Got Herpes? You're Still Worthy

Happy New Year! 

New Year but same feeling of shame and stigma around Herpes?

Don't worry. We got you. 

Join us for this brave and empowering conversation as we navigate the complexities of herpes. 

This is an important one as it affects almost everyone - literally. No more shame, we're all in the same game. 

Find us here!

Email: hello@fgsx.community

Instagram: https://www.instagram.com/fgsx_pod

Resources here!

Website with all the best info

www.herpes.org.nz 

Youtube 

Adam ruins everything - https://www.youtube.com/watch?v=aU4VcOQzQm0

NZ ad campaign - https://www.youtube.com/watch?v=_e1h2ZTJb2k 

Social Media 

Herpes Advocate - @suzbubs

Additional support

Sexual Health Helpline (08) 9227 6178 – an Australian national helpline run by nurses who specialise in Sexual Health. Open from 9:30-16:30 M-F. 

Community guidelines here!

https://sti.guidelines.org.au/sexually-transmissible-infections/genital-herpes-simplex-virus-hsv/

We are your co-hosts, Dr Shyamini and Nurse Ellie, and this, is For Goodness Sex xx

Transcript

SPEAKER_04 0:00

Hello, my name is Shamani and I am a co-host of the podcast for Goodness Sex. I am a Fijian Indian woman of immigrant parents and am proud to live, work, and play on Wajuknyar Country. This podcast acknowledges the past, present, and future traditional custodians of stolen country and the impact this has had on the health and well-being of our Aboriginal and Torres Strait Islander brothers and sisters. Sovereignty was never ceded.

SPEAKER_02 0:27

Hi team. Now, whilst we are healthcare professionals, this episode is for informational purposes only, and it does not replace personalized healthcare advice. Your health is unique to you. If you have healthcare concerns, please seek out your local health professional. Nail it. Nailed. Nailed it. Absolutely nailed it. Thank you, baby. I am secure, I am grounded, I am strong, I am prosperous, I am balanced, and full of abundance. I am secure, I am grounded, I'm strong, I'm prosperous, I am balanced and full of abundance.

SPEAKER_01 1:03

That's beautiful. That's my little mantra.

SPEAKER_02 1:16

Hello and welcome back to For Goodness Sakes. I'm Nurse Ellie.

SPEAKER_04 1:20

And I'm Dr. Charmoney.

SPEAKER_02 1:22

And we're your co-hosts.

SPEAKER_04 1:23

We are. We're back. We're ready.

SPEAKER_02 1:25

I'm so happy to be here.

SPEAKER_04 1:26

We are so happy to be here. Are you actually happy?

SPEAKER_02 1:28

So happy.

SPEAKER_04 1:29

Yes.

SPEAKER_02 1:29

I just have to I just have to get here. It's the getting here.

SPEAKER_04 1:32

And you got here. Yeah. And we're gonna re-jig the schedule. We're gonna rejig up. We can make it that we are, you know, both on fine form.

SPEAKER_02 1:39

Yeah, for context, everyone, we record on a Sunday.

SPEAKER_04 1:42

Um, bad day for others. Yes.

SPEAKER_02 1:44

Yeah, which was a bold, it was an ambitious choice. It was. Um I wanted to think that it would um encourage me to, you know, keep somewhat of a lid on. It hath not. But that's okay. We know our limits.

SPEAKER_01 2:01

Yeah.

SPEAKER_02 2:01

Today we're talking about herpes.

SPEAKER_01 2:04

Herpes.

SPEAKER_02 2:05

Herpes, herpes, HSV, baby. One of my favourite topics. It is. I'm a big herpes advocate, I feel. Um I feel very strongly about the matter.

SPEAKER_01 2:14

As you should. Thanks.

SPEAKER_02 2:16

As we all should. We all should.

SPEAKER_04 2:17

Yeah, actually, the guy that owns this recording studio outside asked me, he was like, Oh, what are you guys recording today? And I just turned to him and I said, Herpes. And he said, Oh, yeah, that's good.

SPEAKER_01 2:28

We should know more about that. We should, Dr. Charmani.

SPEAKER_02 2:32

We absolutely should. Yes, everyone needs to know more about herpes, I feel. Absolutely. Um so that's what we're here today, and I'm very excited. Me too. I thought I'd kick it off with a a quick rapid fire, true or true or false. How do you feel about that? Uh I'm nervous, but I'm ready. I think you can do it. Okay, so shamani. True or false? Only certain sorts of people get herpes. False. That's correct. Herpes is very common. True. That's correct. Um people who have genital herpes can still receive oral sex. Yes. True, true. True, true. True, and true. And please do. Um I could catch herpes from my roommate through shared communal facilities. False. False. People with herpes can never have sex again.

SPEAKER_04 3:24

False. Wow, that's grim. That would be grim if that was true. Very grim. That'd be a lot of the world, do you think? Yes, exactly.

SPEAKER_02 3:30

Yeah. Um, so yeah, that is false. And then lastly, you are not required by law to tell your partners about your herpes diagnosis. That's true. That's true. That is true. But we'll touch on that a bit more later. Okay, so the reason that this topic is so important to me, and the reason I'm so passionate about herpes is because I am a HSV baddie myself.

SPEAKER_04 3:55

I did know that.

SPEAKER_02 3:56

Yes, I'm quite proud of it actually. Um so when I was 19, um, my partner at the time had a cold sore, so HSV1, um, performed oral sex on me, and then transmitted that to my genitals. So I have HSV1 on my genitals. Um so since then I've only had two outbreaks, actually, which is I've been lucky. Everyone's experience is different, but I've been very lucky. Um but yeah, at the time, at 19 years old, I had no education or understanding about herpes or what it was. All I knew was from the media, um, which is very stigmatized and has a lot of misinformation about herpes. Yeah, totally. Um so yeah, at the time it was huge. I thought, I thought my life was over. Um the GP at the time didn't give me any information about it. Um my mum didn't, you know, didn't know herself. She didn't have the education either, so she didn't have the tools to support me either. And it was a really um isolating and scary time and also a painful time. Yeah, totally. I was in a lot of pain. Um I didn't know what it was, so I didn't, you know, I didn't go to the doctor right away, and yeah, it was super painful um and and a bit isolating. So I feel very strongly about um educating people on herpes because I'm sure you had to go through that.

SPEAKER_04 5:17

It's uh I mean I see it, oh, I see it all the time in my clinical practice too, and as you would too, it's just such a um minefield of information and misinformation too, so it's difficult to navigate.

SPEAKER_02 5:27

Yeah, it absolutely is. That's why I love my job now that I'm able to talk to people in that position and help them.

SPEAKER_04 5:34

Um how lucky they are to come across you. Bless you.

SPEAKER_02 5:39

That's very sweet. No, I love I love being able to um have that conversation, like talk people off the ledge, honestly, because they call me so distressed. Yeah. Um, but yeah, the reality is the herpes is very common and it's very manageable. Um, it doesn't mean that you're dirty or bad. Um, anyone can get herpes, and people with herpes have a very normal sex life and love life.

SPEAKER_04 6:04

Yeah, totally.

SPEAKER_02 6:04

And Dem's the facts.

SPEAKER_01 6:06

They are the facts. Yeah. True. True. I got another one.

SPEAKER_02 6:10

Yeah, bonus point. Bonus point. You got 110%. Thank you. Thank you. Um, yeah, so herpes is very common. Um and there are two types, so I'll just go into those a little bit for you. Yeah, of course. So herpes simplex type one and herpes simplex type two, so HSV. Type one is the cold source, um, which often people get on their face or on their mouth usually. Um, and up to 80% of the population has type one.

SPEAKER_01 6:39

Yeah, that's true. So another one. True. Ding ding ding. So common. Yes.

SPEAKER_02 6:45

So common. So common. Yeah, yeah. And about 50% of genital herpes is actually caused by HSV1.

unknown 6:51

Yes.

SPEAKER_02 6:52

So like in my case.

SPEAKER_04 6:53

Yeah.

SPEAKER_02 6:54

Um and up to 22% of sexually active adults have HSV2 or genital herpes. Yeah. So it is common. Very common. So as I said, HSV1 typically affects the face, but particularly the mouth or the nose. Um, but both HSV1 and 2 can affect the genitals, pubic area, buttocks, back of thigh, or the inner thighs. Um herpes can actually occur on other parts of the body as well. Yeah, it can.

SPEAKER_04 7:22

Rarely, but it can.

SPEAKER_02 7:23

It is rare, but yeah, and that's uncommon. Um and so most of the time when a person with herpes doesn't have symptoms, they are not infectious. When when you have herpes, you're not contagious all the time. Correct. Yeah. True. Um I just like overachieving too.

SPEAKER_01 7:43

We know.

SPEAKER_02 7:45

Yeah, we know. Yeah. Um, yeah, so you're not contagious all the time. Okay. Obviously during an outbreak, um, and usually, well, I mean, I usually say wait 10 to 14 days after an outbreak, just to be safe. Yep. Um, because there is something called viral shedding. Um so viral shedding is where you can transmit the virus when there's no symptoms there. Yep. That's true. So um so 75% of people who get herpes get it from partners who actually aren't aware that they have it. Yeah, absolutely. Which I find it really challenging. It is challenging, yeah. Um it does make it a bit tricky. Um in terms of the viral shedding, so the viral shedding occurs only 5% of days per year. Yeah. So it's it's a small amount. It is a small amount. But we just don't know when that will be.

SPEAKER_04 8:36

No, no. And there is some data to support that, you know, when you say to wait the time after the outbreak, that there is some data to support that some of that asymptomatic shedding occurs once the symptoms have resolved around the outbreak. Yes. Okay. So that's that's pertinent as well. Yeah. Um, um and just to demonstrate, I guess, the ambiguity or or like the difficulty in in having this in a in a specific information packet, essentially, is that in a one prospective study, patients with newly acquired infection performed a median number of 40 sex acts.

SPEAKER_02 9:12

Can we do we have details on the sex acts?

SPEAKER_04 9:16

And acquired the infection within three and a half months. So again, 40 performances of sex in variable ways in three and a half months, at some point they've acquired the infection. So it's really, really difficult to know.

SPEAKER_02 9:31

So difficult. Yeah, yeah.

SPEAKER_04 9:43

So um we also know that it can be a little bit tricky when it presents itself. Um there is a typical pattern that can happen with primary infection. So you can um present with severe painful genital ulcers. Can confirm.

SPEAKER_02 10:00

It was there. Had to pee in the shower.

SPEAKER_04 10:03

Shame. Um, burning on urination, yeah. Fever, true, and local local lymph nodes that can swell as well. And often you can be headache. Um the lesions present in like a little cluster of blisters. Um and some people also describe redness and itching with a little bit of a tingle in the skin so that they feel like they know when it's coming on. Sometimes it can also present with um conditions known as cervicitis, which is um inflammation of the cervix, or proctitis, which is uh inflammatory infection of the rectum, essentially. Um very rarely it can also present with neurological symptoms, extremely rare, and the extra genital lesions that you mentioned earlier. Um the average incubation, that means how long it takes to cook in your body before it presents as lesions, is about four days. Four days. Quite short, quite short, isn't it? It is, and it's it's highly, highly variable. Um and I guess the difficulty is that whilst this is how it presents typically, some people will often have some some non-specific little blisters or lesions that they they aren't really sure of, and they just come and go, and then they kind of miss the boat for diagnosis. So um most infections are that, which is subclinical, so just kind of hovering before this big outbreak. Um and so that's why a lot of them do actually go miss. Go miss. Which is sad.

SPEAKER_02 11:33

Yeah, it's sad. And it's not um like always, obviously, it's typically, as you said, the blisters, but sometimes it can even just be like a little opening of the skin. Like a crystal, sometimes even just a break in the skin. Yeah, it might not even present as a blister, which is so confusing.

SPEAKER_04 11:48

Totally. It can also just be like an isolated ulcer as well, like that it can be be very variable. So whilst it's certainly clinically very helpful for us to know that it fits a specific pattern, um, it certainly can be really challenging for for people to seek help if they don't know exactly. Tricky little bugger.

SPEAKER_01 12:07

Tricky. So basically, if in doubt, check it out. If in doubt, check it. If in doubt, check it out. I love that. Actually, I just I just I literally just came up with that right there. Uh smart beautiful. Thank you. Thank you.

SPEAKER_02 12:18

If in doubt, check it out. If in doubt, check it out, if if in doubt, check it out.

SPEAKER_01 12:24

That was beautiful.

SPEAKER_02 12:25

Thank you so much.

SPEAKER_04 12:25

Yeah, so talk us through testing then. Now that we've got the clinical presentation done. Tell us how we actually test for it.

SPEAKER_02 12:32

Okay, so we want to diagnose HSV by using a swab. So um a swab of any lesion, ulcer, or you know, broken skin that someone's concerned about, we can do a PCR swab and send it off. Um and that will let us know if it's either HSV1 or HSV2. We don't recommend routinely testing um for herpes in blood or in serology. So you can um do uh HSV serology, um but it's actually wildly inaccurate and not really helpful at all. Um so what shows up in the blood is the antibodies to HSV1 and HSV2. Um most of us probably would have a I'm sorry, my fake nail just fell off. Hello kitty. My Hello Kitty nail just fell off. Anyway, she's just over there and she's a star. Okay. Um continues. So it shows the antibodies. And um it doesn't necessarily mean that you have an outbreak or that you can pass this virus on. Most of us probably would have a positive blood test. Um well, 80% of the population have it. So they would have it in their blood. Absolutely. HSV1, that is, yeah. Yes, that's it. Um and also it doesn't tell us where where on the body the virus is. It's it's not very helpful at all. No. So we don't recommend routine testing for herpes. Um, but if you have a concern or a doubt, check it out. Check it out. So come in and we can have a look and we'll have a swab. Absolutely.

SPEAKER_04 14:09

Have a swab. Have a swab. You can have the swab and we'll do the swab. Yeah, that's it.

unknown 14:14

Yeah.

SPEAKER_04 14:22

So um what we do know is that we want to initiate treatment um as soon as possible. Yeah. Um, and we don't really wait for the test results. So if it um looks like herpes and it's pretty convincing, we will suggest treatment options.

SPEAKER_02 14:37

Um what is and what is the treatment?

SPEAKER_04 14:39

Yeah, so the treatment is um antiviral medication. Um it's an oral tablet that you take. Um, there's a few different types. Um the treatment needs to be initiated within five days of symptom onset. Okay. Okay. And it's important to remember, yeah. Um and you've got to get in quick. Got to get in quick. Got it in quick. And it's important to recognise that the treatment is not curative. So we're not giving the tablet to cure HSV, it is to reduce the severity and the duration of the episode. Yeah. Um, and then moving forward, if you were to have a recurrence, which, as you've mentioned, is um more associated with HSV2, then it can be managed with episodic therapy. So you give it around the outbreak. And by then, people are pretty good at recognizing when they're about to have one. Yeah, that's it. Yeah, yeah.

SPEAKER_02 15:35

I always say um just keep a box of the antivirals at home. Yeah, that's right. Yeah. And if you feel an outbreak coming on, or you feel the symptoms, a bit of tingling, then you can just start the treatment straight away.

SPEAKER_01 15:47

Totally.

SPEAKER_02 15:48

Um it's also worth noting that um certain things can bring on an outbreak as well. So stress, um, being unwell, being sick, um, basically anything that lowers your immune system can cause an outbreak. Anything. Anything.

SPEAKER_04 16:01

So if you've got allergy in winter, you might get an outbreak. Double whammy. Double whammy. It's not very nice. And for some people, the recurrence becomes um quite disabling. Yeah. Um, and we can offer suppressive therapy. So instead of treating with each episode, we can offer the same treatment just for a longer course, typically six months. Um and the the reasons for initiating that are highly variable, but um often it's associated with multiple episodes within the six-month time frame or significant psychosocial stresses, which is totally fair. Which is fair. And we see it. And we see it a lot. We do see it.

SPEAKER_02 16:40

So and being on the um suppressive treatment does reduce transmission um of symptomatic herpes by 75%. Yeah. Um, so when people, you know, when it does have quite an effect on people and they're really quite stressed.

SPEAKER_04 16:56

It's also important to note that that you might people might think, oh, the topical stuff that I use for a cold sore might be sufficient. We don't we don't use topical antivirals, it's not gonna quite cut it. Um and I guess there are some other treatment options, you know, as we use as adjuncts for this, um, aside from the antivirals, which include regular pain relief as needed. Um you can also use like a topical lignocaine, so topical local anesthetic. Yes. Urinating in the bathtub or the shower. Been there, been there, my friends in there, waterproof dressings, um, those sorts of things that you can to do to sort of get you through the episode as well.

SPEAKER_02 17:35

Free ball, just free ball it.

SPEAKER_04 17:36

Yeah, just free ball and have some time off work or study or whatever it is you're doing.

SPEAKER_02 17:40

I wish I'd done that. I was on night shift.

SPEAKER_04 17:42

Yeah, no, it's a lot going on down there. You need some time to rest. Time to rest.

SPEAKER_02 17:45

That's your body telling you time to rest now. Absolutely. Yeah. Um or sometimes, is it the sits baths?

SPEAKER_04 17:53

Like Sitz baths are useful for symptom treatment of um lots of things in that area in general. So yeah, you can use it for ulcer management. Whatever works. There's there's options.

SPEAKER_02 18:04

There's options, suffer unnecessarily. There will be suffering. So yes, I guess circling back to being on the suppressive treatment. Yes. And you know, you can see why people, you know, it sounds um what's the word? It is right for it. Appealing. You know, when you hear that it uh it decreases transmission by 75%. Because people get very very stressed about disclosing to partners.

SPEAKER_04 18:34

Yes, they do.

SPEAKER_02 18:35

Yeah, so I want to talk about that a little bit.

SPEAKER_04 18:36

Yeah, please.

SPEAKER_02 18:37

Um because as we mentioned in our rapid fire, so legally you don't actually have to tell your partners about your HSV diagnosis. This is because the virus is so common. Um because like there is that fear of rejection, um some people choose not to disclose their status to their partners. Um instead they might just abstain during outbreaks, um, practice safe sex and hope for the best. Um this can sometimes have more disadvantages than advantages though. Um like potentially um it means a lot of your time and energy and anxiety is spent worrying about transmitting um the virus to your partner. And sometimes not telling can be worse than telling, in my opinion.

SPEAKER_04 19:23

Yeah, yeah. I mean, yeah, that's that's that's that's great. That's a really good point. Because we also know that sexual health is not specifically um in the context of absence of infection or disease, but also, you know, the improvement in your quality of your sexual life. And if it's not something we need to disclose, the the stress perhaps would make your actual sexual life worse. Totally. Yeah, yeah.

SPEAKER_02 19:47

I guess I just want to um you know what what you choose to disclose about your diagnosis, I guess is is the people's choice. So I don't want to I yeah, I guess it's giving advantages and disadvantages of both.

SPEAKER_04 19:59

Yeah, absolutely. And it's okay, also okay if you want to disclose. Absolutely. So it goes both ways. It goes both ways.

SPEAKER_02 20:05

So um so yeah, alternatively, um, telling your partner about your diagnosis and allowing them to enter into a relationship um with full knowledge of the virus and the risks, um, it can open up an opportunity for someone to be educated on the virus um and also to reduce stigma and misinformation about it. So I think the biggest thing about herpes is people don't know, um, don't understand. Um so that's scary, you know?

SPEAKER_04 20:32

Oh, it's it is scary, and I see it as you do, as you do too. I see it all the time. Um people that have you know, it's just on their clinical history, but they've never really spoken to anyone about it. Lots of shame. Lots of shame, so much stigma. And it yeah, it is a real shame because it's so common as we keep um hammering on about. Yes. Um, is that we're all in the same boat. Yeah. Really?

SPEAKER_01 20:57

So we share bugs, we share viruses, it's just we share it all. It's just a thing.

SPEAKER_02 21:03

It's just a thing. So yeah, I think um, you know, and I acknowledge that I probably do speak from a place of privilege here, just because um I guess I acknowledge that not everyone moves in the same circles. Yeah. Um I feel like um in my queer community we're all quite sex positive, and um I have had overwhelm overwhelmingly positive experience in disclosing my HSV status. Um, but I acknowledge that not everyone moves in those circles, and some people um do require their their education, but I think yeah, it's it's it's a brilliant opportunity to educate.

SPEAKER_04 21:40

Yeah, I I couldn't agree more. And I certainly think that there are s certain populations that do struggle more with disclosure or um and I I have more often than not, I don't think there's a single new diagnosis I haven't referred for counselling. True. Um most most people I I diagnose. they they will often take up psychology and counselling because it it's a really difficult thing to navigate um if you're not in that sex positive space or you're just really not sure. Yes. Um and I think that's a really important thing to acknowledge too that if if you are someone who has been diagnosed with something like this or any sexual health related um issue you you can actually seek psychological support for that. There's no harm. It's actually probably a good thing. It's a good thing.

SPEAKER_02 22:29

And it's like specific to to this you know you can access counseling specific to this area. Yeah you absolutely can yeah yeah definitely that's such a good point. But yeah you're you're so right um contact your local sexual health clinic have a chat I'm sure um you know they'll be able to support you in your diagnosis as well. Yeah absolutely yeah um and yeah I've I'll put in the show notes this Instagram count that I follow oh my god I love her. Great Suze Bubs Suze Bubs if you're out there I love you chooky I love your work oh my god she's just herpes Queen advocate and she's just hot AF and she just does constant reels about having herpes and it's hilarious. Great. We love her. So I'll put that in the show notes as well. We love her.

SPEAKER_00 23:10

We love her.

SPEAKER_02 23:11

She also um yeah gives tips on disclosing which I'll get into now sip of the gug. Please yeah bite of the jeans nibble the gym um so yeah if we educate the mass so this is my goal I kind of want to be a herpes advocate myself. We already did this is the first did you know actually as well when I was 19 I I was actually doing it at 19 because when I was 19 I posted a photo of my girlfriend and I holly love you chooky ex-girlfriend but she's still my chooky lover. I posted a photo of us and the caption said worth the herbs.

SPEAKER_04 23:44

Oh blessed and that's so 2000s but it's great.

SPEAKER_02 23:50

I thought it was hilarious and cute people did not like it. Everyone yeah I was shamed I was shamed yeah it's tricky it's tricky isn't it yeah um so yes if we educate the masses on HSV it won't seem so scary. So if we normalise it um it it won't be such a big scary thing. It's just like cold sores. So I often say to my clients when you have a partner who has a cold sore right you don't kiss them during an outbreak but you still kiss them every other time right same as herpes you know but just don't have sex during an outbreak but you can still have sex any other time. Yeah. Um now I know rejection is hard and scary trust me rejection sensitive lady did girly here um but I often think as well so like if someone didn't want to pursue a relationship with me after I've disclosed this to them then is that someone I want to be with anyway? You know? Yeah I kind of want to be with a partner who is at least um open to f getting more information about it and figure you know and and having that discussion with me. So that's another thing to think about.

SPEAKER_04 25:00

Yeah and it's it's interesting you mentioned that because I certainly treat a lot of couples in that way is that we manage their outbreaks individually. They come in together we talk about it together and they kind of and we can sort of give a joint education about the relationship and how to reduce and often it's that one has HSV1 and one has HSV two. Yeah. And just trying to navigate that. And it's really lovely to see couples coming in and dealing with it that way.

SPEAKER_02 25:25

Yeah it's as it should be yeah absolutely as it should be it's like um yeah it's affects both of you and yeah so that's really nice. And they should be so lucky to have you down. They sure are um so when disclosing um also so your attitude will also influence how the news is received. So psychologists have observed that people tend to behave the way that you expect them to behave. And expecting rejection um can increase the chances of an unhappy outcome.

SPEAKER_04 25:56

Yes.

SPEAKER_02 25:56

Um so makes a lot of sense it makes a lot of sense so yeah a straightforward and positive conversation about herpes is the best approach and it can help for forward planning as we just discussed with your partner. So don't act like it's a huge deal. Try to be natural and spontaneous if you find yourself whispering mumbling or looking at the floor um maybe just pause for a moment and just speak clearly and calmly yeah um look your partner in the face um and the because the delivery does affect the message. Yeah yeah yeah I understand that it's a tricky conversation to have yeah it is really tricky I do I do I do get that um but I think it is it is important in the delivery about how it'll be received.

SPEAKER_04 26:38

Yeah I I think you really touched on a really important thing about safety and um I guess sustainability if it's someone you want to be with is that yeah if if they are going to um judge you harshly or stigmatise you then that's probably not a safe relationship anyway. So whilst it's difficult to have these um conversations and you are allowed to feel that way too like it's it's okay. Ultimately it's it's I guess it's a part of who you are and if you do want to be positive about it moving forward you you do have to to kind of set those boundaries and having if if having the conversation is important to you then you're just gonna have to do it I guess. Yeah.

SPEAKER_02 27:18

And the more you do it the easier it gets. Yeah yeah um but yeah you're right it's kind of like a good filter. Yes it's kind of like you know yeah it's a good way to sort of assess from the start. Like you know if this person's values align with yours. So maybe look at it that way. Yeah. But yeah so ideally you want to tell partners before you sleep with them if you're gonna disclose. Yeah. And then and then they can make an informed decision you know um and you know at the very least um you know if they just want to go away and get more information come back you know that's that's really fair. Um so yeah ideally before sleeping with them um and then you can have a discussion from there what both of you are comfortable with you know so I've just ghosted a few times I've had people say oh my god I have the exact same thing um like I've had HSV1 on my genitals I've had people be like oh um I have c get cold sores so I'm immune already um so yeah a little bit easier with HSV1 but um it's the same goes for HSV2 it's just an opportunity to to educate people um so people in long-term relationships so um most couples choose not to continually use condoms and understand that getting herpes is is just a part of life. Yep yeah your partner may already have herpes without being aware of it um so yeah that's just something that as you say the couple can um yeah decide within themselves.

SPEAKER_04 28:40

Totally great yeah I mean I've I've that's actually quite useful because I think a lot of people come and ask me how do I disclose or should I disclose and obviously my medical brain says well from a public health point of view you do not need to disclose and inadvertently try and create some sort of bodily autonomy but perhaps I'm not super equipped to give them um those strategies in the interim before they're accessing um psychology. So that's really helpful. Thank you. Yeah I'll take that moving forward into my practice.

SPEAKER_02 29:13

Yeah oh I'm so glad. Well I've I've yeah even got a few conversation starters as well. Okay. So yeah these um I guess a variety of ways to prompt the discussion um with someone this is a really good time I often like to be like when was your last SDI screen? You know it started off like that. Just like oh so when did you last get tested? And then I can say oh I was tested last week and I everything came back negative um all clear just to clarify we say all clear not clean because having SDIs doesn't mean you're dirty. And then I say oh look I had a test two weeks ago all clear but just to let you know I do have HSV1 or I do have HSV two. So I was di you can go into a bit of detail when you're diagnosed, when your last outbreak was maybe a little bit of the statistics um I guess you can be like do you know much about herpes? You know ask them what does what do you know about herpes and um what is it you'd like to know from me. You know? So yeah starting off by asking SDI screens is always good. Sometimes you can say even say have you ever had a cold sore before the reason I ask is that cold sores are caused by a virus herpes simplex virus and I have that virus. Only instead of getting a sore on my face I get one in my general area. You know frame it like that. It also could be cute to be like when two people get along as well as we do I think we owe it to each other to be totally honest and I'd like to talk about our sexual histories. Oh isn't that nice? That's beautiful. Would you not just be like okay Baddie take your clothes off right now. Aww yeah so that's when that's really nice I feel like we get along when two people get along as well as we do I think we owe it to each other to be totally honest and I'd like to talk to you about our sexual histories. That's lovely. That's a good one. Beautiful we'll put these in the show notes too maybe yeah I think that's a that's a good idea yeah yeah another one yeah I really enjoy being with you and I'm glad that we're becoming more intimate I think it's important that we talk about sex. Can we are we are you free to chat now?

SPEAKER_04 31:20

Stop these are just stunning it's really just reframing it isn't it it's it's it's taking the fear of the the the very common diagnosis and shifting it into like an open space or a strength based approach you know opening it up from a place of like curiosity rather than fear which is really lovely.

SPEAKER_02 31:40

And it's also making it about both of them it's shared. It's not just like you you know it's like this let's discuss. Yeah totally another one we're both responsible adults who want to do what's best for each other and for ourselves so let's talk about safe sex. You know and these can be used you know for anyone yeah anyone conversations anyone should be having yeah you know before a casual encounter. Another one is that's cute. So I feel that I can trust you so I'd like to tell you something personal like last year I found out I'd hope he's you know saying it like that as well um that you um that you trust the person to open up and be vulnerable so that's nice. So yeah it's not it's not a confession or a lecture. It's simply sharing information between two people. Okay yeah you you might even be surprised to learn that your partner has been equally concerned about telling you something. You know it just it just opens up that that conversation and in fact the probability of this is reasonably high given the statistics on HSB.

SPEAKER_04 32:44

So like so yeah and I guess this really laughs um yeah this really speaks home to what we're trying to achieve right is this open dialogue and to to to know that this is a it's a perfectly acceptable thing to do to to ask about these things of of a sexual partner. And the more we open up and the more we physically and metaphorically noise queen noise. The more we will get comfortable about having these conversations.

SPEAKER_02 33:13

That's right and so sexy it's hard consent and conversations it's and as I said before like it just makes the experience so much better. It incre it enhances intimacy because you're building trust yeah yeah and you're not you know sex is already hard enough totally without having to be anxious about um you know transmitting something so it just it's just the way to go totally thank you so much Nurse Ellie that was a delight I have learned so much from you thank you so much my absolute pleasure I really I could talk about herpes or up down every which way to Sunday we should be we should be we should be yes so um yeah please as we said reach out to local sexual health links there is supports for you you can get more information we'll put information in the show notes too and resources but basically just all in all people with HSV live a very normal sex and love life.

SPEAKER_04 34:16

Normalize HSV and herbies does not define you or your sex life boom everyone has herbies so everyone has her true everyone's got herbies so okay bye special thanks goes to the Hen House Recording Studios for hosting our recording sessions our production team Dana and Louisa and my good friend Harry Sansafari for our audio