SUCCESSFUL MANAGEMENT OF GENITAL HERPES
From Diagnosis to Recovery
Curtis S. Phinney, MSPH
Rockville, Maryland
February, 2002
My initial diagnosis for genital herpes took place in December 1993. The symptoms
of my primary episode looked like acne to me at first. By the following weekend
a cluster of lesions had formed that defied denial and was frighteningly unfamiliar.
An appointment with my family doctor was a priority for the following Monday.
Almost immediately upon seeing the sores on my genitals, my doctor said "That's
herpes. I know you don't want to hear that, but I've seen a lot of this."
I stood in stunned silence. Subsequently, my doctor took a culture, and explained
the existence of antiviral treatments. Shocked, I said that I was an unlikely
candidate for genital herpes infection. I told him that I was in a relationship
that I had assumed to be committed and monogamous. My doctor told me that he
had heard variations of my story many times before. Shaken, angry, and frightened,
I left the office in a state of dazed disbelief.
I had to cope with a shattered self-perception of my sexuality. I felt dirty,
unlovable and untouchable. I had been divorced some years earlier, and had been
active in the tumultuous world of adult dating in metropolitan Washington. Suddenly,
I felt that a successful outcome was now impossible. The certainty that I was
now "damaged goods" would no doubt prevent me from ever having a mutually
satisfying relationship with anyone again.
HOW did I start my recovery from genital herpes? Honesty, an acceptance of
my condition and the associated responsibilities to myself and others. Openness,
the release of anger and resentment, allowing me to become teachable. Willingness,
a deliberate effort to actively participate in my own recovery. The willingness
to participate in my own recovery was fundamental in breaking the emotional
cycle of stress-induced outbreaks, as well as preparing me for telling another
person that I had herpes.
Telling a potential sexual partner was one of the first and most difficult
problems that I had to face. I had to face the possibility of rejection, social
stigma, and vulnerability. Effectively dealing with this challenge, however,
started me on the path to recovery. Telling a potential sexual partner was important
for several reasons. First, the chance of transmission to somebody else was
considerably lower if we were both aware of the condition. In addition, I was
relieved of the stressful burdens of fear of discovery, guilt, and secrecy.
My partner was allowed to accept a degree of responsibility by making an informed
choice and by accepting some of the risk associated with transmission.
I soon saw that I had a considerable amount of control over how somebody else
would receive the news. Self-acceptance of my condition was of paramount importance
for acceptance by others. Emotional trauma over herpes infections is quite as
contagious as the virus itself. HELP groups were very effective in the development
of my personal information base. A well-informed, confident delivery can lend
considerably to the chances of a positive response by the other person. Becoming
informed about herpes before telling a partner was important because I could
certainly expect questions! I also had to be willing to allow time for others
to adjust, just as I had needed time to adjust myself. With some form of sexually
transmitted infection affecting more than one in five U.S. adults, many people
are delighted to discover a fulfilling relationship in spite of one or both
partners having some sort of STI.
I resisted my physician's first efforts to prescribe daily antiviral therapy,
based in part on my perception that this treatment regimen was reserved for
the worst cases. However, I was to discover that the regimen was both easily
tolerated and very effective. Stressful events that would surely have triggered
an outbreak earlier passed without any indication of new activity. Suddenly,
I felt once again at liberty to pursue life goals and activities that I had
previously considered too risky. The physical cycle of stress-induced outbreaks
was broken at last. Almost immediately, the emotional cycle, i.e., causing stress
by worrying about outbreaks under stressful circumstances, was broken as well.
I felt like I was in control of my life again, and the connection between the
self-perception of my own sexuality and clinical symptoms of genital herpes
was broken.
Suppressive therapy during my first year allowed me to develop coping mechanisms
without the anguish of repeated, severe, or unexpected outbreaks. The temptation
to deny the existence of the condition or lie to partners was greatly diminished.
In addition, the period of highest symptomatic and sub-clinical viral shedding
passed, reducing the chance of traumatic transmission to a partner. While valid
arguments might exist for continuation of a conservative approach to using suppressive
therapy, the undisputed existence of hundreds of thousands of new cases every
year underscores the urgency of developing a new, proactive approach to the
management of this disease. I do not approach this type of treatment as something
that I have to do forever or for the rest of my life. I take suppressive antiviral
therapy, just like other aspects of recovery with genital herpes, one day at
a time.
As a member of the local HELP group, I heard stories from other people with
herpes regarding their infection, management strategies, and relationships.
It soon became apparent to me that the secrecy and stigma associated with genital
herpes was of little benefit to us. This burden of shame and secrecy prevents
us from being able to be honest and open with sexual partners. As a result of
these personal observations, I volunteered to join a small group of individuals
who were willing to break their anonymity with regard to having genital herpes.
Some time later, I was contacted by the producer of a nationwide talk show and
asked to participate in an episode based on "STD's other than AIDS/HIV."
The message that other HELP of Washington DC group members and I tried to pass
on was simply that there is help and information available to herpes sufferers,
and that information and support had enabled us to enjoy life, love and relationships
after herpes. The interest that the show sparked was remarkable. There is an
unfulfilled demand for information and support that exceeds the resources known
to the general public. When I characterize the condition to a lay audience,
I always emphasize five key points. They are that genital herpes is Serious,
Chronic, Contagious, Preventable, and Treatable.
As I have traveled along the journey of recovery with genital herpes, I have
found the experience characterized by a variety of choices. We are almost immediately
called upon to choose one of two paths. One is the acceptance of the condition
and the associated responsibilities. This predisposes us to developing the honesty,
openness, and willingness necessary to enjoy life, love and happiness after
genital herpes. The other, suppression and denial, shuts us off from growth,
information and support. New people can be drawn into this vicious cycle of
bitterness, resentment, and anger by the transmission of the virus. Promoting
acceptance and honesty, using antiviral therapy where indicated, and finding
social support and information positively affected not only my recovery, but
the health and well being of others as well.
Please let me know if this sort of format
is the type of newsletter that you would like to see.
If you have any feedback, please click here!
|