Getting Screened For Genital Herpes Isn’t Worth It, Say Experts

For the most common sexually transmitted infection, new guidelines recommend against testing people with no symptoms

Photo Illustration: Vocativ
Dec 20, 2016 at 12:00 PM ET

Scary as genital herpes may seem, preemptively testing people isn’t a useful way of combatting the viral disease, says a panel of experts that guides nationwide screening practices.

The U.S. Preventive Services Task Force, a government-appointed but independently-staffed arm of the Department of Health and Human Services, issued its latest screening recommendations Tuesday. Acknowledging that one of every six Americans currently have genital herpes, they nevertheless found that the harms of screening people without symptoms would outweigh any possible benefits, including for pregnant women. With a moderate degree of certainty, they recommended against any sort of routine screening.

The recommendation is an update to one made by the organization in 2005, which looked at teens and adults separately from pregnant women but came to the same conclusion: Screening wasn’t worthwhile for either group. But with more research published in the last decade, the task force felt it was ample time to reconsider the pros and cons of screening, Dr. Ann Kurth, one of the task force members, told Vocativ.

There are more than a few hitches that would come with routinely screening for herpes, she explained.

For one, though genital herpes is the most common sexually transmitted infection around, the front-line tests used to detect it are fatally flawed. If, for instance, the most readily available genital herpes blood tests were open to the general public, up to half of the positive results would be false. There is a more accurate test around, but it’s in limited supply. And only one research center in the country, the University of Washington’s Clinical Virology Laboratory, is even capable of performing it.

“More isn’t always better,” Kurth said of preventative screening in general. The added anxiety and broken relationships that comes with a false herpes test shouldn’t be brushed away as harmless, she noted.

The definition of genital herpes is also changing. Typically, herpes is thought to be two separate diseases caused by related viruses — there’s the annoying but harmless oral herpes caused by herpes simplex virus-1 (HSV-1) and the bad genital kind caused by herpes simplex virus-2 (HSV-2). But thanks mostly to the popularity of oral sex, a growing number of genital herpes cases are now being caused by HSV-1. And while we have a HSV-1 test available, it can’t tell us where the germ is in people without any symptoms. As many as 50 percent of adults under the age of 50 carry HSV-1 and most will never know it, and up to 90 percent of people with genital herpes never know either.

There’s also no good way to completely treat the virus. Antiretroviral treatment can shorten or prevent active outbreaks, and lessen the chances of transmitting it to your partner. But again, if routine screening became a reality, there would be a high risk of giving people medicine who don’t need it.

None of this is to suggest that genital herpes isn’t worth caring about, Kurth cautioned.

“Of course if someone has symptoms, is concerned about it, or has a sexual partner who’s indicated they have it, that’s something they should discuss further with their clinician,” she says. Those symptoms include repetitive bouts of itchy or painful blisters and sores around the genitals, fever, body aches and painful peeing.

The USPSTF’s stance is the same voiced by other public health agencies such as the CDC and the American Academy of Family Physicians. Kurth and her team are also calling for further research into creating more efficient tests, a preventative vaccine and a full-on cure.

By that same token, though, people with genital herpes shouldn’t be demonized either. The fear it conjures up in our heads is often outsized by the actual harm it causes.

“The public should realize that genital herpes does not, for most people, result in significant long-term health consequences,” said Dr. Christine Johnston, an assistant professor at the University of Washington and member of the virology lab. “However, in certain populations, such as the immunocompromised or [newborns], it can cause serious and even life threatening infections.”

Indeed, one of the largest reasons why routine testing isn’t recommended by most doctors is because of the unearned stigma a positive test result brings along, even as the disease itself doesn’t cause any lasting anxiety in people without symptoms. Without that stigma, scientists might be more motivated to push for a better way to screen the public, Johnston noted, or to create a better test.

For those wondering what, if anything, they can do about herpes without getting routinely tested, there are practical steps we can take that apply to most every other STI, such as using protection and being open with your partners.