Most adults in the world carry the virus that causes herpes. Most of them don't know it. And the shame around it is doing more damage than the virus.
This week I sit down with Debbie Barish, DNP, MS, WHNP-BC — a board-certified women's health nurse practitioner with 32 years in sexual and reproductive health — for a no-shame, no-bullshit conversation about herpes (both HSV-1 and HSV-2). We get into what it actually is, how it's actually transmitted, why your standard STI panel doesn't test for it, what suppression therapy can (and can't) do, how to talk about it with a partner, and why this one virus carries so much more shame than other, often more serious, STIs.
I also share my own diagnosis story for the first time on the show.
We cover:
What HSV actually is — and the difference (or lack of one) between HSV-1 and HSV-2
Why most new genital herpes cases today are HSV-1
How transmission really happens, and why 70% of cases come from people who don't know they have it
Why HSV is not part of a standard STI panel — and the one situation where a blood test is actually useful
What a first outbreak feels like, and how to take care of yourself through it
Suppression therapy: how it works, how effective it is, what the side-effect profile actually looks like
Disclosure: when to tell a partner, how to say it, and what to do if they react badly
Why herpes carries the stigma it does — and where that stigma comes from
HSV in pregnancy
Debbie's own diagnosis story (including a 26-year-later reunion with the firefighter who gave it to her)
Resources mentioned:
If you're outside the US: Search for your country's national sexual health service. In the UK, Terrence Higgins Trust and the NHS herpes page. In Australia, Better Health Channel or Family Planning Australia. In Canada, Sex & U. Most public health systems have free or low-cost sexual health clinics — use them.
Find Debbie: @thenewdebbieb on Instagram — where she posts zines and art journals about sexual and reproductive health.
Citation for the transmission number: The 50% figure I give at the end of the episode is from Corey et al., 2004, New England Journal of Medicine — the landmark study on daily valacyclovir as suppression therapy for HSV-2 transmission. Read the study here.
Heads-up: This episode talks openly about shame, self-image after diagnosis, and mental health. If those topics are heavy for you right now, take care of yourself listening.
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