How common is herpes?
Herpes simplex virus (HSV) infection is one of the most prevalent infections worldwide. The WHO estimates that approximately 3.7 billion people under 50 have HSV-1 (the strain more commonly associated with oral herpes) and 491 million people have HSV-2 (more commonly associated with genital herpes). In the UK, around 1 in 8 adults has genital herpes. The high prevalence means a diagnosis is not the unusual event many people imagine — it is extremely common.
Understanding outbreaks
The first outbreak — called a primary episode — is often the most severe, as the body has not yet developed immunity. It typically involves blistering sores, flu-like symptoms, and discomfort that can last 2–4 weeks. Subsequent outbreaks (recurrences) are usually shorter, milder, and less frequent over time. Many people with herpes have very infrequent recurrences, or none at all after the first episode. Common triggers include stress, illness, fatigue, menstruation, and UV light exposure.
Transmission and risk reduction
HSV is transmitted through direct skin-to-skin contact with an infected area, including when no sores are present — a process called asymptomatic shedding. Condoms reduce but do not eliminate the risk of transmission. Antiviral suppressive therapy (taking a low daily dose of aciclovir or valaciclovir) significantly reduces shedding and the risk of passing the virus to a partner — by around 50%. Combining antivirals with condom use provides the highest level of protection.
Treatment options
There is no cure for herpes, but antiviral medications are very effective at managing it. Episodic treatment (antivirals taken at the start of an outbreak) shortens the duration and reduces severity. Suppressive therapy (daily antivirals) reduces the frequency of outbreaks, reduces shedding, and is the option chosen by many people who have frequent recurrences or who want to protect a partner. Both options are available on the NHS.
Herpes and relationships
Disclosing a herpes diagnosis to a partner is understandably daunting, but many people in relationships where one partner has herpes and the other does not (serodiscordant couples) have long-term relationships without transmission, particularly when using suppressive therapy and barrier methods. Open conversation, accurate information, and a healthcare provider who can answer questions are the most helpful resources. The stigma around herpes is disproportionate to its medical seriousness.