Genital herpes (HSV)

What it is. Genital herpes is a very common, lifelong skin infection caused by the herpes simplex virus (HSV). It is nothing to be ashamed of — a large share of adults carry it, and most people who have it don't know, because it stays quiet most of the time.

How you'd know. Some people get blisters or small sores on or around the genitals or back passage, sometimes with tingling, itching, or a first-time "flu-ish" feeling. Many people have very mild symptoms or none at all. The virus can also be passed on when there are no sores ("shedding"), which is why it spreads so easily and why it isn't anyone's "fault."

How it's tested. The best test is a swab taken directly from a sore while you have one. There is no blood test we recommend for people without symptoms — a routine "herpes blood test" causes far more worry than it helps, so we don't screen for it.

Is it curable? It can't be cured, but it is very manageable. Medicine shortens outbreaks and can prevent them. For most people, outbreaks get milder and less frequent over the years.

Treatment. Antiviral tablets (like valacyclovir) can be taken for a few days when an outbreak starts (episodic), or every day to prevent outbreaks and lower the chance of passing it to a partner (suppressive). Your provider will help you choose.

What about partners and pregnancy? Condoms lower the risk but don't remove it completely, because of shedding. Tell partners so they can make informed choices — this is caring, not scary. If you are pregnant, tell your provider: herpes can rarely affect a newborn, so we may offer daily antivirals near the end of pregnancy and, if there are active sores at delivery, a C-section to protect the baby.