Reposted from the New York Times Health Blog

New York Times contributor Eric Sabo writes about genital herpes, “the largest epidemic no one wants to talk about.” Genital herpes spreads so easily because many people don’t realize they have an infection and typical safe sex practices, like wearing condoms, do not completely prevent spread of the virus.

Here are five things experts say you should know about protecting yourself against herpes:

  1. Avoid sexual contact during visible herpes outbreaks. The highest risk of transmitting herpes is during an outbreak. Herpes symptoms vary and are not always noticeable, but reddish sores and ulcers on the genital area are the main clues. Itching or pain around the groin may also indicate when an outbreak is occurring. A blister or fever sore along the mouth could signal a less dangerous form of herpes that can still spread to the genitals through oral sex.
  2. Consider a herpes test. While the Centers for Disease Control and Prevention does not recommend widespread screening for herpes, experts say that anyone who is concerned about the disease should consider getting tested. Even if there are no troublesome symptoms, knowing that you carry the virus can help you take precautions to prevent infecting others — who may suffer the ill effects. Telling an uninfected partner may also lower the risk of transmission. A blood test will determine whether you have one of two herpes virus types: HSV-2 or HSV-1. Herpes-2 is the main cause of genital flare-ups and is associated with more severe symptoms than herpes-1.
  3. Know how herpes spreads. You can catch herpes through oral sex or intercourse, as well as skin-to-skin contact where the virus sheds. This includes the genitals, inner thigh and anal region. “Skin-to-skin contact is as much as risk as intercourse,” says Dr. Anna Wald of the University of Washington. Herpes is still contagious when no symptoms are present (also known as herpes viral shedding). As a general rule, the area covered by boxer shorts is a potential transmission point.
  4. Use condoms wisely. Condoms can cut the risk of transmitting herpes by half. Since the virus sheds outside the vagina or anal area, experts advise wearing a condom during genital touching or foreplay. Even some protection is better than none. Those who wore condoms 25 percent of the time reduced their risk of transmitting herpes as well, one study found.
  5. Understand that herpes is not inevitable. Having herpes does not mean that you will eventually infect a long-term partner. Using condoms, avoiding sexual contact during outbreaks, and taking special medications can significantly reduce the risk of transmission. Relationships may be strained if one person has herpes, but it is not a lethal disease and any painful flare-ups typically subside in days, whether treated or not.