn't understand the implications of testing as an asymptomatic person who just wanted peace of mind. I am still in the acceptance phase of all this and sometimes struggle with the choice I made in that regard. I know it's for the best, but it also feels like a burden, given how relatively few positive people are aware of their status and how that (in my opinion) fuels the stigma. I hope to better come to terms with that choice in time.

@optimist, you only found out your status of recent correct? It's normal to feel emotional turmoil over this. That will pass. Just give it time. Hugs!

@2Legit2Quit Thank you. Yes. I'm sure I will better come to accept it with time. I'm a resilient person. For now, I'm still struggling a little and get confused about whether the true issue is the infection, knowledge of my status or the associated stigma. I'm someone who always thinks it's better to know more than less, so my own reaction has surprised me. I suppose it's a natural part of the grieving process and I just have to let myself get through that.

I also didn't understand the implications of testing as an asymptomatic person who just wanted peace of mind. I am still in the acceptance phase of all this and sometimes struggle with the choice I made in that regard. I know it's for the best, but it also feels like a burden, given how relatively few positive people are aware of their status and how that (in my opinion) fuels the stigma. I hope to better come to terms with that choice in time.

THIS is the reason that the CDC recommends not testing - because, in *their* world, the emotional toll is so high for those who test positive vs the reality of living with H for 99% of the population. *Most* people with H are either asymptomatic or have manageable symptoms (at least, once their body has the virus under control). So in the thinking of the CDC, the stress/depression/self loathing/etc that comes with diagnosis for someone who doesn't know they have it is not worth it when you look at the reality of living with it for most people.

Not that it makes it right - but it helps to understand their thinking.

@WCSDancer2010 I completely understand their thinking on that and that same type of thinking informed my opinion about whether my recent partner of very short duration should test (ultimately I left it up to him to decide and told him the results were his business). I'm conflicted about whether to ask asymptomatic partners unaware of their status to test in the future. If they're positive, great for our sex life, but then they are dealing with the diagnosis and I'm responsible for them having that knowledge which has positive (public health) and negative (psychological turmoil) consequences. I also think the lack of testing fuels the stigma that's responsible for the psychological turmoil associated with contracting this. So it's complicated.

I wonder if recent improvements in type specific testing and better accuracy of results will lead to HSV eventually being included in general STI panels. I hope so. But then who knows. Given the prevalence, some people who might otherwise test for Hep, HIV, etc., might chose not to test for anything at all, increasing rates of transmission of other STIs.

I think there are also concerns that 50+ million people in the U.S. will require counseling and demand Valtrex all at once and that would be unmanageable. It's more manageable to counsel symptomatic people and focus on relieving symptoms rather than transmission. But of course more Valtrex means less transmission and fewer symptomatic people, and greater awareness might mean less stigma and less need for counseling. So again...complicated.

Medicine is a very much a business. So, from my understanding genital H was made what it is (the stigma) so that they could sell valtrex. If that's so, you think they'd be jumping on the testing so that more people would be buying valtrex??

Also, if they did have more people aware of their positive status, more people would research it and see how common it is. The stigma would go away. The need for counseling wouldn't be. Just my two cents.

Well, it seems that they did a cost/benefit analysis and decided panicking the asymptomatic people by diagnosing them isn't worth the risk. It is amazing. The doctors are soooo relaxed abt this, I just cant believe it. My giver recently visited his doctor to get the test and I am told that his doctor was so relaxed abt this. He even told him that "Most of the population has one strain or another, it is really not a big deal." On the other hand I see their reasoning too. He (my giver) is so stressed abt this now even though he is not having any symptoms. He told me that "I feel dirty, unlovable and ashamed. How did this happened to ME?" I guess he is going through the emotional part right now and it is not easy to watch. He is completely depressed.

@janedoe

Can you direct him here... he needs support and a bit of a reality check..,

If you can't get him here, give him these links... they may help him to see he's FAR from alone ... he asks "Why is this happening to ME?"... ask him "Why not?" - 15-20% of people get it. Non monogamous sex is a crap shoot where you can up your odds of not getting a STD by using condoms, but fact of the matter is, it's kinda like putting snow tires on your car in the winter. You increase your safety, but that won't stop someone else from hitting you, and it won't help you if you hit black ice. Shit happens. Life isn't always fair. Sometimes ya gotta just deal with the hand you are given ... and I'll take this over that car accident any day... and yet we will all get in a car tomorrow and risk a potential injury that will make H look like a walk in the park 😛

http://projectaccept.org/who-gets-hsv/

Handouts + disclosure e-book:

https://www.herpesopportunity.com/lp/ebook

Herpes facts video

@WCSDancer2010 - I do like the http://projectaccept.org/who-gets-hsv/ link and want to point out that it states roughly 25% of men (and roughly half of women) are HSV2+ by their 50s. I think the statistic you cited (15-20%) is an average of currently infected 14-49 year olds. Some of those negative 14 year olds will ultimately be positive 49 year olds, so the "all ages" average does not correspond to the likelihood of contracting it in an individual's lifetime. And of course those numbers don't include those who are GHSV1+, nor do they factor in the fact that many people remain sexual active and prone to contracting STIs beyond the age of 50. The numbers continue to increase with age.