What Everyone Gets Wrong About Herpes
S1: Warning this podcast contains explicit language.
S2: Hi, I’m Stoya. I’m a writer and former pornographer,
S1: and I’m Rich Juzwiak. I’m a writer.
S2: Welcome to the How to Do It podcast, where we try to help you with all of your sex and relationship issues twice a week. You can ask us anything about sex or your bodies or dating etiquette or whatever. We’re here to help.
S1: Jessica Stoya Have you ever been shamed for anything that you are quote supposed to you enjoy, but in fact do not sexually? I mean,
S2: so I have a very sensitive nose. And there was a time where someone I was seeing had a body part that had a smell, and I did not like that smell. And someone else who was around was like, Oh my God, but I love the smell. And I was like, I do not. And they were like, You’re king shaming me. It got to me, and I was like, Was they being rude about this? Like, today overstep? I don’t think it did.
S1: It doesn’t sound like you did. You’re allowed to not like things, and that has absolutely nothing to do with someone else’s liking of them unless you make it. And it doesn’t sound like you were. Yeah, isn’t like the first lesson of King. The panoply of things there are to like and not like. As somebody who is kinky, I would assume you understand what it is to have that very particular taste, which requires not having a taste for other stuff. You know, that’s what taste is. You like and you don’t like. One thing that I feel like I’m supposed to like that I don’t like as much is kind of roughness and disconnectedness that I think has become eroticized, you know, probably through gay porn, which often, for whatever reason, takes place in a dungeon, even if there’s no S&M happening for a really long time. Gay porn was presented as a horror. I think in the wake of HIV especially, I mean, a lot of the Treasure Island media videos, which were incredibly ahead of their time for presenting condomless sex, which in many parts is now the norm, both on and off screen. Those videos have kind of like a bloody not literally, but like in terms of the font and aesthetic. It feels like a saw movie almost, you know. So I think that there is this aggression thing that a lot of people think goes with men having sex with men like ramming. Slapping like this has to be painful in order for it to feel good, and I just think it can feel good.
S2: When I was younger, I would come in really rough with people with penises because that’s what I was used to. And the first couple of times that someone started teaching me like, not all men want to feel like they’re being sanded with sandpaper or like having the air squeezed out of them, you know, like a pool. Floaty time to go at the end of the day at the beach, the first couple of times I responded really poorly. And there was some element of like, What kind of man are you? This is how men like to be touched. So, you know, it’s a thing that’s complex, that’s actually deeply pervasive and that I’ve been on the giving end of myself.
S1: Yeah, I think that, you know, you bring whatever experience you’ve accrued to whatever interaction you have, but something that’s very useful as a concept to wrap your head around is that should doesn’t really exist in the moment. There only is what is, of course, there are standards. There are certain rules that you know, need to be in place in order for an interaction to be consensual and ethical. But there’s a lot of gray area stuff of like how one should act or should present themselves or what they should like because you’re a man, because you’re a gay man, because you’re a woman, because you’re whatever. You throw that out the window, you have the interaction with somebody. And from that comes the chemistry. From that comes the connection. And it really, really is all about the connection to me. So that has to do with our second question, but let’s hear our first
S3: do you how to do it? I am a divorced 45 year old woman, and I recently started dating and sleeping with a divorced 50 year old man. We like each other a lot, and I am hopeful and optimistic that it will grow into something more long term. I have Herpes, which I disclosed. I told him that other than it’s humiliating to disclose it to new partners. It has no real impact on my life and that breakouts are few and very far between. And just not that bad when they come. I also told him that I would take an antiviral, which lowers the risk of transmission, and that if we used condoms, the risk of transmission was reasonably low. He spoke to his own doctor, who told him basically the same stuff. So why am I writing to you? He doesn’t want to have oral sex? Either way, it seems I accept his boundary and certainly we can work around it. But can I ask if there is any more likelihood of getting herpes from oral sex than from kissing in plain old intercourse signed cautious lover?
S1: Herpes rears its head again. People are obsessed with Herpes. We get so many Herpes questions, and if this appeared anywhere else, I would be referring to it. But there is an amazing slate piece from 2019 called how Herpes Became a sexual boogeyman, how this was largely a media invention. So I think that there was a huge push from that angle and also the fact that like Herpes is theoretically forever or that people may experience outbreaks throughout their life. I think those two things combined created this, you know, boogeyman idea. This idea that Herpes is this thing to fear. And look, it’s completely reasonable to not want to be infected with something with anything, you know? But at the same time, I think we get a disproportionate amount of Herpes questions that don’t necessarily contend with the actual mildness of Herpes in many cases.
S2: So I have a story, please. First, I had what felt like, you know, a pimple or like one ingrown hair on the crease between my thigh and my labia. And I was like, Gosh, it’s annoying. And then the next day there were like three and it was like, Oh, no. Did like a bug? Bite me. And then the following day, poof, it started in my crotch and it rapped over the hip. And then like up around the back to kind of like the dimple above the butt. And it was just all these like horrible sores, and they were very painful. And I was like, Oh man, I got to go to the urgent care and I go in and they’re like, You have shingles. And I’m like, Do you want to run a test because I’m a sex worker? And they’re like, Oh, well, then you have herpes. So they take a swab and they take some blood. Then they give me Valtrex because they’re like, whatever it is, you take Valtrex for it and get home. And I’m like, No, I want to see my normal doctor. All right. So go the normal doctor like a day or two later. He’s like, It doesn’t matter. You take the Valtrex until it goes away. That still wasn’t enough for me. And so I went to this like, highly recommended dermatologist. She also is like, It does not matter. You take Valtrex. You move on with your life. It turns out all four of the tests came back. I had shingles, but every step of the way all these medical people are like, it does not matter, right? Either way. It is a herpes virus that lives in your butt, like whether it’s Epstein-Barr or shingles or chickenpox or like, it’s all. It’s just one kind of virus. It lives in your body. It doesn’t matter if you got it from sex or you got it from stress because you had chickenpox when you were a kid. It’s the same thing. Calm down. This holds more weight now because we have COVID. But prior to that, the advice they would have or the contacts they would have given is like, you know, you go outside, you share air with people, right? They might have a cold 100 percent. It may turn out to be really gnarly, and they put you on your butt for a week and a half. And that’s a risk that you take. It’s a medical risk that you take as part of social interaction.
S1: And you know, you could ride the subway and catch that cold and get riding. The subway is stigmatized. We don’t talk about like how slutty you are for transferring so many trains, you know? But nonetheless, these Herpes questions persist. And so I reached out to an STD expert, H. Hunter Hands Field, who’s a professor emeritus of medicine at University of Washington, chiefly in the Center for AIDS and STD. You know, just to kind of pick through this stuff, I was really curious about like a what an expert has to say about what the actual risks of Herpes are like. What is the worst thing about Herpes from an epidemiological standpoint? And what I thought was really interesting about that is that he said it was actually the association with AIDS transmission, especially in places like sub-Saharan Africa. There’s just a bigger chance, per the data, at least in terms of correlation, that HIV will transmit if there is already the existence of Herpes. So that’s something to think about and consider. The other thing that we have to consider and we don’t know which simplex our letter writer has, but if we’re assuming that they have HSV two in their genitals, the throat is not hospitable to it. You find it very rare or rare enough that people have HSV two in their in their mouth throat. It happens, but that’s to say that transmission is at a lowered risk, which. Kind of renders the particular issue in this question kind of irrelevant or at least their partner’s reaction irrational. So let’s take a listen to my discussion with Dr H. Hunter Hans Field. We got a lot of questions about Herpes, and there’s a palpable anxiety that comes from a lot of our writers. I wonder if it’s possible to broadly say how anxious or scared of Herpes should people be?
S4: Well, should they be versus are they? There’s an elevated level of stigma that is to some extent out of proportion with the clinical severity that most people experience. And that’s one of the big deals. Is this stigmatizing and fear aspects? One point that’s worth making whenever it comes up is that it’s very important if someone has you on a Herpes for them to know and for their providers to know whether it’s caused by HSV one or two. Those are two separate viruses. The numbers Herpes one and Herpes to refer to the virus and not the anatomic area involved. So you shouldn’t use the term HSV two or herpes type two to refer to genital herpes. It refers to the virus, which can affect the oral area as well as Joe. But HSV one genital infection typically has few recurrences and is rarely, if ever, sexually transmitted, the partners. Almost everybody who gets genital HSV one acquires it by oral sex because it’s a common cause of oral herpes and not by vaginal or anal intercourse, whereas HSV two is readily spread nearly exclusively spread by genital, genital or a gentle anal contact.
S1: Okay, so let’s dig into this question. What would be the best way for you to attack this?
S4: Well, from a scientific perspective, HSV two doesn’t take very well to the oral cavity, so even exposure is probably less risky than is genital to genital transmission. So from that standpoint, there’s her partner’s reticence about oral sex is perhaps not as important as he would assume. Secondly, with her taking A. Herpes treatment, the likelihood that she will be infectious if in addition to taking the drug, if she’s avoiding sexual exposure, when she’s having symptoms that suggest she’s having an outbreak, his chance of getting it is going to be very, very slow. And I would point out the data even for genital the genital transmission, which is the main risk if a partner is not on treatment, the couple is not using condoms and they’re just having sex whenever. And the only avoidance is if I have an outbreak, I want to have sex. The average transmission risk probably is one in a thousand for each episode of sexual intercourse. Wow. Which means at the rate that most people have sex, it’s often many years the couples who are discordant for HSV two never transmit. People tend to assume if I’m exposed to somebody with STI X, there’s no way I can have sex without catching it. And in fact, all STIs are transmitted with relatively limited efficiency and asymptomatic. HSV two appears to be transmitted an average of somewhere in the ballpark of once. For every 1000 episodes of that litter course, it’s going to be probably tenfold less than that for oral exposure. So even without her taking antiviral therapy, just avoiding contact when she’s having a perceptible outbreak. This guy’s probably never going to get it, at least not through oral sex. He’s a much greater risk. He’s always going to be at greater risk from having vaginal sex or anal sex with her than he is from performing cunnilingus on her. By the way, in her transmission to him by oral sex is also nil. The large majority of who HSV two generally don’t have an orderly. And even if they do the transmission efficiency from someone who happens to have an oral HSV to infection to a partner exposed by intellectual Stoya, you are kind of like this is extremely low. We don’t have conclusive data to put a detailed number on it, but it’s probably in the order of one chance in many, many thousand for each episode in the absence of an overt outbreak.
S1: Is this story different at all if she has HSV one in her genitals?
S4: Well, yes, there’s even lesser transmission risk if you talk to people who are immersed in Herpes and spend their careers taking care of patients, they say they’ve never seen a case of general HSV one that appeared to have been acquired by vaginal or anal sex. Every case of genital HSV one seems to have been acquired by oral sex, and that’s because, unlike HSV two number one outbreak frequency of general, HSV one is low. There are few people who will have an outbreak a few times a year, but probably under 10 percent of infected people. Most people will get genital agency one 40 percent, according to research. Have no recurrences at all in the next two to three years, and another 40 percent have one or two recurrences in the next two or three years and then none, as opposed to an average outbreak frequency of six to eight times per year for people with symptomatic. HSV two, so this is one of the reasons the HTC One generally is less stigmatizing if her genital herpes is HSV one, then statistically there’s a greater chance. She also has oral infection. But again, asymptomatic shedding of the virus that is in the absence of symptoms is far less common both orally and Jolie. For HSV one, that is eight. Yes, we do. So the transmission risk is correspondingly lower.
S1: So this is a case of the writer’s partner just being completely irrational and not understanding the science.
S4: Oh, I wouldn’t argue completely irrational is too strong a term. I mean, he’s got a legitimate concerns. He doesn’t want to be infected. And I can certainly understand that. But I don’t really understand his reticence about oral sex. Assuming that they are having vaginal intercourse were able. The odds are statistically that he could have a lifelong sexual relationship with this woman with daily sexual exposure. He’d probably never get it orally and would always have some small chance of giving it generally.
S1: So we have to make an assumption here about what herpes simplex we’re talking about, it seems rational to go with two. I think the biggest takeaway is that it is far easier to transmit HSV two via intercourse than it is oral sex. And so the partner’s thinking is just entirely backwards here. And personally, I’m glad to get this information to understand it because I think Herpes is that boogeyman and what powers the boogeyman fear of the unknown. The boogeyman is scary because you don’t face off with him because he’s the monster in your closet. Opening the closet, taking a look at the boogeyman. Understanding him, I think, is really useful. And I think then he becomes a lot less scary. So I was happy to have that conversation and to get to the bottom of some of this stuff.
S2: Why not use a condom and a dental dam for oral?
S1: I mean, do you, though I don’t know to me, like that is particularly unappealing, I guess, because I don’t have HSV to risk that I know of in my life. So I never even think to do it, really. But just in general, I’d kind of rather not suck addict and suck my dick with the condom on.
S2: I have sucked eggs with condom on when there was a reason and it was it was really fine. Not preferred, but dental dams actually have an interesting sensation to them. Oh, which can be cool for the receiver? Not necessarily cool for the giver, but like he’s the one who’s uncomfortable, so he may be more open to like latex in or do this activity without risking oral exposure to him.
S1: Yes. Yeah.
S2: Personally, I’ve made my choices. I am OK with them having had shingles all the way around to my spine. I’m just not sure that I’m not afraid of herpes simplex.
S1: He conquered the mountains.
S2: That was pretty awful. Something I’ve seen I’ve seen pictures of like standard Herpes outbreaks on genitals, and I don’t want it. But it doesn’t terrify me. Yeah. So to sum it up. Accepting his boundary, which you’re doing, is great. You could look into barriers for oral sex if that seems tolerable. And you know, I’d have your partner listen to the expert here and see if that helps assuage any of his fears.
S1: OK, let’s listen to our next letter.
S5: Dear, how to do it. I’m a 25 year old guy who has been hooking up with a 26 year old girl for the past few weeks. We were having sex in my bed last week when suddenly there was liquid everywhere. I was really taken aback and not in a good way because it looked smelled and had the consistency of urine. She seemed to be disappointed in my reaction to it, but I tried to play it cool even though the fluid was soaking into my mattress. Later, she asked me if something was wrong, and I said if someone wanted to do piss play, they should talk about it beforehand. She got really offended and said she wasn’t peeing. She was squirting, and most guys are really into it. She never had a negative reaction before. I didn’t want to seem like I was questioning her experience with her own body, so I didn’t argue. I just apologized for the misunderstanding and cut the date short. I haven’t heard from her and honestly don’t plan to see her again. The thing that really gets me is I am actually kind of interested in golden showers and would be willing to try it. But like I said, it should have been discussed first and then I would say I prefer to do it in the shower or outdoors. My mattress smells and I can’t afford a new one, so I’m kind of irritated about that. Plus, I keep questioning it because I told one of my male friends about it. And he said he thought girl squirting was super hot and kind of implied. I was weird for how I reacted. Was I wrong and how I responded to this signed pissed off?
S2: So when a deal with the practical stuff first, OK, which is the scientific jury is still conflicted. Yeah. Regardless of whether the fluid that comes out of the vulva is pee or ejaculate, it’s still going to do things to your mattress so you can get mattress covers or sex throws. It’s not going to fix the mattress situation now, but in the future, protect your mattress. Right? Because it’s still liquid. Sometimes this happens, and it’s one small thing you can do to prevent a lot of hassle and frustration later.
S1: And to that point, I think that the partner, if aware that she squirts which she is because she says she never got negative feedback before on it, maybe give a heads up ahead of time, especially if it’s a stranger you know somebody that you’ve never had sex with before. Hey, I squirt. What do you want to do about that?
S2: Yeah. You know, I know not everyone is as comfortable talking bluntly about sex as someone who does for a living. But I don’t squirt often, and I usually have plenty of warning. So I can in the moment be like, this might happen. I can also like choose not to largely which I usually choose to do, because who wants to deal with laundry? You know, I don’t want to get up in the middle of the night and change the sheets and go back to bed. And I don’t I don’t think that’s like a rare thing. I think most people with Volvos who do squirt have some idea of when it’s coming and the ability to say, like, Oh, let’s not do this. So even if you’re not comfortable, like in the middle of the first date being like, Oh, and by the way, squirt, by the time you’re doing things where you might squirt. I think you ought to be able to also communicate that you might. So she she should have said something then. Yeah, they could have had this like positive experience doing something new for the letter writer.
S1: Yeah. You just don’t want to spring your score on someone. I think because it could backfire, which it did. Right? Like, I mean, it could be a wonderful surprise. A lot of people are super super into it. Also, people are protective of their mattresses,
S2: and this also is like gender equity. Right? If someone who ejaculate semen came on me out of the blue, I would be like, Excuse me? Right?
S2: And I wouldn’t necessarily be upset, but it would be really great. What you didn’t?
S1: Yeah, I mean, in general, I’m less particular about this sort of thing. But I think even if you’re having, let’s say, condomless sex with somebody and you’re topping, you should probably just make sure that you can ejaculate into them. It’s implied. But then again, there are people who have, you know, responses to that. I think you just like, give it a heads up. I’m going to come. Where do you want it? You know, and that is something that people go into and intercourse experience expecting. Oh, the person with a penis will ejaculate, you know?
S2: Yes. Yeah. I don’t think we’re seeing anything groundbreaking or scandalous by stating that a heads up that you’re going to come is expected. These are people who ejaculate semen. So for people who ejaculate something else? Give a heads up. Exactly. It’s basic etiquette. I feel like that’s acceptable.
S1: Yes. I think that our letter writer cutting the date. Sure, it could be seen as shaming. I don’t know that he handled it necessarily so well in the aftermath. I think he was kind of, you know, pun intended pissy about this experience, you know, wasn’t quite as open minded or affirming as I would prefer with a partner. That said, you know, you squirt on somebody, you might piss them off. That’s life.
S2: Yeah. Give you a heads up and you don’t need to present it as this. Like, Oh my god, sometimes I do this thing. That might be shocking, right? You just be like, I’m about to squirt. If you keep doing that, that’s what’s going to happen. You can say it just like a dude would. Yeah. Oh my god, I’m going to cop. Well, you do need to add in an explosive and liquid way. Right? Because when you have a vulva doesn’t necessarily imply that fluid is going to squirt out. But how could our writer have reacted? It better,
S1: so I didn’t argue, I just apologize and cut the date short. I think if he really wanted to smooth things over, he could have not cut the deal short. Look, life is short. You want to keep it moving, whatever. That said, if you want to like, actually tend to somebody’s feelings, especially after surprising them with your reaction to this thing that usually gets a great reaction. Maybe. Hang in there a little bit longer and have the conversation and really articulate your completely justified feelings about this. It’s kind of a matter of aftercare, I think. I think that was cut short, and that’s kind of like the biggest error that I see our letter writer making. On the other hand, I don’t think it’s any kind of error to not be into something like he’s got two people now saying, Why aren’t you into this? You should be into this. Well, he’s not into it. He doesn’t like squirting. And he didn’t like the way that it came at him. So that’s fine.
S2: It’s not his thing. Yeah. Or maybe it is his thing, but he’s so wired towards consent, which is awesome. Yeah, that there’s no way he’s going to find it arousing or sexy in the way that it happened. I think she should have apologized, and I think the friend should have supported our writer a little more in his experience and his feelings. Yeah, our writer is like, I didn’t want to question her experience with her own body, but then the friend is questioning his own experience with his own body.
S1: Exactly. And this is what I meant when I said there is no should, should like squirting, shouldn’t like squirting whatever. The fact of the matter is that as our letter writer stands, he does not. And that’s totally OK. You don’t have to, because it’s a thing that’s been eroticized. It’s the thing about a lot of men talk about enjoying and women. Something is for you and it’s not for you, and it’s completely reasonable to come down on either side.
S2: OK, that’s all for now, but we’re not done this week on tomorrow’s episode, just for Slate Plus members, we hear from a letter writer who’s astounded by what he’s hearing from prospective BDSM partners to hear that discussion. Sign up for Slate Plus at Slate.com. Slash age, she’d IPL us.
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