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Avatar universal

rejection, support, research

Dear Dr.,

I contracted HSV2 several years ago. A matter of days after exposure, I manifested typical symptoms: genital lesions, swollen inguinal lymph nodes, low grade fever, itching, severe pain/burning sensation in the anogenital region, frequent recurrences, et al.

It was my second sexual partner.

I tested HSV2+ several months later through AB IgG testing and have been on Valtrex combined intermittent suppressive/episodic therapy since then. The stigma and fear of transmission has been overwhelmingly devastating.

Sometime this year, I fell deeply in love, and the fear of transmission resurfaced. Several months prior to becoming intimate, I undertook Valtrex 500 mg bid suppressive therapy. I waited to reveal my HSV2+ status until the relationship was on more stable footing. I offered to use a condom which was refused. However, when I began feeling prodromal symptoms after an intimate encounter, I decided to have "the talk".

In the course of a few weeks, the relationship rapidly deteriorated. Having read differing opinions, I realize that the timing for disclosure is arguable, even if it is strongly advised that it take place before initiating sexual intercourse.

My question, though, relates to how risky HSV-2+ is to someone with an autoimmune disorder. I have been accused of exposing this person to a disease that may have been life threatening and of course, my moral code has come under scrutiny.

Though GH altered my life to near tragic proportions, especially in the early years, and again after this failed attempt at a loving relationship, it can be managed.

I think my greatest fear is the possibility of another rejection in future. Do you have any suggestions (e.g. medications, therapy, support)?

Is there an immunotherapeutic vaccine in the works, something that can be administered to minimize transmission in discordant couples?

Thank you.
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207091 tn?1337709493
COMMUNITY LEADER
"Regardless of how we try to rationalize herpes on this message board, the truth is that no body is actually that 'ok' with the fact that they have herpes."

Actually, I'm ok with it.  Really, truly ok.  I don't like outbreaks, but I also don't like that I woke up with a stuffy nose, sore throat, earaches, and a headache from allergies today (and many other days), but I've accepted that, too.


I find it interesting, Blood, that you got it from someone who wasn't honest with you, but then you went ahead and put your partner at risk without being honest.  Interesting dichotomy there.

You need to change your mindset about this.  You use words like "chronic condition", "diminished", etc.  You have a virus that causes a stupid little skin rash every now and then.  How does that make you feel that way?  Self-talk is about the most important thing a person needs to change when trying to cope with something, and yours is incredible, I'm sure.  

You sound as if you feel bad for having more than 1 partner, when 3 partners at 40 is nothing.  

Poker - you have anger, and its not in_the_blood's fault that you got herpes.  I don't know your story, but if you were lied to, that's on the person that lied.  If you didn't ask about stds, herpes, testing, etc., then its a 50/50 deal there.  You are responsible for your body.

Yes, relationship and sexual ethics say we should tell.  That's the ideal.  That's what I do.  But I don't have casual sex.  If I did, I wouldn't expect anyone to tell me anything, really.  There is an inherent risk with casual sex, and sex NEVER comes without risk.

And lets face it - people aren't telling because people are afraid of rejection.  Its not about waiting till relationships become more stable, or until the time is right, or till the planets are aligned in a certain way.  When you don't tell, you make the decision that your partner's health and body aren't as important as your comfort.

I don't see it as a gender issue at all.  I don't see it as any kind of issue.  If you want a relationship to be based on honesty and trust, and to be "stable", you tell.  You would tell a partner, "Hey don't get too close, I have the flu" right?  You wouldn't put them at risk for getting the flu without telling them.  Why would you put them at risk for herpes without telling them.

You can cite 100 different studies that say there is a major psychological fallout from having herpes, and I will still say that if you don't want to feel the stigma, don't feel it.  I can also find you 100 people that aren't psychologically bothered about having herpes.  Grace, waring, and myself are 3 such people.  I also wonder if people feel they are "supposed to" feel like doody about having herpes.  All the ads, the media, studies, etc., will tell a person its horrible to have herpes.  No one feels bad about having the flu, mono, strep throat, allergies, whatever, because we aren't bombarded with all the doody messages about that.

End of rant, and Grace comes back in a couple of days.  I'm sure you will all be thrilled.  ;)

Aj

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Avatar universal
I contracted this chronic condition years ago from someone, who led me to believe was in a long-standing, exclusive relationship with me and who also lied to me about being HSV2+.

At 40+, having had three partners is two more than the ideal, but still falls below what one might consider 'multiple'.

I agree that there is every reason to assert the highest moral standards.
However, I seriously considered all the possible foreseeable consequences of my actions, but universals did not lend themselves to application in this particular context.

GH and the ethics of disclosure will continue to be a polarizing subject.
It is a health issue with a moral side and a 'one size fits all' approach to disclosure inadequately addresses its psychosocial aspect.

The message out there to us with GH is that we should dig deep into our inner resources and feel undiminished in spite of it. The 'stigma' exists primarily because the language that GH publicity employs, at times, 'blames the victim'. Additionally, if examined more closely, this could be a gender issue because the greater number of HSV2+s are female.

This forum is one place where a person with GH like me can count on sound advice and support, and I thank you all for your help. I've certainly come out of this with a firm resolve in future to take a responsible approach.




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Avatar universal
I agree with warningblender, its people like in_the_blood that allow this disease to continue to be spread to innocent people. It makes me sick! Regardless of how we try to rationalize herpes on this message board, the truth is that no body is actually that 'ok' with the fact that they have herpes. It *****, and people like in_the_blood who don't disclose that they have it propetuate its existance and I blame people like you for what has happened to me.
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Avatar universal
Did you really say partners?--plural--The implications are horrible.
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101028 tn?1419603004
The vical product is one of the "theracines" that are currently being researched.  The antigenics AG707 theracine is the only one currently being trialed in humans if I recall.  It's the 2nd version of their product - ag709 was trialed a few years ago and unfortunately failed miserably as far as decreasing ob's and shedding :(    Last I heard the vical product hadn't reached human trials yet. I have no idea what's going on with the pfizer theracine for herpes ( formally known as the powdermed theracine ).  Those are the 3 I'm aware of.  I honestly don't keep too up on that sort of thing until they've completed phase 2 trials - usually if they make it that far they are worth starting to pay attention to.  

you hadn't brought up the psychological side of herpes in your original post - you talked about the health issues of it which is how I responded.   Yes indeed if you let it herpes can do a number on you - why it's become so stigmatized for some folks I have no idea with as common as it is. Darn shame the medical establishment and the media have dropped the ball on it.  It's something that we here at this forum work hard to overcome.

grace
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Avatar universal
If there are a number of illnesses (say, of an autoimmune nature) that GH would pose a serious risk, what would they be?
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Avatar universal
Early days, but perhaps something to raise hopes?


Vical Receives NIH Grant for an Immunotherapeutic Herpes DNA Vaccine; Herpes Experts...
Thu Apr 3, 2008 6:30am EDT Vical Receives NIH Grant for an Immunotherapeutic Herpes DNA Vaccine; Herpes Experts at University of Washington and University of Texas to Conduct Preclinical Development

SAN DIEGO, April 3, 2008 /PRNewswire-FirstCall/ -- Vical Incorporated
(Nasdaq: VICL) today announced that it has been awarded a two-year,
$2.0 million Phase II Small Business Technology Transfer (STTR) grant from the
U.S. National Institute of Allergy and Infectious Diseases (NIAID) of the
National Institutes of Health (NIH), an agency of the U.S. Department of
Health and Human Services. The grant will fund the ongoing development of
Vical's immunotherapeutic plasmid DNA (pDNA) vaccine against herpes simplex
virus type 2 (HSV-2).
    The initial preclinical development activities covered by the grant will
be conducted at the University of Washington School of Medicine and the
University of Texas Medical Branch, both centers of excellence in herpes virus
research. The vaccine will be designed for use in people already infected with
HSV-2, with the goal of reducing or eliminating periodic viral flare-ups and
the associated viral shedding and transmission.
    
     Contact:   Alan R. Engbring
                (858) 646-1127
                Website:  www.vical.com


SOURCE  Vical Incorporated

Alan R. Engbring of Vical Incorporated, +1-858-646-1127
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Avatar universal
1. Preparation while waiting for test results of genital herpes: An integrative approach for women to manage the psychological impact and stigma of a chronic sexually transmitted disease
by Kearns, Kelly A., Psy.D., The Chicago School of Professional Psychology, 2006, 49 pages; AAT 3287163

2. Damaged goods: The sexual self-transformations of women with chronic STDs
by Nack, Adina Lee, Ph.D., University of Colorado at Boulder, 2001, 238 pages; AAT 3005082

3. Low-income women with genital herpes: Recognizing and managing their fear trajectory
by Gordon, Shirley Countryman, Ph.D., University of Florida, 1998, 217 pages; AAT 9919569

4. ATTRIBUTIONAL SELF-PRESENTATION: THE DISCLOSURE OF GENITAL HERPES
by LARSON, JOYCE A., Ph.D., University of Illinois at Chicago, Health Sciences Center, 1986, 196 pages; AAT 8627810

5. " Relationship between attachment style and self-disclosure of genital herpes" (Kristin Briggs, Ed.D. Counseling Psychology in Education, Rutgers University, 2001)

6. Title: The impact of stigma on couples managing a sexually transmitted infection.
Authors:
Newton, Danielle
McCabe, Marita1 ***@****
Source:
Sexual & Relationship Therapy; Feb2005, Vol. 20 Issue 1, p51-63, 13p
Document Type:
Article
Subject Terms:
*SEXUALLY transmitted diseases
*INTIMACY (Psychology)
*MEDICAL personnel
*COUPLES
*RESEARCH
*INTERPERSONAL relations
Author-Supplied Keywords:
disclosure
genital herpes
genital human papillomavirus
relationships
stigma
STIs
Abstract:
Recent research has indicated that the stigma surrounding sexually transmitted infections (STIs) creates a psychological and emotional burden for individuals with these conditions. It would be expected that the stigma of having a STI would also alter the dynamics of an intimate relationship. This paper reviews the literature on the impact of STIs on intimate relationships, and considers the relevance of this research to both clinicians and researchers. In particular, the types of relationships in which the presence of a STI may have a varying degree of impact are examined. Since disclosure of a STI would also be expected to impact on a relationship, an overview of the factors involved in the disclosure of a STI to a partner is also considered. Finally, the implications of this research for both clinicians and researchers are discussed. [ABSTRACT FROM AUTHOR]
Copyright of Sexual & Relationship Therapy is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts)

7. Doing Psychotherapy with Patients with Genital Herpes: Issues and Interventions.
Authors:
Zacharioudakis, Manos A.
Source:
Scandinavian Journal of Behaviour Therapy; Aug2001, Vol. 30 Issue 3, p108-133, 26p
Document Type:
Article
Subject Terms:
*PSYCHOTHERAPISTS
*HERPES genitalis
*PATIENTS
Author-Supplied Keywords:
Cognitive
COPING
DISEASE
Distortions
EMPOWERMENT
ETHICS
Genital
Herpes
Psychotherapy
SEXUALLY
Stigma
THERAPY
TRANSMITTED
Abstract:
This article presents issues that the psychotherapist is likely to have to deal with in treating patients with genital herpes. A review of medical issues, clinical manifestations and pharmacotherapy of herpes infections is presented. Common psychological reactions and psychopathology related to herpes simplex virus infection, a discussion of the patient's dilemma of disclosing his or her herpes simplex positive status to others and a list of cognitive-logical distortions often encountered in, and negatively affecting, patients with genital herpes are presented in detailed examples. A practical model (SANE) conceptualizing psychotherapy for patients with genital herpes in 4 intervention stages (Stabilization-crisis intervention, Acceptance, Normalization and social-personal Empowerment-evolution) is suggested for use. The use of cognitive-behavioral therapeutic strategies in facilitating the patient's assumption of a healthier psychosocial perspective in each stage is comprehensively detailed. Ethical and legal concerns in working with herpes simplex positive patients are also discussed.
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Avatar universal
/// there have been reams of research on herpes as a psychologically disturbing personal experience. ///

I'm not sure I buy this, but if you have links, feel free to post them here.

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207091 tn?1337709493
COMMUNITY LEADER
Yes, herpes can be upsetting, but that doesn't mean you have to let it be.  If you buy into the social stigma, you aren't doing yourself any favors.

I can see waiting to tell a partner until things get more serious, but if you are being intimate with that person, its serious enough to tell them.  That's really contradictory - if you are intimate enough to sleep with them, you are intimate enough to tell them.

I have a journal that gives some good telling tips.  Just click on my user name.

Aj
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Avatar universal
It may be that GH is insignificant in the scheme of things, but there have been reams of research on herpes as a psychologically disturbing personal experience.

The moral high ground is H-I-G-H and not always within reach.

With infertile couples, contraception would not be relevant.

Having said that, I do appreciate your sound advice, words of comfort, and encouragement.

Thanks.
Helpful - 0
101028 tn?1419603004
You did not expose them to a life threatening illness. Depending on the disease they have, depends on their risk. There are very few illnesses that contracting genital herpes would be an issue with.  Thankfully for the most part herpes is an annoyance no matter if you have it orally or genitally. Yes it can lead to complications but for most adults it's not an issue.  This person is playing head games with you - obviously they didn't care all that much that they didn't talk to you about std's and didn't even want to use condoms - HELLO!!!  They can't be that darn concerned about their health now can they?

I'm totally with waring in that it just saves you a lot of potential grief if you talk about your herpes upfront.  folks appreciate the honesty.  Yes indeed the risk is very low of transmitting it in general but it's still just the "nice" thing to do.

the herpevac vaccine is just about done with trials now and it'll be awhile yet until we hear the final results. It was 40% effective in completely hsv negative females in the phase 2 trials. We are just waiting on the phase 3 trial info to come in to see if it'll bother to go for FDA approval or not.  It's not a lot of help but it's the best we have so far next to suppressive therapy in the infected partner.

grace
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Avatar universal
Your story is a little convoluted, but from what I've read here, you didn't disclose your status until AFTER you had intercourse? Is that correct?

That's showing exceptionally poor judgment on your part. It's better to let your potential partners know your status before you ever reach the intimacy stage in your encounters. Your partners have the right to make a decision about whether to have sex with you or not. You should also be discussing STD testing and birth control in general with them, which of course should happen before any sexual activity as well.  

Herpes isn't the black plague, for pete's sake. It's herpes. To say that it has "devastated" your life is a little overdramatic, don't you think?  You'll be fine. Just use medication and condoms to protect your partners, tell them what the risks are to them, have them get tested (and you be tested as well for the relationship), and discuss birth control and STDs in general before having sex.  

Why would you not use a condom even if your partner didn't want to? Did you know your partner's STD status? You were putting yourself at risk for other STDs by not using a condom. These are all things that should be discussed BEFORE you hit the sheets, for obvious reasons.

Forget about a vaccine - probably won't happen in our lifetime, or if it does it's years away. Better to educate yourself, become comfortable with having herpes, and get in the habit of informing your partners and discussing it before jumping into bed.

If you were taking Valtrex, even if you didn't use a condom, and you had sex once with this person, their risk of contracting herpes from you is extremely low. That doesn't excuse your behavior, however - not informing them of your status beforehand and not using a condom (which would have been for your protection as well).

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