Hello PAGuy,

Thank you for your request for pictures and clarification question. Yes, it is possible to have just one bump in an outbreak. Typically these singular blisters are “cold sores” which are typically from the HSV-1 virus on the mouth. It is important to remember that Herpes is an evolving STI. A few decades ago HSV-1 was oral herpes and HSV-2 was genital herpes. Now the two have crossed over and either can infect the genitals or the mouth, so there are a variety of outbreak numbers and appearances.

Here is a link to a medical journal article that was sent to me by a friend who is in the medical health field. It goes into WAY more detail about the Medical perspective of Herpes than this blog does, so it might be helpful for some of you who want a little more information about Herpes. If you don’ t want to read the entire article, I still think you should look at the pictures. There are 4 great pictures that show various appearances that Herpes outbreaks can have. But I have to warn you; these are graphic images of real human bodies.

http://www.aafp.org/afp/20051015/1527.html

Your Loving Sex-pert,

Emily

Eao2116@columbia.edu

Well, the problem with most STIs is that they are not easily detected by observation. If someone you are about to be with has an outbreak (bumps on their genitals, mouth, thighs, or anus) then obviously that is a sign to say “Hold on”. But, if there are no obvious signs, that is where it gets tricky. I like to believe that everyone will respect their potential partners enough to tell them whether or not they have something that is contagious. Unfortunately, not everyone is willing to be THAT honest. It probably has something to do with fearing rejection or just wanting to get laid, no matter what the cost for their partner. So here is where Human Intimacy comes into play. You need to develop a close enough bond with a potential partner so that when the topic of STI’s comes up (and it should) then honesty is probably going to be what you get out of the conversation.

Another way that you might be able to gauge your STI risk with a partner is by how many people they have been with and whether or not they use protection every time and during the entire time. If you ask your potential partner, “So, how many people have you been with?” and they say, “Um, I don’t know, a few,” that is a red flag because the more partners a person has, the more likely they are to have an STI. Especially if each one of those partners was not significant enough to remember!

It will also help you to stay STI free if you insist on using protection for the entire duration of any sexual activity. As great as honest communication is, it is very difficult to determine if someone is REALLY telling the truth, or just telling you what they think you want to hear. People have their reasons why they do or don’t tell their partners everything, so the bottom line is just to be careful. Try to get to know the person (and their sexual history) as best you can before you two start having a sexual relationship of your own. And use protection just incase your partner “forgot” a partner or two. ☺

As far as rejecting someone goes, that really depends on the situation and your communication style. You can say goodbye and run, have a long conversation with the person about why you are rejecting them, or something in between. That really depends on your preferences. As you can probably tell, I would want to list the hundreds of ways in which that person is not worth risking the health of my body. But that’s just me. ☺ There are some great PSAs about condom use and rejecting sex on the MTV website that might help to give you some ideas. Go to www.mtv.com and search “Sex PSA”. A bunch will come up, but I recommend watching “The Speech”, “One of Those Guys”, and “The Rollercoaster”. Each of these approach the epic question, “To protect, or not to protect” in very different, yet effective ways. Enjoy and I hope you get an idea or two about how you can address the issue of saying “NOPE” if/when the time comes.

Thank you for this follow-up question, BiggerLilSista! I’m sure you are not the only one who was wondering about these issues. Is there anyone else out there who could share an experience or idea about how to reject someone? That would be helpful for all of us! Thanks again and keep the communication going!

Your Loving Sex-pert,

Emily

eao2116@columbia.edu

Thanks for submitting these questions! I will list each one of them with an answer below.

How is it contracted?

Herpes is spread by sexual intercourse, anal intercourse, hand-to-genital contact, and by oral-genital sex. You are also at a moderate risk of getting Herpes if you share sex toys and make-out with someone who is infected. You can get Herpes from someone who isn’t experiencing an outbreak. In fact, most people who have Herpes are asymptomatic (they don’t have outbreaks). But don’t be fooled! You can still contract Herpes from someone who is A-symptomatic!

Herpes can be contracted in many different ways. This virus is very contagious, so basically any sexual activity that goes near mucus membranes is increasing the chances that Herpes will be passed between partners if one partner has it.

Are oral and genital herpes the same thing?

There are actually 2 strains of Herpes, HSV-1 (cold sores) and HSV-2 (genital herpes). These strains used to be different, but they are actually interchangeable now.
HSV-2 is different than HSV-1 infections for a number of reasons. One big risk with HSV-2 is that it can be passed from mother to child during childbirth. If a baby contracts Herpes from their mother, it is possible for them to die from brain infections.

Can you pass oral herpes through genital contact?

YES! You can definitely pass oral herpes through genital contact (ie. giving oral sex) or vice versa. Like I said before, there are 2 types of Herpes strains and at this point in human history, they are interchangeable when it comes to areas they can (and do) infect.

If you give oral sex to a male or female, you are at a high risk of contracting Herpes from them if they have it. If you have cuts in your mouth from sores or flossing (yes, FLOSSING), then you are putting yourself at even GREATER risk of getting Herpes from an infected partner.

So, what’s the solution for protecting yourself? Latex! Use condoms, latex gloves (for hand to genital contact), and/or dental dams if you are performing oral sex on someone, especially if you don’t know their ENTIRE sexual history and their latest STI test results. Seriously, how many of you ask your Saturday night hook-up when the last time they were tested was? In my opinion, you SHOULD have that conversation. ☺ Condoms and Dental Dams even come in various flavors so you don’t have that rubber glove taste in your mouth. Use protection because it is better to be safe than sorry, especially for Herpes because there is no cure for it (or any virus) at this point.

What does the virus look like?

The outbreak bumps are little bumps or blisters that appear on the outside of the genitals. Now don’t confuse these bumps with Genital warts. If the bumps have a raise, cauliflower shape about the size of a pea, that is more likely to be genital warts. Herpes it outbreaks are blisters, not warts. Either way, if you see any sort of bumps or blisters on your genitals, have them checked out by a doctor!

But remember, these bumps are not constantly there. Herpes outbreaks are called outbreaks for a reason. Think of it like zits. You don’t always have a zit on your forehead, but the possibility is always there that one will pop up sometime in the future.

Can you see it on the inside or outside of the mouth?

Both! Cold sores can be seen on the outside of the mouth around or on the lips. The Herpes blisters can also appear on the inside of the mouth. But remember, Herpes comes in outbreaks, so you might not see any blisters at all or the blisters are tucked away in a part of the mouth that can’t be seen.

Can you get herpes from making-out with someone who has it?

Yes, you can get Herpes from making out. The good news is that this puts you at moderate risk of contracting it. Remember, you put yourself at a higher risk of getting infected if you have cuts in your mouth or if your partner is having an outbreak. Clearly, if someone has an outbreak you can get Herpes.

The bottom line is that by the time young people today are 25, it is estimated by the CDC that ½, yes HALF of them will have contracted AT LEAST one STI. Just keep in mind that if you have contracted one STI (especially Herpes), then you are at a greater risk of getting another one or two or more. So just be careful. Protection is a cheap and easy way to keep unwanted infections away from your favorite body parts. ☺

Your Loving Sex-pert,

Emily

eao2116@columbia.edu