Foreword | p. vii |
Acknowledgments | p. ix |
Introduction | p. 1 |
The Top Ten Questions About Genital Herpes: Everything You Always Wanted to Know but Were Afraid to Ask | p. 5 |
The Herpes Family of Viruses: Getting to Know the Whole Clan | p. 11 |
Transmission: What You Wish You Had Known Sooner | p. 31 |
Diagnosis: Certainty Is the Starting Point | p. 45 |
Special Concerns for Women: Protecting Yourself and Your Baby | p. 69 |
Treatment and Vaccines: The Really Good News | p. 83 |
Telling Someone You Have Herpes | p. 107 |
Psychological Response to Genital Herpes: Getting Your Head on Straight | p. 133 |
HIV and HSV 2: Things Could Be More Complicated | p. 157 |
Other STIs: There Are More! | p. 161 |
Herpes Resources: Finding What You Need | p. 179 |
Reference List | p. 191 |
Index | p. 203 |
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Whew! Buying this book about herpes was abigstep! Good for you! Some of you purchased it on the Internet, knowing it would be shipped to you without a hint as to the content. Others found it in a bookstore. If you bought it in person, maybe you were hesitant about asking the clerk for titles on this subject. Did you buy a few other books at the same time so that this one "blended in"? Was it like buying condoms or tampons at the grocery store—maybe you also buy potato chips and a celebrity-gossip magazine so that such personal items aren’t as obvious?
Welcome to the much-misunderstood world of genital herpes! It’s a subject most people don’t feel comfortable with, no matter where they live or who they are. Thanks to recurring TV commercials, I think we now feel a bit more comfortable talking about things like erectile dysfunction and urinary frequency—and yes, even genital herpes. The number of people who have herpes surprises most everyone. There are more people with genital herpes than with erectile dysfunction and urinary frequencycombined. There are even more people with genital herpes than with either diabetes or high blood pressure! About one in every five adults in the United States has genital herpes (Xu et al. 2006). Amazingly, almost 90 percent of the people who have it don’t know they have it (Xu et al. 2006). So if youknowyou have herpes—and you or someone you care about probably does since you’re reading a book about it—you’re clearly the exception and not the rule.
Erectile dysfunction (ED), bladder problems, and herpes all involve that part of the body we tend to be nervous talking about—the mysterious area between waist and thigh. For most people, it’s quite a challenge to talk about genital problems. And that publicly held neurosis makes herpes a more difficult issue than just the medical condition itself. When you were first diagnosed, you may have wondered what the future would bring and worried about how the people around you would react. We can’t quickly change society’s negative notions about this problem. Hopefully, however, I can changeyourattitudes andyourlevel of knowledge about it. That’s what this book is all about: to make you more informed about this virus, to help you feel more empowered about having herpes, to give you more control over passing the infection to sex partners, to describe treatment options, and most importantly, to help you learn to accept and respect yourself or other people who have herpes.
Since 1982, I’ve run a private sexually transmitted infection (STI) clinic in Portland, Oregon. As you might imagine, very little about people’s sex lives and their genitalia surprises me anymore. This applies particularly to genital herpes. In addition to seeing thousands of STI patients every year, our clinic has run more than 120 research studies—most of them about oral or genital herpes—evaluating things like new treatments, new diagnostic tests, and new vaccines. Since 1999, I’ve also been the WebMD herpes resident expert, answering questions daily about herpes. (WebMD is the largest online source for medical information:www.WebMD.com.) These questions range from "How do I interpret these particular blood-test results?" to "Can my eight-year-old get herpes by digging through the laundry basket for his favorite T-shirt if my underwear is in there too?" Answering these questions every day keeps my finger on the pulse of the herpes world.
Last year I asked myself, "Where are these WebMD posters getting their information?" There was only a handful of books about herpes on the market. But compared to the number of publications on hypertension or diabetes, books on herpes were rare. That shortage of truly helpful books on the topic led me to write this one. I believe you need information that’s easy to understand but complex enough to satisfy your need to know the details.
In the first chapter, I’ll address the top ten questions people ask about genital herpes, offering a kind of late-night TV talk show summary about this infection, and I’ll tell you where in the book you can find more details on these questions.
In chapter 2, we’ll talk about the eight different herpes viruses that can infect humans. "Herpes" means genital herpes to most people, but the herpes simplex virus has seven siblings. I’ll give you all the scuttlebutt about this family called "Herpes."
Chapter 3 addresses the difficult topic of transmission to a sexual partner. If herpes weren’t infectious to other people through sex, there’d really be very little concern about it. But it is, so we’ll talk about the risks, the odds, and the ways to reduce the chances of giving herpes to a partner. We’ll also discuss how herpes impacts sexuality.
An accurate diagnosis of herpes is the foundation of everything that comes afterward. Yet, to use a football metaphor, this diagnosis gets "fumbled" more often than you’d think. Chapter 4 gives you a clear summary of the best diagnostic tools, their limitations, timing, uses, and cost, and we’ll have a good discussion about the misdiagnosis of genital herpes.
Women have special concerns about herpes: the risk of passing it to a baby during pregnancy, delivery, or both is scary, and so are the nasty rumors about a link with cervical cancer. We’ll discuss realities and dispel myths about these topics in chapter 5.
In chapter 6, we look at treatment options. Did you know that before 1982, there was no treatment available at all for herpes? Now there are three good drugs, with more on the way, and vaccines for both prevention and treatment are being studied. We’ll also touch on alternative treatments in this chapter.
Are you nervous about the prospective of telling a future partner that you have genital herpes? Well, join the group and get information about how to handle that challenging task in chapter 7. I’ve got some really good tips for talking about herpes successfully.
In chapter 8, we’ll discuss the emotional, psychological, and relationship concerns associated with genital herpes: the sick feeling in the pit of your stomach when you first hear the diagnosis, the bad jokes, and the emotions that may follow, such as guilt, shame, loss, isolation, and, finally, acceptance.
Chapter 9 will tackle the relationship between HIV and HSV 2. If both viruses exist in the same person, they make each other more troublesome; I’ll tell you why and how.
Since herpes isn’t the only STI around, in chapter 10 we’ll review the other STIs commonly found in the United States.
And finally, in chapter 11, I share some resources for learning more about herpes so that you can stay current on the topic.
This isn’t a science book; it’s a people book. I’ll give you clear and accurate facts, but I’ll also address your feelings. This is a book that I hope you’ll refer back to regularly over the years. You can give it to potential partners after you’ve had "the talk" so that they have accurate information on which to base the decision of whether to make sex a part of your relationship. And you can even give this little volume to family members if you decide to tell them you have herpes, so they’ll know you’re really going to be okay.
This is a casual and friendly book. Like most people, I learn things best when facts are presented in easy-to-understand terms with lots of examples. When I was in school, I used to wonder, "Why do they use the term ‘erythema’ when they mean ‘red’? Why say ‘edema’ for ‘swollen’? Why do we use ‘fissure’ when ‘skin crack’ will do?" For me, the simple terms are always best when learning about an unfamiliar subject. Technical medical words can even put distance between medical professionals and their patients. But in this book, I hope you feel as if we’re sitting somewhere discussing this together. I hope this book is a personal experience for you and a resource you can use whenever you need reassurance, comfort, or just more information.
When you finish this book, you’ll know more about herpes than you did before—or may have ever wanted to know! And you’ll have the tools necessary to find more information if you need it. I’ll be right there with you in spirit as you study these chapters. If I could sit next to you and answer your questions or hold your hand if you get sad or anxious, I would. But, short of that, I know that reading this book will help you live better with genital herpes.