Genital herpes: Why you may have it without knowing

One in five adults globally under 50 has a genital herpes infection, the World Health Organisation (WHO) has said.

The new infection estimates were published this week in the scientific journal Sexually Transmitted Infections by the BMJ analysing prevalence data for the year 2020.

Genital herpes is an incurable disease characterised by painful blisters or ulcers spreading mainly by skin-to-skin contact.

There are two types of herpes –one spread through oral contact (HSV-1), and another through sexual contact (HSV-2).

The BMJ study shows that Africa had the highest prevalence of herpes infections spread through sexual contact.

The Americas region had the highest number of infection of herpes spread through oral contact.

Their analysis shows that the number of people who were infected with herpes transmitted through sexual contact remained almost the same as that recorded in 2016.

Risky sexual behaviour

“HSV-2 prevalence appears to be slowly declining. This decline may reflect less risky sexual behaviour following the HIV epidemic, improved sexually transmitted infection (STI) awareness, increasing access to HIV/STI services, and/or changes in the structure of sexual networks following changes in socioeconomic conditions,” explains the study.

On the other hand, the number of people infected with herpes transmitted orally (HSV-1) (376 million) nearly doubled compared to the 2016 data (192 million).

Dr Meg Doherty, the director of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes at WHO said that the world urgently needs better prevention and treatment options to reduce herpes transmission as well as HIV.

Dr Sami Gottlieb, an author of the report and Medical Officer within WHO’s Department of Sexual and Reproductive Health and Research said in a press statement that genital herpes is usually discussed in hushed tones because of the stigma around it, despite affecting millions of people globally. He said that not enough is being done to fight the disease.

“Expanded research and investment in developing new herpes vaccines and therapies, and their equitable use, could play a critical role in improving quality of life for people around the world.”

Kenya has no recent nationwide study on herpes but we spoke to Dr Alicia Magara, a medical officer at Ruben Medical Clinic in Mukuru-kwa-Reuben, in Nairobi who sheds light on the rising cases of genital herpes in the country.

She says that she has witnessed a growing number of patients seeking help for the condition, including pregnant women. In four months, Dr Magara says she has seen over five new cases of genital herpes.

Complications during pregnancy

Genital herpes, caused by the herpes simplex virus (HSV), often goes unnoticed, especially in its early stages. The condition can be asymptomatic, and those infected may not realise they have it until they experience painful outbreaks of sores and blisters in the genital area.

Though the virus remains dormant in the body, it can resurface, causing recurrent flare-ups that bring discomfort and pain. For some, the emotional toll is as impactful as the physical symptoms.

Dr Magara points out that genital herpes is often linked to high-risk sexual behaviours.

“In Kenya, we are seeing a rise in cases, particularly among adolescents and young adults aged 15 to 24 years,” she says.

“This age group is more sexually active, and they often lack the knowledge and resources to protect themselves against STIs, including herpes,” she adds.

According to Dr Magara, pregnant women are also particularly vulnerable.

“Genital herpes can cause complications during pregnancy, such as neonatal herpes, a rare but serious condition where the newborn acquires the virus during childbirth,” she tells Nation.

High numbers among youth

Dr Magara notes a worrying trend: an increasing number of young patients seeking treatment for genital herpes.

“While we haven’t seen a drastic rise in cases this year, there has been a consistent increase in young people coming in for check-ups, particularly in the last few months,” she explains.

“What’s concerning is that many young people are unaware of the symptoms or risks associated with the disease.”

While the virus may remain dormant, Dr Magara explains that when symptoms appear, they can be severe. The most common signs of genital herpes include painful sores, itching, and irritation in the genital area.

“In some cases, the sores are not painful but still cause discomfort. For men, there can also be urethral discharge, while women may experience vaginal discharge or painful urination,” she explains.

In the case of recurring outbreaks, the physical symptoms can take a significant toll on individuals.

“It’s not just about the sores. Genital herpes also affects one’s mental health. The stress of managing a recurring infection can contribute to anxiety and depression, especially when combined with the social stigma surrounding the disease,” she says.

Tackling stigma

One of the most significant hurdles in the fight against genital herpes is the stigma that surrounds it. Dr Magara emphasizes the importance of open discussions and education to reduce stigma and raise awareness about prevention and treatment.

“We have community health groups where we educate people, especially the youth, about sexual health and how to protect themselves,” she says.

“Peer pressure is strong, and many young people are unaware of the risks they’re taking. We must continue educating them on safe sexual practices.”

She believes that with more education, individuals will feel more comfortable seeking treatment and taking preventive measures.

“Genital herpes can be managed effectively if caught early. It’s important for people to recognize the signs and get tested,” Dr Magara urges.

Stress and herpes

Dr Magara also highlights a significant link between stress and herpes outbreaks. “Stress can trigger herpes outbreaks,” she said.

“When we’re under stress, the virus, dormant in our nerve cells, can reactivate and travel along nerve pathways to the skin, causing visible symptoms.”

This connection between stress and herpes outbreaks emphasises the importance of mental health in managing the condition.

“Mental well-being is often overlooked in herpes treatment, but it is just as important as addressing the physical symptoms,” Dr Magara says.

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