Genital Herpes and Why Condoms Are not Enough

Herpes is the ammunition many of the abstinence-only advocates and sex-unfriendly preachers use when trying to explain why condoms are not the answer. They are in general very much mistaken, but when it comes to herpes*, there is something to be noted about condom use.

Condoms are well studied and proven to offer a very high level of protection for sexually transmitted infections (STIs) transferred in semen and vaginal fluid. These include HIV, gonorrhea, chlamydia, in short, the big names. However, the dreaded and ever-popular herpes is transferred by contact with a herpes sore. When a sore appears on a man’s penis or inside the vagina, a condom actually will offer protection, but many herpes sores appear on the skin around the crotch, around the anus, around the vulva and at the vaginal entrance, a condom may not cover area of contact. For that reason using a dental dam can protect spread from a female carrier, when it covers the affected area, but condoms do not provide the same complete coverage.

While there has been some disagreement about the amount of protection, research by Martin et al. (University of Washington, Seattle) has supplied the most comprehensive answer on this question yet, by comparing various studies on over 5,000 healthy people who were exposed to the herpes virus. These findings show that condoms provide 30% protection, or put otherwise, a person who does not use condoms has about a 1 in 4 chance of contracting herpes while a consistent condom user would have about a 1 in 6 chance.

Condoms are not exactly what you would consider to be a sufficient method of protection, but it still means 30% fewer people with herpes, a virus that will last them for a lifetime. Just for comparison, the research that led experts to advise health care providers to start circumcising all men in HIV prevalence areas, showed that circumcision (a whole lot trickier than donning a condom), provided an extra 6% protection. A mere 6% , and yet it has many public health experts waving scalpels in excitement.

So what can be done to effectively protect against herpes? There is no fail-safe answer nor method. People who know that they have herpes can sharply cut the chances of spreading it by abstaining from all genital contact during an outbreak, using medication to suppress the virus when they feel an outbreak coming on, and using condoms regularly in between outbreaks. The main danger exists for herpes carriers, as with all STD bearers, who don’t know that they are infected and contagious.

Getting down to basics, true protection for a person who is not in a monogamous relationship with a “clean” partner, depends on open communication and absolute honesty.

* Just as herpes simplex virus-2 (HSV-2) can be spread by skin-to-skin genital contact 
that sometimes goes beyond the reach of the condom, so too are syphilis, HPV and scabies.

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