There have been changes in the prevalence of genital herpes over time. Scarcely a concern in the 1950s, it is now a real risk for anyone sexually active.
The two groups who tell us this are the media and the scientific community. Let’s look at the message they’re sending.
1960s-1970s
As far as the media were concerned, genital herpes was still quite rare up until the end of the 1960s, at least in Western countries. According to Time magazine, for example, “Doctors were talking of only 5%” infection rates in the USA.
The 1970s seems to be the decade when genital herpes “went mainstream”.
According to The New York Times in 1979, for example, genital herpes was “becoming [a] major threat”. Scientists, for their part, were detecting rates of around 16% for HSV-2 in the general US population. And according to Time magazine in 1980, “as many as 30% of the sexually active U.S. population have been exposed to genital herpes…”. (Whatever that means.)
What on earth had people gotten up to in the 70s to create such an increase? According to Time magazine in 1980, they were having more sex. And that was a result of the change in sexual attitudes that took place a few years earlier: “With the sexual revolution of the 1960s, herpes broke out of its confines… Suddenly, ‘viruses of love’ infected entire college dormitories and rode the waves of rising divorce and crumbling monogamy”.
Damn those Beatles!
1980s-1990s
Attitudes to sex changed in the early 1980s when HIV arrived. Actually, we didn’t even know it was HIV at the time – we just called it AIDS, and worried terribly about what the hell was going on. (Bizarrely, a few prominent South African politicians still don’t believe AIDS is caused by HIV, but that’s another website).
Anyway, suddenly condoms were de rigueur. No glove, no love, and so on. Great news for the war on ALL sexually transmitted diseases. Except that it didn’t seem to last.
And that’s why, despite the arrival of HIV, rates of genital herpes infection continued to rise in the Western World in the 1980s and 1990s.
Remember Dr George Kinghorn, “consultant in genitourinary medicine”? Dr Kinghorn said on the website of the UK’s Herpes Viruses Association: Herpes Viruses Association: “In the US there was concern because serological studies [blood tests] showed that between the 80s and 90s type 2 infection increased by over 30%.”
And what does the article recommended to me by the World Health Organisation (WHO) have to say? “In the USA, a 30% increase in overall HSV-2 prevalence was observed between the late 1970s (16%) and early 1990s (20.8%). In Hong Kong, HSV-2 prevalence rose from 7% to 18% from 1977 to 1995. Increases in HSV-2 prevalence were also apparent in Sweden from studies conducted between 1969 and 1989 in pregnant women (17% – 33%) and between 1970 and 1990 in male STI clinic attendees (13%-24%).”
Of course, there have been exceptions, but they tend to be in odd spots of the world. The WHO-recommended article says, for instance, that in the 1980s and 1990s “HSV-2 prevalence remained relatively constant among antenatal patients in Malmö, Sweden, and decreased in a random population sample from central Japan. In Amsterdam, HSV-2 prevalence was markedly lower in men having sex with men during 1995-1997 (19%) compared with 1984-1988 (51%) and appears to decrease in STI clinic attendees from 1993/4 to 1998.”
Reassuring news for gay Dutchmen who take their holidays in Sweden and central Japan.
Today… and Tomorrow
I like the way that, just as we say the Nineties for the period 1990-1999, we can call the years 2000-2009 the “Noughties”. Schoolboy giggles aside, what has been happening to genital herpes in this period?
Dr Kinghorn puts his finger on the major development of the last few years:
“In years gone by when I was first working in GU medicine, we only used to talk about herpes simplex type 2. There was a clear differentiation between ‘type 1 above the neck’ and ‘type 2 below the waist’. But it isn’t like that any more: the proportion of new cases we see of type 1, especially in women, exceeds those with type 2. This is a trend that is seen everywhere, but of all the countries that report the number of cases, the UK probably has the highest proportion of genital infection with type 1. It is interesting why this should be. It is actually because of improved socio-economic conditions and standards of hygiene, so there is a lower level of infection with type 1 in childhood.”
That’s right: the Noughties will be remembered as the time that HSV1 went south. It might be because, as Dr Kinghorn suggests, because fewer of us have HSV1 antibodies these days, or it might be because more of us are trying oral sex. Whatever the reason, HSV2 has lost its monopoly on our private parts.
Interestingly, though, the arrival of a new way to catch genital herpes doesn’t seem to have led to an increase in the number of genital herpes cases. Rates in very recent years seem to be staying stable. High, too high, but stable.
And what does tomorrow hold? Will rates rise? Are we likely to see a time when 50%, 60% or even more people have an HSV infection in their genitals, regardless of their race or socio-economic status?
That’s a damn good question.
In any event, if we do get that far, it can only help to reduce the stigma unfairly attached to this condition.
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