CityofAngels

Since it is clear that my postings have discouraged certain people, I think from now on I will stop posting and leave this forum for good. I feel badly because it was never my intention to hurt anyone or to make them feel badly about themselves or their condition. Yet despite that, it seems that that has taken place. My whole point in first coming on here was to discuss this ailment with people who had firsthand knowledge of it, because a girl I was dating disclosed to me. No one I had ever dated before had ever disclosed a sexually-transmitted infection to me before. I am pretty jaded, as people go, but this really took me by surprise. After I gained the information I needed, I thought I could be of help by occasionally and respectfully offering an "alternative" viewpoint of someone who doesn't have "h." But it seems that I have hurt more people than I would have ever intended to. Thus I wish to part by saying thank you to everybody, thank you so much for listening to me, for answering my questions when they were numerous, for offering your perspectives and unique insights, and for challenging me to think about the assumptions behind my own beliefs and reasoning. I truly believe this forum is composed of a winning group of people, and I wish you all the very best going forward with your lives. Sincerely, CA

@ Theo1824 Well, your question is not at all nice, and I do not appreciate it. I have more than adequately addressed this question in other posts. If you would like an answer to it, you'll have to read them.

@Vanguard1 As I already said, the CDC and other medical establishments are not going to devote limited resources to genital herpes. GH competes with many, many other diseases, most of which are far more serious than GH itself, as you say. *We don't know* what Americans would or would not do were they educated about the fact that they have genital herpes. The CDC is not going to invest greater resources in education and testing just because they have a "hunch" or a "feeling" or an "intuition" that doing so "might" decrease the stigma. Perhaps doing so would *increase* the stigma instead. You can't make these statement in an evidential vacuum. They need to be borne out and supported by data and evidence. Data and evidence are what allow us to make the hard choices about what programs to support and which ones not to. We can think all we like if people found out about their genital herpes, this would decrease the stigma. Yet hypothesis built upon speculation and conjecture does not come near the threshold of validity required to make informed public policy decisions. Scientists need *data*. If they didn't have that data, they would not be able to make any informed policy decisions, and doing so would be like walking in the dark with a blindfold on and your hands tied behind your back. Just because something "sounds right" is *not enough* for a scientist. Every day, all the time conclusions that "sound right" are disproven by rigorous, in-depth scientific research. Any scientist worth his salt knows this for a fact.

@forgivenessandpeace This study highlights the fact that for most with genital herpes disclosure is dependent upon an array of variables, including the perceived likelihood of rejection: http://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=6477&context=etd This article cites an array of studies that have examined disclosure within the context of both genital herpes and HPV: http://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=6477&context=etd On page 21 it reports that fully 46% of women with genital herpes did not disclose their condition until after the commencement of sexual relations. This is only among those who actually did (eventually) disclose. It does not include the percentage of women who chose not to disclose at all. Page 20 also cites related research on HPV, since the comorbidities of HSV and HPV are so similar: fully 69% of those who disclosed--which by definition excludes the percentage of those who chose not to disclose at all--did so after the beginning of sexual relations. Among those with only casual partners, rates of disclosure are much, much lower; cf. Green et al., 2003; Scrivener et al., 2008. I will post more studies as I go through my medical research bookmarks, which are numbers at over 1,000.

@WCSDancer2010 I fully agree that much, much more needs to be done, and urgently so. Unfortunately, it seems like other research priorities far, far outweigh research on and education about genital herpes. Certainly, were the CDC to become far more proactive about educating the public in this regard, positive consequences would most likely follow. I recently asked one of my professors, who is an MD/Phd, whether seeker's proposal to use a mutant strand of the HSV virus to attack native HSV-2 would be plausible. He giggled a little and stated (a) that doing so would likely not remove HSV-2 entirely from the body, and more importantly, (b) that attempting to use gene therapy to cure HSV would be like using the equivalent of nuclear weapons to dig a crater in the earth. So unfortunately, research priorities trump HSV research in favor of far "sexier" conditions with bigger payoffs in terms of their relative complexity and challenge. This, in addition to the prestige that those who find effective gene therapy treatments for these diseases would garner for those who cured them. It seems that education about genital herpes is a victim of the "survival of the fittest" competition among scientists to outdo one another working on the "holy grails" of science. Remember, scientists are people too, and are attracted by many of the same goals that the rest of the population is. All of the professors who teach in my department are men who are giants in the field of molecular genetics; many of them have very big egos, and are as much motivated by prestige, academic accolades, fame, and money as the rest of the population.

@seeker Hi Seeker, I just wanted to take a minute to address the issues you raised in your post. You wrote: "ok, but A, its not the CDCs money when it comes to testing. B, it then should be policy to offer the option. C, even if its a minority of people who actually change behavior that minority would slow/stop the spread of a virus. D, since when has testing been about behavior and not knowledge? E, the negative consequences are a direct result of a lack of knowledge that would be given out IF every damned splint and pill quack were up to date on their info. and if it were SOP, there might be a chance they would be. I had to go to a private lab for my test, I found out via email and almost lost my lunch and didn't sleep. now if I had been able to go to a knowledgeable doctor and gotten my results with a " well you have H2 but its manageable and you can and will have a normal life with a few precautions, precautions that for the most part you should be doing anyway until in a committed relationship. those people aren't changing because they aren't being given the proper info AND the whole reason for not testing is stigma driven thereby reinforcing the stigma. law of unintended consequences anyone?" In response: (a) No, it is not the CDC's money. That is why there are currently no federal regulations that mandate that individuals cannot get tested for HSV. It is ultimately up to the individual, in consultation with his or her doctor, whether s/he gets tested. Yet it is the function of the CDC to provide guidance and policy recommendations on best health practices, based on the best and most widely available empirical data. (b) Private practices and state- and federally-funded health centers follow the CDC's policy recommendations, although they are by no means legally obligated to. The CDC likely does not recommend offering the option to test for genital herpes for the above-stated reason(s): testing is expensive, false-positives occur, and it is not clear that testing and subsequent knowledge of an infection with genital herpes has any effect on one's behavior. © Yes, even a minority of individuals who chose to engage in safer-sex practices would help to stop the spread of the virus. Yet the CDC weighs the potential benefit of increased disclosure in a minority of persons against the significant and negative psychosocial consequences that accompany diagnosis for the much larger group of individuals who test positive for HSV, and then do nothing to alter their behavior(s). (d) Science is about empirical observation and experiment. The values of public goods like "knowledge" are not weighed in the abstract, but with respect to the empirical and measurable consequences to which they give rise in the long- and short-term. It is part of the fabric and texture of the natural sciences to weigh any putative benefits just in terms of their measurable consequences. The claim that "knowledge is intrinsically valuable" has no clear status or meaning with scientific discourse. It is a subjective assertion of value that cannot be clarified further with the context of scientific research. For example, whether knowing Goldbach's conjecture is intrinsically valuable is up to philosophers, mathematicians, and value-theorists to decide. Natural science, by methodological design, can only answer the more narrowly-focused question concerning the measurable results that knowledge of Goldbach's conjecture brings with it. (e) I fully agree that knowledge of genital herpes among most general practitioners is woefully inadequate. Yet the CDC is not reasoning that: "the only reason there are negative consequences among those who are informed of a genital herpes diagnosis is because of ignorance and stigma." Rather, the CDC is reasoning that, whatever the causes of adverse psychosocial consequences happen to be, they presently exist and will likely continue to exist in the near- and medium-term, if not also the long-term. The CDC probably sees its role as informing clinicians of best practices based on current consequences, and what might or might not improve the situation vis-a-vis disclosure and mitigation of the adverse consequences I mentioned.

I am studying to be a scientist, so I'm going to chime in here. While I don't have any unusual amount of knowledge about herpes beyond that which I've gained educating myself about all sexually-transmitted infections, I do know a thing or two about clinical studies. First, let me say that I really respect what people are trying to achieve on this forum by encouraging disclosure. I think that is a worthy and inherently admirable goal, and I think everyone will be well-served by being honest. The reason the CDC does not recommend disclosure is this: rigorous clinical studies have shown that being informed that one has genital herpes does not by and large change a person's behavior vis-a-vis disclosure. These studies have consistently shown that, once informed of a diagnosis of genital herpes, individuals are on average not more likely to disclose their diagnosis to either their current or future partners. Since these studies concern preponderant behavior, there are of course exceptions to this rule. But the findings of the studies in question illustrate an important point: just because we think or "intuit" that a person will act a certain way due to the downward normative pressure that having herpes exerts on a person to disclose, does not thereby mean they will act in that manner. That is why we conduct clinical studies: to assess real-world behavior and quantify over a variety of variables whose influence and effects on behavior are unknown on the basis of mere speculation alone. We also conduct clinical studies for the very general reason that, by and large, our common sense understanding of the world collapses in the face of rigorous scientific scrutiny. Natural science constantly reveals the world and actual human behavior to be highly counterintuitive. Policymakers have concluded that, due to the significant negative psychosocial consequences that often accompany a diagnosis of genital herpes, and the fact that knowledge of one's infection does not in general change sexual behavior or encourage disclosure, it is best not to encourage testing. Now, speaking of my personal opinion here, my "gut" tells me that it is always appropriate to become aware of the state of one's sexual health. I believe that, combined with more rigorous education and greater available resources devoted to educating people about genital herpes, this will have a positive impact on one's post-diagnosis behavior that will show up in future clinical studies. Unfortunately, increased resources are not being committed at present to educating individuals with genital herpes about their condition. As a result, I suspect that disclosure rates will plateau for the general population of HSV-2-positive persons, at least in the short-term.

@risingsun Personally, I think you're showing really great composure, maturity, and a lot of class by showing restraint. I know that if it were me, I'd be banging on my partner's door by now because I'm the impatient type. When I was a child I used to look up to adults because I thought they had it all "figured out." I thought they knew expertly how to handle any situation, especially awkward ones. Growing up one of the biggest revelations to me was realizing that this is simply not true. By and large, so-called "adults" do not handle awkward situations well. I don't know why. Maybe it's just those few who are lacking; maybe it is just the nature of being human. But I agree how he conducts himself, much more than his response, will be very revealing. I'm pulling for you.....

@Anonemess It's really interesting that you mention that, because we all had a very interesting discussion about this topic last week on one of the threads. Almost everyone agreed that it is a person's prerogative to not date someone with HSV if they so choose. It was agreed, however, that the specific manner in which a person communicates his/her intentions is important and revealing. For many, many people (me included), contracting an std would be a major and psychologically disruptive life event. Thus, they choose not to get involved. Fine. Yet if they're laughing at you or rolling their eyes when communicating this, that probably tells you something about their level of respect and sensitivity, and it also reveals that they are not going to speak to you in a manner that will respect your own dignity. As I have said, different people process different life events differently. Herpes may be a "2" or "3" on a scale of 10 to most people here. But to some people it is an "8" or a "9." And just because herpes is an "8" or a "9" to them doesn't mean that other things that you consider an "8" or "9" will similarly be an "8" or "9" to them. We all weigh and assess different life risks differently. Herpes is a "big deal" to me too. But some other things that people consider a "big deal," are less important to me. I know this as a fact because I approach all risks differently. Since there is no way to prove or provide an objective, universally agreed-upon ranking of all life events from "major" to "minor," it is just a fact of life that different people quantify risk differently.

@risingsun I'm sorry that it's so heart-wrenching for you. Just try to see that different people process information differently, at different rates. Personally, I'm a "slow" decision-maker: I take the time to make sure I've considered all relevant variables and possible outcomes, and I also weigh my feelings regarding each of those outcomes. That takes time. The fact is, most people generally don't give a lot of thought to herpes, because they do not think they have it, and/or they think they won't contract it. So disclosure is in essence compelling someone to think about something about which they have little, if any, prior information. It's a lot to process. Yet I sincerely hope that you will receive a definitive answer this weekend, one way or the other. Good luck.

If it were me, I would sue and press charges. I would feel that a serious injustice was committed that demanded legal action. Proving that you contracted herpes from one specific person is notoriously difficult in a court of law, because the defense can always argue that another partner gave it to you, unbeknownst to you. But I keep all my medical records in order and my STD records are constantly updated when I'm considering becoming intimate with someone new. Also, to me a civil suit reflects the gravity of what happened, and someone who contracted herpes from a partner who they can prove knowingly lied to them, can win 7-figure verdicts in a court of law. Moreover, in civil suits the burden of proof is lower. In criminal cases, you have to prove guilt beyond a reasonable doubt. In civil cases, a preponderance of the evidence has to suggest culpability. That means that one only has to prove that it is more likely than not that one contracted herpes from the person in question.

Personally I think he had the responsibility to become informed once he knew he had herpes, that it was incurable, and that it was contagious. *The least* he could have done was find out enough information to become informed so that he could protect his future partners. At the very least, he was negligent. At the worst, he knowingly kept secret a condition that you had every right to know about.

Different people handle herpes disclosures in different ways. I would say give him the time and space to think it over by himself until you meet this weekend. While his change in demeanor was not encouraging, there is a possibility that he, like you, is processing a whirlwind of emotion.

Most differences in "potency" are modulated by individual immune system response. The relative strength and effectiveness of one's immune system goes a long way toward determining the frequency and severity of outbreaks. As for what factors determine the "strength" of one's immune system, this is very difficult to determine and there is no conclusive answer as of yet, only speculation based on informed hypotheses and "best guesses." However, it still stands to reason that there are certain actions you can take that can strengthen your immune system. While the efficacy of most supplements has not been proven in rigorous clinical trials, certain things tend to convey modest benefits over time. As for what supplements are most effective, others on this forum would know that much better than I would.

As I have said, and said repeatedly, different things possess varying degrees of importance to different people. To you, herpes might be a 2 or a 3. Great. To this man, it was obviously an 8. Likewise, something that is an 8 to you might be a 2 or 3 to him. Everybody subjectively weighs different risks in a different manner, and there is absolutely no objective ranking of risks from "major" to "minor." What is a risk to one will be no risk at all to another. You just happened to be with someone who viewed herpes as an 8. The key, I imagine it, is to find someone who views it as a 2 or a 3. Considering that, as I said, everybody quantifies and weighs risk differently, you will likely be able to find such a person in the future. *The important thing* to remember is that everyone has a different view of the seriousness of the risk(s) involved, and there are millions and millions of men and women who would date someone who has herpes, so there will be no shortage of opportunities to find dates in the future, if and when you are ready to begin dating again. Good luck.