Herpes (Herpes Simplex Virus)

This post is also available in: English (英语) ไทย (泰语) 한국어 (韩语)

Herpes is a common and very contagious infection caused by the herpes simplex virus (HSV). Herpes/HSV is spread through skin-to-skin contact and can cause sores or blisters in or around the mouth or genitals.

There are two main types of Herpes/HSV:

  • HSV-1, which causes oral herpes. It usually affects the mouth and surrounding skin but can also affect the genitals. It is often called ‘cold sores’.
  • HSV-2 causes genital herpes (but can also affect the face) and is usually sexually transmitted. It is generally a more severe infection, and can include fever and flu-like symptoms.  

It is estimated that around 70-80% of Australian adults have been exposed to HSV-1, and approximately 12%  have HSV-2. 

Most herpes infections are asymptomatic or mild enough that many people do not realise they carry the virus. There is no cure for herpes, but medication can help manage and reduce the severity of symptoms, the frequency of outbreaks, and the risk of transmission.

Signs and Symptoms

Content warning: click to show images

The first symptoms of herpes may occur within days, weeks or years of exposure or may not occur at all.  For many people the first episode of symptoms is the most painful, and reoccurrences are usually less in intensity. Some people may not get another occurrence.

  • Genital discharge
  • Fevers, swollen glands, headaches, muscle aches and tiredness may also be present
  • On the skin surface, people may experience:
    • An itching, tingling or burning or swelling feeling
    • Inflammation
    • Blisters or bumps filled with clear fluid that eventually breaks open
    • Skin sores that are painful to touch

If symptoms do occur, it will often be within 2 – 12 days of exposure but can also appear days or years after exposure to the herpes virus. If left untreated, herpes symptoms can become more severe and last longer, increasing the risk of transmitting the virus to other people. 

Recurring outbreaks of genital herpes generally become less frequent and less painful over time. HSV-1 tends to be associated with less severe and less frequent episodes compared to HSV-2. Episodes can last for 7-10 days.

Vagina/Vulva

Penis

Anus/Rectum

Mouth/Throat

Eyes

Transmission

Herpes is easily spread from skin-to-skin contact with someone who has the virus. You can get it when your genitals and/or mouth touch their genitals and/or mouth – usually during oral, anal, and vaginal sex. The virus enters the body through small cracks in the skin or through the lining of the mouth, genitals, anus and under the foreskin.

Activities that can transmit herpes include: 

  • HSV-1 (oral herpes) 
    • Mouth-to-mouth contact (such as kissing)
    • Oral to genital contact (such as oral sex)
    • Oral to anal contact (rimming)
  • HSV-2 (genital herpes)
    • Genitals/anus to genitals/anus (such as penetrative vaginal or anal sex), 
    • Anus/genitals to mouth (such as oral sex)
  • Mother to baby (usually during vaginal delivery, but rare). People who are pregnant and have genital herpes should inform their midwife or doctor.

Herpes/HSV is most easily spread when there are blisters or sores, but it can still be passed even if a person has no current symptoms. Herpes is most infectious between the first signs of sores developing (including tingling and numbness) until the scabs have gone. 

Prevention

As herpes/HSV is transmitted through skin-to-skin contact, there is always a risk of transmitting or getting herpes for any sexually active person, no matter how careful they may be.

Here are some ways to reduce your risk of herpes/HSV infection:

  • Use condoms or dental dams as barriers (even when there are no visible symptoms). Remember that they will only protect the skin directly covered by the barrier.
  • Avoid skin-to-skin contact with blisters, sores or other potential herpes symptoms, especially around the genitals.
  • If cold sores are present, avoid kissing and do not allow the mouth to touch the vagina or anus.
  • If a client shows potential herpes symptoms, you can offer alternative services, such as hand relief, erotic massage, voyeurism, etc. 

If you already have herpes, here are some ways you can reduce the risk of transmission:

  • Use condoms or dental dams (even when you are not having an outbreak) can provide some protection from herpes transmission. Remember that they only protect the skin directly covered by the barrier.
  • Don’t touch herpes sores on yourself or others – if you do, wash your hands thoroughly with soap and water immediately after.
  • Transmission is more likely while a sore is present. If possible, avoid sexual contact from the time you first experience any symptoms until the sore has completely healed (the scab has fallen off, and there is new skin where the sore was).
  • Avoid kissing services if you have a cold sore on your mouth.
  • Some medication may also reduce the risk of passing on herpes (see ‘treatment’ below). 
  • Learn how to tell when an outbreak is coming. You may feel a burning, itching, or tingling, indicating you are about to get sores.
  • Do not share food/drink containers or products like lipstick if you have a cold sore. 
  • Looking after yourself – herpes outbreaks are more common when you are unwell or stressed.

Testing 

Here’s some information about testing for herpes/HSV. You can view a list of sex worker-friendly sexual health clinics at our Where To Test page.

Testing Method

When to Test

Other Info

Treatment

There is no cure for herpes, but the symptoms are treatable. Here’s what you need to know about treating it.   

Treatment Method/s

Costs and Other Information 

Stigma

Herpes carries a disproportionate level of stigma (especially HSV-2), even though many people live with the virus. Infection and/or outbreaks can lead to depression, distress, anger, low self-esteem and hostility towards the person believed to be the source of infection. It can impact your ability to work, or how you feel at work. 

For many people, overcoming the emotional effects and stigma of herpes is often much more challenging than managing the physical symptoms. Herpes is almost never a life-threatening illness, and it has few long-term health effects for most people. You may want to talk you your GP or connect with sex worker peers if you are having trouble managing the emotional/psychological effects of herpes stigma.

How might this impact my work? 

Practical Considerations

Legal and Reporting Considerations

Rate this resource:

Was this article useful?

As you found this post useful...

Follow us on social media!

We are sorry that this post was not useful for you!

What can we do to make this a stronger resource for sex workers?

Tell us how we can improve this post.