Dear Abby: Fever Blister Fallout

[cereta]

DEAR ABBY: I'm a 68-year-old divorced woman who has been dating a slightly older widower. We were beginning a nice relationship until he got mad at me for giving him a fever blister. He suggested we not see each other or talk for more than two weeks. After that, he texted me to see if my fever blister was gone. He said he was still sort of angry about it, and described how ugly and painful the blister was.

I feel he was really petty, and it has put a damper on things. Am I wrong to feel this way? What is your advice? Hurry, please, because his blister is healing and he wants to see me. -- EMBARRASSED IN MISSOURI

DEAR EMBARRASSED: Your gentleman friend's behavior wasn't petty. The fever blister you gave him was a herpes virus. Before you see him again, talk to your doctor so he or she can explain how the virus is passed and what you can do to lessen the chances or prevent it in the future. If you do, you'll be doing both of you a favor.

Comments

[kaberett]

Good grief. I am with Abby.

[cereta]

Honestly, I am mostly confused. If they are able to say with certainty that she gave him the virus (which, given rates of HSV1 infection among adults requires some clear evidence), then she must have had a visible cold sore/fever blister when they kissed (which the letter seems to support).* So, he kissed a woman with a visible cold sore, and is angry that he got one. Did he not know they're caused by a contagious virus? Did she tell him she wasn't contagious anymore? I guess what I'm getting at here is that I don't see how there could have been any deception involved, in which case...I'm back to confused, again. I'm not downplaying the infection itself (although, again, a whopping majority of adults already have it), but the whole situation just makes me blink.

*Note: I am assuming his fever blister was on his mouth, which is admittedly a big assumption, but the general tone and word choice of the letter makes me think it probably was.

[likeaduck]

Lots of people have really minor outbreaks, especially if they’ve had the virus a long time! I totally get sores that I can tell are there because they’re itchy/sore but unless someone knew to look for them and was in prime lighting probably nobody else would notice them.

And “deception” is tricky for me with oral herpes, because lots of people don’t categorize it mentally as an STI and so it doesn’t trigger the thought that they *should* tell a partner about it the way something like chlamydia would. Plus some people have had it for so long (lots of people contract it as children, not sexually so even if the LW weren’t 68 this would be a possibility) and it’s such a non-issue in their lives that it doesn’t occur to them it might be a big deal for someone else. plus people are often contagious in the couple of days before an outbreak happens, which would still give away the source but is harder to warna partner about, absent precursor symptoms or psychic powers.

[kaberett]

My grandmother had no idea that cold sores were herpes and an STI until the point at which they'd left her blind (THIS CAN HAPPEN AND IS HORRIFYING), and was then utterly miserable at the entire concept, being a good Catholic woman in her 70s who had been married once and faithfully at that. My terrible ex also had the vague idea that cold sores were An STI but didn't really put together that it was herpes til I'd explained to him in very small words, at which point his risk-taking attitude changed a lot.

So that's one factor! Another is that the general reckoning is that one is shedding the virus enough to be contagious up to 20% of the time while asymptomatic i.e. with no visible sore.

So: (1) he might genuinely not have known that cold sores were herpes, (2) LW may very well not have been visibly contagious, and (3) if you're not familiar with what you're looking at it's tolerably easy to confuse cold sores for e.g. any other kind of spot or soreness.

(ALSO: HSV1 has traditionally been predominantly oral and HSV2 has traditionally been predominantly genital, but either is happy in either location and "cross-contamination" rates are on the rise and have been for a while; furthermore, having one strain gives you a sliiiiiiight protective effect against the other, but it's not guaranteed.)

For my part I am a carrier, and before kissing new people I am on the whole very careful to give them all the information they need to make considered decisions and give informed consent. It's my experience that the vast majority of people, even generally clued-up people, actually don't know the risk and transmission factors involved, and don't know the asymptomatic transmission rates, and need reminding that it's herpes, unless they are actually actively working in sex ed. (I did in fact screw up informed consent with A, but (i) I was pretty sure I wasn't contagious at the time because handwave reasons, and (ii) I realised I'd fucked up a few kisses in, apologised profusely, did the infodump, and was met with "does transmission risk rise significantly if we keep doing this *now*?", lol).

I'm also keenly aware that I know people whose abusive partners have used "oh, didn't I mention I had herpes? it's just been asymptomatic for so long!!!" as a straight-up control tactic, so in addition to My Own Personal Standards Of Ethics, I bristle about it from that angle, too.

I think for me it's mostly that the LW is treating this as embarrassment on her part because of her (ex-?)partner's "unreasonable" behaviour, which she's classifying as "petty", rather than taking this as a prompt to go "oh shit I screwed up, I should absolutely have given you the opportunity to give informed consent."

(My view here is also informed by the fact that knowingly exposing people to STIs without their informed consent can in the UK be prosecuted as Grievous Bodily Harm, be it intentional or reckless. I believe the first test case was for HIV, but it's a precedent that's subsequently been upheld for herpes, too.)

[ayebydan]

All. Of. This

[cereta]

Thank you for that information and perspective.

[kaberett]

<3 Apologies if overly strident/otherwise off - it has been A Week. No further engagement expected. :-)

[cereta]

No, I thought the tone was perfectly justified. I really meant it when I said thank you: these are things I did not know, and am now glad that I do.

[kaberett]

<3

[likeaduck]

1. There’s lots of stigma about herpes, which means a lot of people have a lot of feelings about contracting or being at risk for contracting it, which is understandable.

2. That doesn’t justify being a jerk about it.


3. It’s hard to tell from the letter how much of a jerk this person actually was. Saying “this makes me pretty upset and I think I need a couple of weeks to cool off” and at the end of the two weeks “I’m still sort of angry, the blister is painful and makes me feel ugly” is different from “what the fuck you gave me herpes that’s disgusting/you’re disgusting I can’t look at you right now” and then two weeks later really harping on the ugliness and soreness and trying to make someone feel guilty, and there’s a fair spectrum in between.

Basically my read depends a lot more on how this dude has been handling his feelings and their impact on the LW than on the fact that it involves herpes.

[kaberett]

I mean there's also the bit where oral herpes has much nastier potential complications than genital herpes, including blindness and neurological damage, so honestly I'd be pretty furious.

(To be clear, I'm saying all of this as someone living with oral herpes in several relationships with people who are as far as we know HSV-negative.)

[likeaduck]

I saw your comment above, and I’m really sorry that happened to your grandmother.

Like I said, people have a lot of feelings about herpes and that’s understandable, but doesn’t justify treating someone badly. People are still responsible for their own feelings. I’m not convinced the person in the letter did treat the LW badly, but if he had I think the LW would be justified to be upset about it.

Stigma about herpes is complicated and I don’t know if I feel like saying everyone should disclose 100% of the time, putting all of the responsibility for communication about it on folks who know they have it, emphasizing rare but possible complications, or criminalizing non disclosure are contributing to reducing that stigma long term. And in order for it to be less devastating for folks when they do get it (which most people will, or already do) I think we have to work on increasing education and decreasing stigma.

[ayebydan]

The virus impacts various people in various ways and people are entitled to get as angry as they want if they get an infection like that, no matter how they do so.

You can then decides how you react to their reaction