Worldwide rates of either HSV-1 or HSV-2 are between 60% and 95% in adults. HSV-1 is usually acquired during childhood. Rates of both increase as people age. Rates of HSV-1 are between 70% and 80% in populations of low socioeconomic status and 40% to 60% in populations of improved socioeconomic status. An estimated 536 million people worldwide (16% of the population) were infected with HSV-2 as of 2003 with greater rates among women and those in the developing world. Most people with HSV-2 do not realize that they are infected. The name is from Greek: ἕρπης herpēs which means "to creep", referring to spreading blisters. The name does not refer to latency.
The broader issue is whether, if you do get infected, herpes will ultimately harm your health. Although I don’t want to trivialize this infection, in your general scheme of health, it probably will not. The major concern is that if you are pregnant and develop a new outbreak of herpes, the virus can be transmitted to the fetus, especially during vaginal delivery. What’s more, people with genital herpes have a much greater risk of acquiring HIV if they are exposed. (It’s theorized that the lesion causes microscopic breaks in the skin, allowing HIV to enter the body.)
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Genital herpes is passed on by skin-to-skin contact during vaginal, oral or anal sex, or by sharing sex toys. You can get genital herpes even if there are no visible sores or blisters, and once you have the virus, there is no cure. 'Herpes is more likely to be passed on just before, during or straight after an outbreak, as herpes blisters and sores are highly infectious,' says O’Sullivan.
Doctors prescribe suppressive treatment if a person experiences more than six recurrences in a year. In some cases, a doctor my recommend that the individual takes daily antiviral treatment indefinitely. The aim here is to prevent further recurrences. Although suppressive treatment significantly reduces the risk of passing HSV to a partner, there is still a risk.
You may have concerns about how genital herpes will impact your overall health, sex life, and relationships. It is best for you to talk to a health care provider about those concerns, but it also is important to recognize that while herpes is not curable, it can be managed with medication. Daily suppressive therapy (i.e., daily use of antiviral medication) for herpes can also lower your risk of spreading genital herpes to your sex partner. Be sure to discuss treatment options with your healthcare provider. Since a genital herpes diagnosis may affect how you will feel about current or future sexual relationships, it is important to understand how to talk to sexual partners about STDsExternal.
A doctor will base a presumptive diagnosis on information provided by the patient and on the physical examination. The characteristic appearance of the herpes sores leaves little doubt about the diagnosis, so the typical appearance of the sores is key to the diagnosis. This appearance helps distinguish oral herpes from oral thrush, shingles, gonorrhea, and syphilis. In addition, chapped or sunburned lips can resemble oral herpes, but the tissue stain (Tzanck smear, see below) shows no virus-induced cell changes. Further testing is usually not necessary but is sometimes done.