The STD Discussion


At what point do you disclose an STD and how? I have genital herpes and seldom have outbreaks, but I haven't told my boyfriend of three months. We've been through HIV testing, we're monogamous, and I'm on the pill, so we don't use condoms anymore. With the treatments available, I won't likely give it to him, but not telling him seems dishonest.

He Said: You don't need to consult Miss Manners for this: We're obligated to disclose any STD before having unprotected sex. This is hard, especially early in a relationship; hormones and pheromones swell the chorus of the union, so speak, and silence the better angels of our nature.
As you know, it’s still possible for a person with genital herpes (HSV-2) to infect someone even if there are no signs of an outbreak. Now is a good time to tell your boyfriend. Do this soon, not just because the longer you wait the harder it will be, but also because people infected with genital herpes often don’t realize they have the virus. There’s an outside chance he had the virus before you two met and if he later has an outbreak he might blame you for giving him a virus he already had.
The likelihood of an infected woman giving a man genital herpes is only 5 percent over the course of a year’s sexual activity, so at three months—during part of which you were using condoms—it's not likely you’ve infected him. And antiviral meds you refer to in your letter can further reduce the chance of transmission. My point is: While herpes is a troublesome bug to live with, with care and meds it’s less of a relationship killer than some other STDs, so try not to bring too much drama into the talk with your boyfriend.

She Said: This talk is way overdue. You should have had it before you took the condom off; the perfect moment was when you discussed HIV testing. I know it's not easy to have an STD talk with a new guy you're trying to bond with and keep attracted to you, but risking someone else's health is not a good option. And, as you now see, the problem doesn't go away while you wait.

Given the stats quoted above, it's unlikely you've infected him, but one word of warning: While antiviral herpes medications can definitely decrease your outbreaks, they generally do not affect the risk of transmission—with the exception of Valtrex (valacyclovir), which has been shown to lessen the risk of transmission by 50 to 77 percent. Keep that in mind when you choose which medication to take.

As to the "how" part of your questions, choose a time when you both are feeling relaxed and connected—a Saturday or Sunday afternoon, perhaps—and state it as simply as possible. Make sure you relay the small transmission percentages we talk about here, and if you've been taking Valtrex, tell him that to reassure him even further. Explain that you wanted to tell him earlier but you focused on how small the risk was because you wanted to be closer to him before divulging the situation. STD disclosure is one of those situations that has a strict PC code of conduct—which is in fact being espoused here in this column—which often doesn't play out in real life. At bottom, most people understand this. Hopefully he will too.

photo: Hendrickson/Getty via Flickr

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