Why Isn't Herpes Included in Regular STI Screenings?

Why Isn't Herpes Included in Regular STI Screenings?

Did you know that most doctors do not screen for herpes if there are no symptoms present?

Of course, we know how important knowing our STI status is. But there are valid reasons why experts (like the CDC) recommend against herpes screening for individuals who are asymptomatic.


First, a little background:

Herpes is a common viral infection caused by the herpes simplex virus (HSV). There are 2 main types:

    1. HSV-1 (which mostly spreads by oral contact and causes infections in or around the mouth (oral herpes or cold sores)
    2. HSV-2 (which mostly spreads by sexual contact and causes genital herpes)

There is no cure for herpes, but antiviral medications can help manage and reduce outbreaks caused by the virus.

However, not everyone will show symptoms of herpes. In fact, between 75% and 90% of people with HSV-2 (genital herpes) may not even be aware that they have the virus, as they may never develop symptoms. It is also possible to contract HSV-1 (oral herpes) without experiencing symptoms.

It's actually more common NOT to experience any symptoms of herpes than it is to be symptomatic.

But, unlike other STIs, herpes does not lead to any long-term complications even though it is life-long and incurable.


Screening vs. Testing

It's worth noting that screening & testing are not the same thing.

Screening = no symptoms are present
Testing = symptoms are present

So if you go in for your routine STI screening and have no symptoms, your doctor will likely not check for HSV. However, if you have symptoms, you will likely be tested.

When a person has an active outbreak (i.e. blisters, sores), a swab can be taken and tests can detect the virus directly. However, if no symptoms are present, a blood test can be taken to look for antibodies in the blood.

It's important to note that a herpes test cannot determine when you contracted the virus or how long you have had it.


Why it's not included in typical STI screenings

There are a few reasons why experts recommend against screening for HSV.

    1. There is no medical benefit to getting tested if no symptoms are present, because you only need treatment if symptoms are present.
    2. Research shows that diagnosing herpes does not prevent it from spreading.
    3. A positive test usually leads to anxiety and shame because HSV is so stigmatized.
    4. The blood test that is used to test for herpes when no symptoms are present has risks of a false positive result.
    5. Since the test cannot tell you how long ago the virus was contracted, there are often false assumptions about how and when a person actually acquired HSV.


The Takeaway

It can be unsettling to know that HSV isn’t something that is being routinely screened for. But the first step in reducing your risk is to practice safer sex with barrier methods, like condoms.

It can be surprising that something with such a stigma isn't a priority to doctors - but the reality is that it is a common, mostly harmless, virus. In fact, the stigma causes more harm than the actual infection does. Which is a major reason why screening isn't recommended.

Ultimately, it is important to reject the stigma around genital herpes, know the symptoms to watch out for, and get tested if you have symptoms.


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