Ask Debby Herbenick | Herpes testing
Q: Last year, I was diagnosed with the Big Herp. I believe that I got this affliction from a woman who was asymptomatic, although I recognize I may have also been one of the many people who are HSV-2–positive and carry the infection for a long time but don’t express symptoms. The symptoms are minimal, but the self-loathing and fear of infecting a “normal person” interferes with relationships. So about 20 percent of the fucking population has this condition? My question is: What the fuck? If a disease is truly this prevalent in the population, why has there not been more done to raise awareness to reduce this social stigma, if the incidence is really approximately one in four? If I were a marketing moron at Valtrex Inc., I would have a field day with this information, but instead, I am perceived by the general population as a leper. I am aware of the support groups and dating services, but why not a general push for HSV-2 testing for everyone who is sexually active?
A: Many people who contract sexually transmitted infections want to know why someone didn’t tell them what they could get, how they could get it, how they could prevent it, or what their testing and treatment options were. But whatever you did or didn’t learn in time, let me say this: Every day, teenagers and adults get infected with the herpes simplex virus (HSV-1, which is typically found on the mouth; or HSV-2, which is responsible for most cases of genital herpes) and we are all (especially adults) doing little to raise awareness. Abstinence-only sex education that avoids medically accurate information about infections is irresponsible. True, not all teenagers or young adults are having sex. But many do, and most everyone will one day have sex, and I think that people deserve to know how to protect themselves and their partner(s). And now—in case you haven’t heard—the government plans to extend abstinence-education efforts to adults as old as 29. Do I hear another WTF? If you want to learn more about increasing knowledge and education about sexual-health issues, check out sites like www.icah.org (at the local level) or www.advocatesforyouth.org (for national and global issues). As for your question about widespread population-based testing, my understanding is that the quality of HSV testing continues to be so variable (some poorer-quality tests remain on the market and not all clinics use high-quality, type-specific testing) that the best, most reliable tests first need to be identified and made available in more clinics. There are also some issues remaining about how to interpret test results and who would benefit from taking antiviral medication (such as Valtrex) to reduce outbreaks or transmission versus who may not. When all of this is figured out, I’m sure that the marketing gurus will push their products. For now, check out the Centers for Disease Control website (www.cdc.gov/std) for information.
Q: My best friend and her man had a bad breakup and now she is upset because he has been fucking around with his ex, even though the whole time my friend was with him he said nothing but bad things about his ex’s personality, skills in bed, etc. She’s terrified of running into them together. Can you tell her it’ll all be fine?
A: I’m with you. Knowing that any of my old boyfriends were with their exes would make me giggle like a catty little school girl. Or, more likely, feel really sorry for them both. Why? Because being desperate enough to get back with someone who he said “nothing but bad things about”—even just for sex—is sad, bordering on pathetic. If he trashed her or, for example, said she was passive-aggressive, bad at sex, only moderately good-looking or psycho, then you have to wonder (1) if he’s a liar who made up bad things about her, (2) if he’s so immature that all he does is bad-mouth exes even when he doesn’t mean it (and then he might be saying bad things about your friend now) or (3) what he’s doing with someone for whom he has such disdain. Whichever of these is the case, he’s probably not someone your friend wants. Case closed. But that’s logic talking, not the heart. The fact is that she may run into them together and feel hurt, but she can respond with the kind of integrity that’s important to her (this is not the time to ask, “Why are you with that ho?” or get into a girl-fight). She can act pleasant or evasive and then do what she’s got to do to recoup—call you, grab a drink or laugh a little (not in front of them) about the possibility that this is truly a gift. Life will indeed go on.
Q: I have trouble feeling much sensation from vaginal sex with my girlfriend or really from sex with any of my past girlfriends, so much that it can be hard to orgasm. Oral sex and anal sex are okay. I am of Asian descent and they have all been white women. A friend of mine said that Asian women have smaller vaginas than white women. Is this true? I’ve generally been attracted to white women all my life, so this could be a problem if so.
A: Speaking on behalf of white/Caucasian women, I can confirm that our vaginas are not big, gaping, sensationless holes. I’ll also add that it never ceases to amaze me that men, when worrying about sensation, suggest that their partner’s vagina or anus might be too “big” or “loose” rather than consider that their penis might be a bit small. In reality, it is probably more useful to consider genital fit rather than the size of your own or your partner’s genitals. Sadly, I can’t confirm whether Asian women (in general) have smaller vaginas than do white women. There have been very few rigorous studies on vagina size, and the little work that has been done has not addressed this question, to my knowledge. However, the research does suggest that most vaginas are pretty similar in terms of size, so I’d be surprised if this is a vaginal issue that you keep running into. Some sex therapists have found that men who have difficulty ejaculating during vaginal intercourse—but not other types of sex—have concerns about getting their partner pregnant or else may have other psychological issues related to vaginal sex (e.g., guilt, etc.). I’m not saying this is true for you, but it may be worth exploring (visit www.aasect.org to locate a sex therapist). Alternatively, you may find that reading a book with your girlfriend such as For Each Other: Sharing Sexual Intimacy (Signet, $8) helps you to explore your relationship in ways that enhance your sex life.
Q: Is there a physical/reproductive function for women’s orgasms? Do they do anything other than maybe just making sex enjoyable?
A: It depends on whom you ask. Some evolutionary-focused researchers have speculated that the contractions associated with a woman’s orgasm might help to bring sperm toward the uterus, thus increasing her chances of pregnancy. But the research hasn’t fully supported that mechanism. Researchers have suggested a range of advantages for women’s orgasm (e.g., pair bonding, identifying “Mr. Right”) but it is unclear what purpose, if any, they serve, or if they are just for fun. For an in-depth analysis of the female orgasm and evolutionary theories (and which ones don’t seem to hold water, let alone sperm), check out The Case of the Female Orgasm: Bias in the Science of Evolution (Harvard University Press, $27.95).
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