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People should not have genital, oral or anal sex while sores or blisters are present. However, it is important to remember that it is possible to transmit infection even if there are no obvious blisters, sores or other symptoms.

If a child is younger than 6 weeks of age, notify a doctor if cold sores appear. Severe infection or disease complications occur more commonly in infants. For instance, besides affecting the mouth, HSV-1 may go to the brain and produce damage.

Spread of infection is most likely when a moist blister is present. However, people with a history of genital herpes may shed the virus (and are capable of infecting others) even without a blister being present.

HSV-2 infection is more common among women than among men (20.3% versus 10.6% in 14 to 49 year olds), 4 possibly because genital infection is more easily transmitted from men to women than from women to men during penile-vaginal sex. 5 HSV-2 infection is more common among non-Hispanic blacks (39.2%) than among non-Hispanic whites (12.3%). 6 This disparity remains, even among persons with similar numbers of lifetime sexual partners. For example, among persons with 2–4 lifetime sexual partners, HSV-2 is still more prevalent among non-Hispanic blacks (34.3%) than among non-Hispanic whites (9.1%) or Mexican Americans (13.0%). 6 Most infected persons may be unaware of their infection; in the United States, an estimated 87.4% of 14–49 year olds infected with HSV-2 have never received a clinical diagnosis. 4

Pregnant women with symptoms of genital herpes should inform their health care providers. Preventing acquisition of a new genital herpes infection is particularly important for women in late pregnancy, as this is when the risk for neonatal herpes is greatest.

If you think you have an STD, tell your partner(s) as soon as possible. You may be able to spread the infection even if you have already begun treatment or are using condoms. With some STDs, doctors recommend treating both partners at the same time. This may be a difficult conversation. Some people find it helpful to write a script ahead of time. Be sure to let your partner ask questions and express his or her feelings.

HSV-1. This is the type that usually cold sores or fever blisters around your mouth. HSV-1 is often spread through skin-to-skin contact, though it can be spread to your genital area during oral sex. Recurrences are much less frequent than they are with HSV-2 infection.

Herpes infection can be passed from you to your unborn child before birth but is more commonly passed to your infant during delivery. This can lead to a potentially deadly infection in your baby (called neonatal herpes). It is important that you avoid getting herpes during pregnancy. If you are pregnant and have genital herpes, you may be offered anti-herpes medicine towards the end of your pregnancy. This medicine may reduce your risk of having signs or symptoms of genital herpes at the time of delivery. At the time of delivery, your doctor should carefully examine you for herpes sores. If you have herpes symptoms at delivery, a ‘C-section’ is usually performed.

Many HSV-infected people experience recurrence within the first year of infection.[12] Prodrome precedes development of lesions. Prodromal symptoms include tingling (paresthesia), itching, and pain where lumbosacral nerves innervate the skin. Prodrome may occur as long as several days or as short as a few hours before lesions develop. Beginning antiviral treatment when prodrome is experienced can reduce the appearance and duration of lesions in some individuals. During recurrence, fewer lesions are likely to develop and are less painful and heal faster (within 5–10 days without antiviral treatment) than those occurring during the primary infection.[12] Subsequent outbreaks tend to be periodic or episodic, occurring on average four or five times a year when not using antiviral therapy.

HSV1 and HSV2 are genetically similar to each other. For this reason, having one form of the virus sometimes reduces risk of contracting the other form. This is because your body actively produces antibodies to fight the virus once you have it. However, it is possible to contract both forms.

Herpes simplex virus is usually spread by contact with blisters. However, people with genital herpes can shed the virus from the genital area and infect others even without a blister being present. Cold sores on the mouth are a potential source of genital infection during mouth-to-genital contact (oral sex).

The human immunodeficiency virus (HIV) causes HIV infection and the acquired immunodeficiency syndrome (AIDS). Symptoms and signs of HIV infection include fatigue, enlarged lymph glands, and recurrent vaginal yeast infections. Highly active antiretroviral therapy (ART) is the standard treatment for HIV infection.

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