Sexual Health Guide: Genital Herpes Management & Prevention

Genital herpes (HSV) affects 1 in 6 adults globally. While incurable, modern treatments can reduce outbreaks by up to 80% and transmission risk by ~50%. This guide covers antiviral therapies, prevention strategies, and lifestyle management to support long-term sexual health.

Herpes 101: Causes & Transmission

• HSV-1: Causes 50% of new genital cases (often via oral sex)
• HSV-2: Primary genital strain (spread through skin-to-skin contact)

Key Facts:

• Spread through asymptomatic shedding (accounts for 70% of transmissions)
• Condoms reduce risk but do not eliminate it
• NOT spread via towels, toilet seats, or casual contact

Symptom Stages & Diagnosis

Initial Outbreak (2–20 days post-exposure):

• Flu-like symptoms (fever, headache)
• Painful blisters/ulcers on genitals or anus
• Swollen lymph nodes

Recurrences:

• Tingling/itching prodrome before sores
• Milder lesions that heal within 3–7 days

Diagnosis:

• PCR swab (active outbreak testing)
• IgG blood test (for asymptomatic screening)

Antiviral Treatment Options

Oral Prescription Medications

Topical Agents

Key Differences: Valacyclovir has ~55% better absorption than acyclovir. Brand vs. generic (Valtrex® = Valacyclovir) are clinically identical.

Treatment Strategies

1. Episodic Therapy: Start antivirals within 24h of tingling shortens outbreaks by ~50%.
2. Suppressive Therapy: For patients with =6 outbreaks/year or discordant couples. Reduces transmission by ~48%.
3. Severe Cases: IV acyclovir in hospital settings.

Prevention & Partner Protection

• Daily Antivirals: Reduce shedding days by 70%
• Condoms: Cut female-to-male transmission risk by 65%
• Disclosure: Discuss before intimacy and abstain during outbreaks
• Vaccines in Trial: 2025 mRNA vaccines show 90% efficacy (Phase 2)

Note: Doxy PEP prevents bacterial STIs (chlamydia, gonorrhea, syphilis) but not herpes.

Outbreak Management Toolkit

• Pain Relief: Lidocaine 4% gel applied to sores
• Healing: Cool compresses + loose cotton clothing
• Avoid: Fragranced soaps, sexual contact until healed
• Stress Control: Daily 30-min meditation reduces recurrence risk

Living Fully with Herpes

“HSV is a manageable skin condition – not a life sentence. With modern antivirals, most people have fewer than 2 outbreaks per year and maintain vibrant sex lives.”
– Dr. Elena Rodriguez, STI Specialist

Support Resources

• ASHAA Helpline
• HSV Discordant Couples Guide