If you laughed at Usher being sued for millions over allegedly giving people herpes, you probably have herpes, too. That’s because most people in general have some form of the virus, which makes it odd that herpes stigma continues to be so strong.
The herpes virus exists in several forms, including herpes simplex viruses 1 (oral) and 2 (genital). The World Health Organization estimates that a half a billion people around the world have HSV-2, while two-thirds of the global population have HSV-1. As many as 80% of Americans have oral herpes, with the National Institutes of Health estimating that 90% of adults have been exposed to the virus by age 50.
Most people who are infected and show symptoms may have painful outbreaks initially, then experience periodic reactivations that usually amount to no more than a minor annoyance. Scientists are continuing to make breakthroughs in research for ways to treat them. Meanwhile, cases that escalate beyond an annoyance are extremely rare, and while it does present risks during natural childbirth, the risk can be avoided with C-sections.
To be clear, though, Usher was accused of concealing an alleged herpes infection, which is a separate issue from how common or severe the effects of the virus are. But the uproar over his lawsuits, and the shaming that ensued, led me to research where our fear of Herpes comes from.
Photo: U.S. Army
WHEN, AND HOW, DID WE GET
SO FREAKED OUT OVER HERPES?
Herpes stigma is relatively new. There are various theories about why the proliferation of fear-mongering herpes headlines came at about the same time as a release of a treatment for the virus in the early 1980s—namely, that the pharmaceutical company Burroughs Wellcome was stoking unwarranted panic in order to market Zovirax, which in 1982 became the first drug to receive federal approval for treatment of genital herpes. This fits into widespread criticism of alleged “disease-mongering” by drug companies.
Burroughs Wellcome, now GlaxoSmithKline PLC through a series of mergers, did not respond to requests for comment, so it wasn’t possible to discern the intention behind marketing for Zovirax and whether the subsequent media response was planned or accidental. Instead, I looked at archives of articles in major publications in the 1970s to see how genital herpes was characterized, and how public perception evolved.
Early mentions of genital herpes rightly characterized it as a non-life threatening infection, often as a side note in stories about other types of herpes viruses that caused more painful symptoms, like chicken pox. Somewhere along the way, as people became more aware of sexually-transmitted infections, headlines about an incurable venereal disease of epidemic proportions appeared with more frequency in the early 1980s.
The stories by that time referenced multiple cases of people with genital herpes committing suicide, which suggests that there were newsworthy reasons to write about the spread of the virus before Burroughs Wellcome began marketing Zovirax. Backlash against a shift toward more liberal attitudes about sex in decades prior seemed to already have set the stage for people to view genital herpes as a reason for embarrassment and shame, and it applied to other STIs that were known before herpes, including gonorrhea. Herpes, however, was incurable.
In his book “No Magic Bullet*,” about the social history of venereal disease in the U.S., Allan M. Brandt said discussions of herpes encapsulated many arguments throughout the 20th Century for more restricted sexuality, and they were symptoms of “profound sociosexual maladjustment.” In other words, people have long used STIs as an argument that too much sex was destroying society—a moral argument, not a medical one.
Coverage of genital herpes did pick up alongside the pharmaceutical industry’s investment in herpes treatments. In July of 1980, Time Magazine published an article sensationally headlined, “Herpes: The New Sexual Leprosy,” in which it describes one man as contracting the virus after he “succumbed to the temptation of a local lady” in Asia.
This article is often referenced by advocacy groups as being a part of the origins of herpes stigma, but it’s telling that the article itself discusses herpes stigma and the groups that were already forming around the U.S. to combat it.
Knowledge of the stigma didn’t stop Time from publishing another story in 1982 about genital herpes, this time on the cover, titled “The New Scarlet Letter.” The story is an entertaining read on face value, full of historical and literary references, and clearly played into a negative perception of sex for pleasure, associating it with “philandering” husbands, prostitutes and swingers. This article is also commonly referenced in examinations of the history of herpes stigma, but in truth reads more like a reflection, not the cause, of attitudes about sex at the time.
The stories neither prove nor disprove that pharmaceutical companies engaged in disease-mongering over herpes. But even if they did, it appears that Burroughs Wellcome wouldn’t be the only one. According to an article in The New York Times in 1983, “virtually every major drug. Manufacturer—including Seattle, Upjohn, Merck, Hoffmann-LaRoche and Schering-Plough—is focusing part of its research and development budget on vaccines, medications, diagnostic procedures or advanced forms of genetic engineering to combat, if not actually cure, herpes.”
That story predicted the market for herpes treatments would reach $200 million. The market is now expected to grow to $668 million by 2023, according to research firm GlobalData.
THE REAL TABOO IS STILL SEX
In the public eye, herpes continues to be a symbol for promiscuity. The shame and stigma people with herpes face appear to be just as traumatizing today as it was decades ago, despite the fact that many people are asymptomatic, and most outbreaks aren’t physically debilitating.
“Herpes is unnecessarily stigmatized, as any STI,” said Debra W. Soh, a sex writer and sexual neuroscientist at York University in Toronto. “Sex is still considered taboo in our culture, so any medical conditions that are associated with sex share that tabooness. Herpes, for some reason, has a higher level of stigma attached to it.”
The character Joey from “Friends” is rejected by a woman after he unknowingly models for a clinic for venereal disease.
The stigma of herpes and other STIs don’t just cause unnecessary trauma; it can also prevent people from making informed decisions about their sexual health, such as using protection, getting tested regularly, and informing their partners of any STIs they have. This, in turn, leads to more spreading of infections.
The surest answer, experts say, is better sex education. Unfortunately, sex education isn’t required in many places in the U.S., and many states is only permit it if it’s abstinence-only, despite studies showing that omission of information about safe sex leads to higher rates of STI transmission and teen pregnancy.
As for the media, the industry as a whole has become slightly more conscientious about reporting on herpes with occasional reports, like this one in The Atlantic, that seek to remind the public that shame and and isolation are the worst effects of being infected. But outlets looking for quick-hit, traffic generating headlines offer less nuanced coverage.
There is room for improvement. In the media, “sex in general tends to be a topic that is more sensationalistic and salacious,” said Soh, who writes for publications including The Globe and Mail and Playboy.
Despite the continued shaming, however, media has “gotten better at downplaying that, and really focusing on the science,” she said. “Acceptance and compassion and empathy have been added to the conversation, which is a positive thing.