I'm Paranoid About Catching Herpes! What's the Difference Between Oral and Genital?

Dear Couch,

Ok, here's the deal: I've read that most of the US population gets cold sores, which are a variant of the herpes virus. And from what information I've been able to glean, the virus is easily transmitted via activities such as kissing, or oral sex. And that once the 'oral' herpes virus gets in the genital area, it can become genital herpes. I'm just wondering if all that is true, and if so, how can everyone be so cavalier about kissing others, or giving/receiving oral sex? Or am I just paranoid? I can't help but be nervous about kissing people, for fear of contracting cold sores (herpes virus), or somehow, in the course of things, contracting genital herpes. Any thoughts? I hope I'm misinformed.


Dear Scared One,

You're at least partially right. The Herpes virus comes in two most common flavors: type I and type II. Type I is the virus that causes the common oral sores, and type II most commonly the genital form. One type can't change into the other, but if you go down on your partner that has genital herpes, you can get type II around your mouth, and vice versa. That's the reason that between 50 and 80 of sexually active people have been infected with one of them. Just another reason to use CONDOMS...

But let's not run out for that can of liquid latex too soon. Herpes is only contagious when there is an active breakout, a sore or a few days before. Millions of people who are aware they carry the Herpes virus have unprotected sex for years at a time, knowing they're not able to pass on the virus. Breakouts are often few and far between in most people and if they're the responsible type they know when a breakout is there or coming on and abstain from any sexual/kissing contact. Are there those that don't know or don't care? Yes! Is it possible you could end up getting picked up by a Ricky Martin look alike that happens to be one of those people? Yes! Should you run around being paranoid that anyone you're attracted to is Typhoid Mary? No!

[edited in 2006 to add] In reality one type is just as easily transmitted to their site of preference, and can be spread to other locations as well. Both types are most contagious during active outbreaks, however they can be transmitted during times of viral shedding, when no symptoms of an outbreak are present. HSV-1 is shed into the saliva and is likely coming from the mucosa inside the mouth and on the lips, approximately 18 of the days on average, of asymptomatic days, in the person who has intermittent cold sores, when measured by PCR. To date there is no way of possibly knowing when shedding is occurring without the constant supervision of trained researchers.

Get a grip on yourself! Sex is currently about as dangerous as driving a car. Sure you could have a wreck at any time driving so what do you do just in case? You wear your frigging seatbelt right!?! So take the same type of care if you're going to ' futz' , use a frigging condom! If you want to be really uptight about it, use a dental dam for cunnilingus. Of course it goes without saying you should avoid sexual contact/kissing with someone sporting an obvious sore on their mouth or genitals. If you end up in what appears to be moving towards a monogamous relationship then get some STD tests. Then you can both toss the latex, assuming you use another form of birth control, and get that clean skin to clean skin contact!

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