Table of ContentsView AllTable of ContentsWhat Is It?TransmissionStatisticsBy Race/EthnicityBy Age and GenderCauses and Risk FactorsCan Herpes Kill You?Screening and DetectionFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
What Is It?
Transmission
Statistics
By Race/Ethnicity
By Age and Gender
Causes and Risk Factors
Can Herpes Kill You?
Screening and Detection
Frequently Asked Questions
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What makes the scale of the epidemic all the more concerning is that most people with genital herpes do not know that they have it.
Genital Herpes Overview
Herpes can be diagnosed with a physical exam and a swab of herpes sores. Blood tests are also available to confirm the diagnosis.
There is no cure for genital herpes, but there areantiviral drugsthat can reduce the severity and duration of an outbreak (and sometimes even avert it). In people with chronic (persistent) herpes, daily low-dose antivirals may be prescribed to reduce the frequency of outbreaks.
Mild or No SymptomsAccording to the CDC, most people with genital herpes are either asymptomatic (without symptoms) or have mild symptoms that are easily missed or mistaken for other conditions.
Mild or No Symptoms
According to the CDC, most people with genital herpes are either asymptomatic (without symptoms) or have mild symptoms that are easily missed or mistaken for other conditions.
How Herpes Is Diagnosed
How Herpes Is Transmitted
Herpes is most efficiently passed via direct genital contact with a herpes lesion, but it can also be passed through skin-to-skin contact with someone who has an active infection but no symptoms.
The latter manner of transmission, referred to as asymptomatic genital shedding, occurs when the virus reactivates and literally sheds viruses out of the part of the body where the initial infection occurred.
In people with asymptomatic HSV-2, shedding can occur in episodes throughout the year, silently passing the infection without the person even realizing it.
What Does Herpes Look Like?
How Common Is Genital Herpes?
Of the eight most common STIs in the United States—chlamydia, genital herpes,gonorrhea,hepatitis B,human immunodeficiency virus (HIV),human papillomavirus (HPV),syphilis, andtrichomoniasis—genital herpes ranks fifth in terms of annual new infections but second overall in terms of the number of people currently living with the disease.
According to the CDC, there are roughly 18.6 million people living with HSV-2 in the United States. In their most recent survey, the CDC estimated that 572,000 new infections occurred in a single year.
Around 1 of every 9 people in the United States between the ages of 14 and 49 has HSV-2.
Even so, studies have shown that the rate of both HSV-1 and HSV-2 have been steadily declining for the past two decades, due in part to safer sex behaviors.
How Quickly Does Herpes Develop?
As with most infectious diseases, genital herpes is more prevalent among some racial/ethnic groups than others. This is especially true of Black people in the United States who are nearly 4 times as likely to have HSV-2 as White people.
The causes for this disparity are many, including poverty and limited access to health care and diagnosis. Institutional racism andhealthcare discriminationcan often discourage people from seeking the care they need, as well. Moreover, living in a community where STI rates are already high increases the likelihood of infection.
Even more concerning is the fact that genital herpes increases therisk of HIV, in part because open sores provide HIV easier access into the body and the inflammatory response attracts the very immune cells (calledCD4 T-cells) that HIV targets for infection.
As a result of these intersecting risk factors, a 2013 study in the journalPLoSsuggested that genital herpes in Black people increases their vulnerability to HIV three times more than in White people.
How STIs Increase the Risk of HIV
In the United States, most new HSV-2 infections occur in people under 50 who tend to be more sexually active. Because genital herpes does not go away, the prevalence (the proportion of people affected over a specific period of time) will increase with age.
Data from the National Center of Health Statistics demonstrates how the HSV-2 prevalence in the United States increases with age:
In short, the older you get, the more likely the odds of having herpes if you are sexually active and have risk factors for the disease.
Genital Herpes Risk in FemalesFemales are nearly twice as likely as males to have genital herpes (15.9% vs. 8.2%).The disparity is due in large part to the female anatomy in which mucosal tissues in the vagina are more porous and vulnerable to tiny tears that further increase the likelihood of infection.
Genital Herpes Risk in Females
Females are nearly twice as likely as males to have genital herpes (15.9% vs. 8.2%).The disparity is due in large part to the female anatomy in which mucosal tissues in the vagina are more porous and vulnerable to tiny tears that further increase the likelihood of infection.
Causes of Genital Herpes and Risk Factors
Genital herpes is an enormous public health concern because a person doesn’t have to have symptoms to infect others. Because many people with HSV-2 are unaware of their infection, they can continue to spread the virus without even knowing.
An estimated 87.4% of people between the age of 14 and 49 who are infected have never been diagnosed with HSV-2 and may not even realize they have the virus.
Risk factorsfor genital herpes include:
What Are the Mortality Rates for Genital Herpes?
For most people, genital herpes may be aggravating and disruptive, but the condition is not associated with an increased risk of death. The one exception is newborns, in whom a herpes infection can be catastrophic.
Neonatal HSVOne in 4 newborns infected with HSV will experiencedisseminated herpesin which the virus can spread to the eyes, skin, mouth, liver, lungs, and digestive tract. Even with aggressive treatment, 1 in 3 of these babies will die.
Neonatal HSV
One in 4 newborns infected with HSV will experiencedisseminated herpesin which the virus can spread to the eyes, skin, mouth, liver, lungs, and digestive tract. Even with aggressive treatment, 1 in 3 of these babies will die.
If thecentral nervous systemis affected, it can lead to herpes simplexencephalitis(HSE), a condition that causes severe swelling of the brain and leads to death in 70% of cases.While HSV-1 is the more common cause of HSE in adults, HSV-2 is often the culprit in newborns.
When Will We Have a Herpes Vaccine?
Screening and Early Detection
Unlike some STIs, routine blood testing (called serologic testing) is not recommended for people who don’t have symptoms of herpes. However, if there is concern about exposure or new symptoms, this testing may be recommended. People should talk with a healthcare provider to determine whether blood testing is necessary.
Although blood testing is not routinely done, screening for STIs should include a thorough exam to check for herpes lesions on the genitals (including a speculum exam for females to check for lesions on the cervix).
The CDC recommends blood testing if you have symptoms of genital herpes. Testing should also be pursued if you are pregnant and are having sex with someone with herpes.
Testing may also be useful if:
Is It Herpes or Shingles? How to Tell
Summary
Genital herpes is the fifth most common sexually transmitted infection in the United States in terms of new infections and the second most common with respect to the number of people living with the disease.
Currently, over 18 million people in the United States have herpes simplex virus type 2 (HSV-2), the type most commonly associated with genital herpes. In 2018, over 570,000 were newly infected. The majority of people with genital herpes have no idea they have the disease.
Females more so than males and Black people more than White people have a disproportionately higher prevalence of genital herpes. Though blood screening may not be advised, it is recommended to talk with a healthcare provider about how to prevent exposure and know if you should receive blood testing.
A Word From Verywell
If you are sexually active, the best way to reduce your risk is to limit your number of sexual partners and use condoms consistently.
If you have frequent outbreaks, ask your healthcare provider if taking daily antiviral drugs (calledherpes prophylaxis) can help. By keeping the virus under control, you are less likely to infect others.
Coping, Dating, and Living Well With Herpes
Over 491 million people globally have genital herpes, according to the World Health Organization. That is equivalent to 13% of all people living on the planet between the ages of 15 and 49.
Consistent condom use is associated with a 30%–50% reduction in the risk of genital herpes.Condoms are far more effective at preventing other STIs.
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Genital herpes – CDC detailed fact sheet.Centers for Disease Control and Prevention.Genital herpes.Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.Schiffer JT, Mayer BT, Fong Y, Swam DA, Wald A.Herpes simplex virus-2 transmission probability estimates based on quantity of viral shedding.J R Soc Interface.2014;11(95):20140160. doi:10.1098/rsif.2014.0160James SH, Sheffield JS, Kimberlin DW.Mother-to-child transmission of herpes simplex virus,J Pediatric Infect Dis Soc.2014;3(Suppl 1):S19–23. doi:10.1093/jpids/piu050Centers for Disease Control and Prevention.Incidence, prevalence, and cost of sexually transmitted infections in the United States.Spicknall IH, Flagg EW, Torrone EA.Estimates of the prevalence and incidence of genital herpes, United States, 2018.Sex Transm Dis. 2021;48(4):260-5. doi:10.1097/OLQ.0000000000001375Chemaitelly H, Nagekerke N, Omori R, Abu-Raddad LJ.Characterizing herpes simplex virus type 1 and type 2.PLoS One. 2019;14(6):e0214151. doi:10.1371/journal.pone.0214151Stebbins RC, Noppert AN, Aiello AE, Cordoba E, Ward JB, Feinstein L.Persistent socioeconomic and racial and ethnic disparities in pathogen burden in the United States, 1999–2014.Epidemiol Infect.2019;147:e301. doi:10.1017/S0950268819001894Looker KJ, Elmes JAR, Gottlieb SL, et al.Effect of HSV-2 infection on subsequent HIV acquisition: an updated systematic review and meta-analysis.Lancet Infect Dis. 2017;17(12):1303-16. doi:10.1016/S1473-3099(17)30405-XDes Jarlais, Arasteh K, McKnight C, et al.HSV-2 infection as a cause of female/male and racial/ethnic disparities in HIV infection.PLoS One.2013;8(6):e66874. doi:10.1371/journal.pone.0066874National Center of Health Statistics.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.Office on Women’s Health.Genital herpes.Public Health Agency of Canada.Genital herpes guide: risk factors and clinical manifestations.Jouan Y, Grammatico-Guillon L, Espitalier F, Cazals X, Francois P, Guillon A.Long-term outcome of severe herpes simplex encephalitis: a population-based observational study.Crit Care.2015;19(1):345. doi:10.1186/s13054-015-1046-yCenters for Disease Control and Prevention.Genital herpes screening FAQ.Magaret AS, Muiugira A, Hughes JP.Effect of condom use on per-act HSV-2 transmission risk in HIV-1, HSV-2-discordant couples.Clin Infect Dis.2016;62(4):456–61. doi:10.1093/cid/civ908World Health Organization.Massive proportion of world’s population are living with herpes infection.World Health Organization.Herpes simplex virus.Johnson C, Wald A.62. Genital herpes. In:Infectious Diseases (Fourth Edition).Amsterdam: Elsevier; 2017.
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Genital herpes – CDC detailed fact sheet.Centers for Disease Control and Prevention.Genital herpes.Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.Schiffer JT, Mayer BT, Fong Y, Swam DA, Wald A.Herpes simplex virus-2 transmission probability estimates based on quantity of viral shedding.J R Soc Interface.2014;11(95):20140160. doi:10.1098/rsif.2014.0160James SH, Sheffield JS, Kimberlin DW.Mother-to-child transmission of herpes simplex virus,J Pediatric Infect Dis Soc.2014;3(Suppl 1):S19–23. doi:10.1093/jpids/piu050Centers for Disease Control and Prevention.Incidence, prevalence, and cost of sexually transmitted infections in the United States.Spicknall IH, Flagg EW, Torrone EA.Estimates of the prevalence and incidence of genital herpes, United States, 2018.Sex Transm Dis. 2021;48(4):260-5. doi:10.1097/OLQ.0000000000001375Chemaitelly H, Nagekerke N, Omori R, Abu-Raddad LJ.Characterizing herpes simplex virus type 1 and type 2.PLoS One. 2019;14(6):e0214151. doi:10.1371/journal.pone.0214151Stebbins RC, Noppert AN, Aiello AE, Cordoba E, Ward JB, Feinstein L.Persistent socioeconomic and racial and ethnic disparities in pathogen burden in the United States, 1999–2014.Epidemiol Infect.2019;147:e301. doi:10.1017/S0950268819001894Looker KJ, Elmes JAR, Gottlieb SL, et al.Effect of HSV-2 infection on subsequent HIV acquisition: an updated systematic review and meta-analysis.Lancet Infect Dis. 2017;17(12):1303-16. doi:10.1016/S1473-3099(17)30405-XDes Jarlais, Arasteh K, McKnight C, et al.HSV-2 infection as a cause of female/male and racial/ethnic disparities in HIV infection.PLoS One.2013;8(6):e66874. doi:10.1371/journal.pone.0066874National Center of Health Statistics.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.Office on Women’s Health.Genital herpes.Public Health Agency of Canada.Genital herpes guide: risk factors and clinical manifestations.Jouan Y, Grammatico-Guillon L, Espitalier F, Cazals X, Francois P, Guillon A.Long-term outcome of severe herpes simplex encephalitis: a population-based observational study.Crit Care.2015;19(1):345. doi:10.1186/s13054-015-1046-yCenters for Disease Control and Prevention.Genital herpes screening FAQ.Magaret AS, Muiugira A, Hughes JP.Effect of condom use on per-act HSV-2 transmission risk in HIV-1, HSV-2-discordant couples.Clin Infect Dis.2016;62(4):456–61. doi:10.1093/cid/civ908World Health Organization.Massive proportion of world’s population are living with herpes infection.World Health Organization.Herpes simplex virus.Johnson C, Wald A.62. Genital herpes. In:Infectious Diseases (Fourth Edition).Amsterdam: Elsevier; 2017.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Genital herpes – CDC detailed fact sheet.Centers for Disease Control and Prevention.Genital herpes.Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.Schiffer JT, Mayer BT, Fong Y, Swam DA, Wald A.Herpes simplex virus-2 transmission probability estimates based on quantity of viral shedding.J R Soc Interface.2014;11(95):20140160. doi:10.1098/rsif.2014.0160James SH, Sheffield JS, Kimberlin DW.Mother-to-child transmission of herpes simplex virus,J Pediatric Infect Dis Soc.2014;3(Suppl 1):S19–23. doi:10.1093/jpids/piu050Centers for Disease Control and Prevention.Incidence, prevalence, and cost of sexually transmitted infections in the United States.Spicknall IH, Flagg EW, Torrone EA.Estimates of the prevalence and incidence of genital herpes, United States, 2018.Sex Transm Dis. 2021;48(4):260-5. doi:10.1097/OLQ.0000000000001375Chemaitelly H, Nagekerke N, Omori R, Abu-Raddad LJ.Characterizing herpes simplex virus type 1 and type 2.PLoS One. 2019;14(6):e0214151. doi:10.1371/journal.pone.0214151Stebbins RC, Noppert AN, Aiello AE, Cordoba E, Ward JB, Feinstein L.Persistent socioeconomic and racial and ethnic disparities in pathogen burden in the United States, 1999–2014.Epidemiol Infect.2019;147:e301. doi:10.1017/S0950268819001894Looker KJ, Elmes JAR, Gottlieb SL, et al.Effect of HSV-2 infection on subsequent HIV acquisition: an updated systematic review and meta-analysis.Lancet Infect Dis. 2017;17(12):1303-16. doi:10.1016/S1473-3099(17)30405-XDes Jarlais, Arasteh K, McKnight C, et al.HSV-2 infection as a cause of female/male and racial/ethnic disparities in HIV infection.PLoS One.2013;8(6):e66874. doi:10.1371/journal.pone.0066874National Center of Health Statistics.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.Office on Women’s Health.Genital herpes.Public Health Agency of Canada.Genital herpes guide: risk factors and clinical manifestations.Jouan Y, Grammatico-Guillon L, Espitalier F, Cazals X, Francois P, Guillon A.Long-term outcome of severe herpes simplex encephalitis: a population-based observational study.Crit Care.2015;19(1):345. doi:10.1186/s13054-015-1046-yCenters for Disease Control and Prevention.Genital herpes screening FAQ.Magaret AS, Muiugira A, Hughes JP.Effect of condom use on per-act HSV-2 transmission risk in HIV-1, HSV-2-discordant couples.Clin Infect Dis.2016;62(4):456–61. doi:10.1093/cid/civ908World Health Organization.Massive proportion of world’s population are living with herpes infection.World Health Organization.Herpes simplex virus.Johnson C, Wald A.62. Genital herpes. In:Infectious Diseases (Fourth Edition).Amsterdam: Elsevier; 2017.
Centers for Disease Control and Prevention.Genital herpes – CDC detailed fact sheet.
Centers for Disease Control and Prevention.Genital herpes.
Centers for Disease Control and Prevention.Sexually transmitted infections treatment guidelines, 2021: genital herpes.
Schiffer JT, Mayer BT, Fong Y, Swam DA, Wald A.Herpes simplex virus-2 transmission probability estimates based on quantity of viral shedding.J R Soc Interface.2014;11(95):20140160. doi:10.1098/rsif.2014.0160
James SH, Sheffield JS, Kimberlin DW.Mother-to-child transmission of herpes simplex virus,J Pediatric Infect Dis Soc.2014;3(Suppl 1):S19–23. doi:10.1093/jpids/piu050
Centers for Disease Control and Prevention.Incidence, prevalence, and cost of sexually transmitted infections in the United States.
Spicknall IH, Flagg EW, Torrone EA.Estimates of the prevalence and incidence of genital herpes, United States, 2018.Sex Transm Dis. 2021;48(4):260-5. doi:10.1097/OLQ.0000000000001375
Chemaitelly H, Nagekerke N, Omori R, Abu-Raddad LJ.Characterizing herpes simplex virus type 1 and type 2.PLoS One. 2019;14(6):e0214151. doi:10.1371/journal.pone.0214151
Stebbins RC, Noppert AN, Aiello AE, Cordoba E, Ward JB, Feinstein L.Persistent socioeconomic and racial and ethnic disparities in pathogen burden in the United States, 1999–2014.Epidemiol Infect.2019;147:e301. doi:10.1017/S0950268819001894
Looker KJ, Elmes JAR, Gottlieb SL, et al.Effect of HSV-2 infection on subsequent HIV acquisition: an updated systematic review and meta-analysis.Lancet Infect Dis. 2017;17(12):1303-16. doi:10.1016/S1473-3099(17)30405-X
Des Jarlais, Arasteh K, McKnight C, et al.HSV-2 infection as a cause of female/male and racial/ethnic disparities in HIV infection.PLoS One.2013;8(6):e66874. doi:10.1371/journal.pone.0066874
National Center of Health Statistics.Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016.
Office on Women’s Health.Genital herpes.
Public Health Agency of Canada.Genital herpes guide: risk factors and clinical manifestations.
Jouan Y, Grammatico-Guillon L, Espitalier F, Cazals X, Francois P, Guillon A.Long-term outcome of severe herpes simplex encephalitis: a population-based observational study.Crit Care.2015;19(1):345. doi:10.1186/s13054-015-1046-y
Centers for Disease Control and Prevention.Genital herpes screening FAQ.
Magaret AS, Muiugira A, Hughes JP.Effect of condom use on per-act HSV-2 transmission risk in HIV-1, HSV-2-discordant couples.Clin Infect Dis.2016;62(4):456–61. doi:10.1093/cid/civ908
World Health Organization.Massive proportion of world’s population are living with herpes infection.
World Health Organization.Herpes simplex virus.
Johnson C, Wald A.62. Genital herpes. In:Infectious Diseases (Fourth Edition).Amsterdam: Elsevier; 2017.
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