Ella Dawson's TEDx Talk on STI Stigma

Comments

1
That really was amazing.
2
Terrific talk. I have a dear friend who has asymptomatic HSV 2 (tested positive during routine blood screening at 19 and has never had a sore). Ten years later, he's never given it to a partner. He tells everyone "I have herpes and you probably do too."

Shit. I think I told him he was brave.
3
2@, I have a terrible time (immunologically) with the whole family of Herpes viruses. When I get a Trigeminal outbreak (face), I end up in bed for several days with a high fever and terrible body aches. For this reason (not the stigma), I would prefer not to be exposed to genital herpes. So, it's nice to know that transmission from a sex partner is not an inevitability.
4
That was terrific. I wish everyone on this planet was required to watch that and learn that herpes (and STIs) are not badges of shame, they're just things that happen to ordinary people.
5
3: Sandiai: You'll be happy to know then that some studies indicate that people who have HSV 1 orally have a slight resistance to contacting HSV 2 genitally.

I feel like there is a lot we don't know about the herpes virus, particularly about the 80% of people who test positive but are asymptomatic (the 1 in 5 rates she sited are great, but it's important to note that 80% of those folks have no symptoms at all). For example, how come I can avoid passing on my HSV 1 by not kissing people when I have an outbreak (and have avoided transmission this way for 25 years) but someone with genital herpes is contagious all the time?
6
It's worth remembering that the herpes stigma was invented by people who developed medication for it and found out that not enough people cared to build a market base. So they manufactured shame and stigma so people would buy their drugs.

Source
7
@5, thanks, I think I knew that (about the resistance). Probably why I have not contracted genital herpes, even though statistically speaking (ahem), I have most surely been exposed to it.

"but someone with genital herpes is contagious all the time," yeah that must be a myth, right?

On another interesting note, another primate's Herpes viruses may be deadly to us and vise-versa. Thus demonstrating how much we have co-evolved with our pathogens. When I work with monkeys, I pretty much have to stay home when I have a cold-sore, lest I kill the poor primate who has no immunity to my herpes variant. Likewise, when I was bitten once by a Rhesus monkey, the (extremely knowledgeable) physician on call was most concerned with monkey herpes, which can be deadly to humans.
https://en.wikipedia.org/wiki/Herpes_B_v…
Yes, very interesting group of viruses.
8
Great talk. Everything she says is true and she says it perfectly.
And yes, I have herpes. Have had it since 1985. No big deal.
9
Fantastic!

@5 Prof L - For example, how come I can avoid passing on my HSV 1 by not kissing people when I have an outbreak (and have avoided transmission this way for 25 years) but someone with genital herpes is contagious all the time?

Yes, that's a very damaging myth. Both are highly contagious when an outbreak is present. Both have a small risk of transmission when symptoms are not present. Both produce noticeable symptoms in perhaps 13-20% of those who do contract one or the other virus type.
10
@7 @Sandiai - Yes, I've wondered about that, too. Since HSV is typically not included in STI panels and I don't have symptoms, I only discovered recently through comprehensive testing that I am positive for type 2. Who knows how long I've had it. But I've somehow managed to remain negative for the more common type 1 for almost five decades. My understanding is that 40% of people with type 2 are also infected with type 1. That's a significantly lower percentage than the general population.
11
@7 Sandiai - If you are actively attempting to avoid contracting genital herpes for immunological reasons, you'll want to keep in mind that roughly half of new genital herpes cases are believed to be caused by HSV1, most commonly transmitted through oral sex from a partner with oral HSV1. The majority of adults have oral HSV1 and are capable of transmission.
12
Thanks Catlady.
13
@6: "It's worth remembering that the herpes stigma was invented by people who developed medication for it and found out that not enough people cared to build a market base. So they manufactured shame and stigma so people would buy their drugs."

While the stigma is unfair, this conspiracy theory is unhelpful.
14
Though now that we're discussing the subject, it'd be fascinating to go over the average person's opinion of nonfatal STIs throughout history beyond the DREADED SOCIAL DISEASE scare films.
15
@13 the source linked @6 seems pretty plausible to me, do you have reason to think not? Evidence to the effect that they knew they were initially lacking in demand for their drug, and lo, demand appeared. Or do you mean maybe they wanted people to dislike herpes but not think it was /dirty/?

Whatever created the stigma, it is interesting, my limited data with Europeans is they have much less of it. And in the US it attaches specifically to the word "herpes", not to cold sores.

PSA: don't kiss a newborn with your cold sores. Infant herpes is quite bad.

https://www.health.ny.gov/diseases/commu…
16
Adam Ruins Everything - You Probably Have Herpes and Thats OK ... - https://www.youtube.com/watch?v=aU4VcOQz…
17
For those of you wondering about why people with genital herpes are contagious all the time, that's actually not the case. People with herpes go through what's called viral shedding, which means that they're contagious at that time. It can be associated with an outbreak (e.g., blisters) or it can be completely asymptomatic.

Think of it like ovulation. There aren't necessarily any physical symptoms that a woman is ovulating, but she is most likely to get pregnant at that time. People with genital herpes do not shed all the time, but they could be shedding at any particular time with or without physical symptoms. The good news is that, as stated before, 80% of people will never exhibit symptoms.

I had an outbreak once of what a nurse practitioner told me was most likely herpes, but I've had three tests (one swab of the outbreak, two blood tests) that came back negative. So, who knows; I'm the Schrodinger's Cat of herpes.
18
@17 @Lucy - I think one way to help people understand is to explain that it works the same way as when HSV is located in the mouth. HSV1 in the mouth is extremely common and often asymptomatic. Sometimes someone gets a herpes sore (better known as a "cold sore" when it's on the lips) upon infection and never again. Some people get a sore or sores every once in a while when their immune system is compromised. Some people get lots of cold sores very frequently and it interferes with their quality of life. And in all of those cases, viral shedding occasionally occurs when no symptoms (cold sores) are present, meaning that there is a small risk of transmission to a partner's mouth or genitals when no symptoms are present.

As with oral herpes, some people with genital herpes have no symptoms, some have occasional symptoms, some have frequent symptoms that impact quality of life, and all have occasional viral shedding when asymptomatic.

One difference I'm aware of is that genital HSV2 tends to shed almost twice as frequently as oral HSV1, but antivirals can cut viral shedding of HSV2 by at least half. Also, genital HSV2 rarely spreads to a partner's mouth through oral sex for some reason. I don't understand why, but HSV1 is thought to cause perhaps half of new genital herpes cases while HSV2 only accounts for 1-2% of oral herpes cases.
19
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