Genital Herpes and Unrecognized Infection

Genital herpes is a common infection caused by herpes simplex viruses. Public health agencies in Canada and elsewhere describe it as widespread, and a large share of people who carry the virus have never been told they do. That gap between infection and awareness shapes how the condition is discussed in sexual health circles.

The sections below cover the two virus types, the reasons infection often passes unnoticed, and how it is identified.

Two related viruses

Herpes simplex virus type 1, usually shortened to HSV-1, is best known as the cause of cold sores around the mouth. Herpes simplex virus type 2, or HSV-2, has traditionally been the main cause of genital infection. Over time, HSV-1 has been recognized as a growing cause of genital herpes as well, since the virus can pass from mouth to genitals through oral sex.

Both viruses spread through skin-to-skin contact with an infected area. Once a person is infected, the virus stays in the body for life, usually lying dormant in nerve cells between episodes.

Why many carriers do not know

A substantial proportion of infections cause no symptoms, or only mild ones that are mistaken for razor irritation, a rash, an ingrown hair or a yeast infection. When symptoms do occur, they can include small blisters or sores, itching, tingling or pain, and a first outbreak is often more pronounced than later ones.

The virus can also be shed from the skin on days when nothing is visible. For this reason, transmission can occur between partners when neither is aware of an infection.

Testing and surveillance

Diagnosis in a clinic often relies on swabbing a sore and testing the sample in a laboratory. Blood tests that detect antibodies to the virus also exist, though health authorities have discussed their limits, including that they cannot always say where on the body an infection is located. Routine screening panels for sexually transmitted infections in Canada do not always include herpes, which is one reason many infections stay unrecognized.

Population surveys and public health monitoring have been used to estimate how common the infection is. Studies of this kind have often found that many people who test positive were unaware of their status.

Stigma and public understanding

Despite how common the infection is, social stigma around genital herpes remains strong, and many people describe the label as more distressing than the physical effects. Health educators often point out that the virus is closely related to the one behind cold sores, and that antiviral medication is available through prescribing clinicians to shorten outbreaks and reduce shedding.

Because the topic touches on privacy and personal relationships, public health messaging in Canada tends to frame herpes as one infection among many, with an emphasis on accurate information over blame.