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Speaker 1: I'm Jacob Goldstein. This is incubation on today's show Herpes.

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Speaker 2: Yeah, I became the Herpes Girl for a while, which

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Speaker 2: I didn't expect, and there's some pros and cons to that.

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Speaker 2: I was really delighted by how excited people were to

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Speaker 2: have this conversation, but it was also very strange and

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Speaker 2: like I would go back to my college campus around

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Speaker 2: that time and people would be like, it's the herpes girl.

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Speaker 3: I'd be like, Hi, you've.

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Speaker 1: Heard Ella Dawson writes about sex and culture and she's

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Speaker 1: also one of the billions of people billions with a

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Speaker 1: bee living with herpes. We'll hear a lot more from

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Speaker 1: Ella later on, but first let's do a little herpes

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Speaker 1: one on one For this part of the show, I

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Speaker 1: called up a herpes authority on a wault. Is it

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Speaker 1: true that you're the Queen of Herpes?

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Speaker 4: Yes, that's my less formal title. Let's just say I

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Speaker 4: was introduced like that about now twenty years ago, and

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Speaker 4: I decided to adopt that namucher and I've been doing

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Speaker 4: herpes work now for thirty years. There are not a

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Speaker 4: lot of experts in this field, and I've stuck with it.

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Speaker 1: In addition to being Herpe's royalty. Anna is also a

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Speaker 1: professor of epidemiology at the University of Washington, and today

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Speaker 1: we're turning to Anna to explain five key things to

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Speaker 1: know about herpes. By the way, Anna talks about the

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Speaker 1: two types of herpes that we usually hear about, which

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Speaker 1: are known as HSV one and HSV two. So thing

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Speaker 1: number one to know about herpes, most people have it.

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Speaker 1: How many people in the world are infected with herpes.

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Speaker 4: Well, it depends if you're talking about HSV one or

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Speaker 4: HSV two. HSV one about two thirds of people in

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Speaker 4: the world have HSV one infection and most of its oral,

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Speaker 4: but not all. Some of it is genital, and about

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Speaker 4: fourteen percent or so have genital HSV two infection.

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Speaker 1: Wow, So that's thing number one to know about herpes.

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Speaker 1: Thing number two, it's really common to have herpes and

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Speaker 1: not even know it.

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Speaker 4: Only about twenty percent of people who have HSV two infection,

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Speaker 4: which is the main cause of genital herpes, at least

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Speaker 4: historically know that they have genital herpes.

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Speaker 1: Next thing to know. Part of the reason so many

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Speaker 1: people don't know they have herpes is that testing is

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Speaker 1: notoriously unreliable.

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Speaker 4: The problem is that many of these essays that are

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Speaker 4: now commercially available, they're not that accurate. And what's happened

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Speaker 4: because the frequency of herpes has gone down, but the

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Speaker 4: frequency of testing has gone up, the proportion that's actually

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Speaker 4: diagnosed incorrectly has increased.

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Speaker 1: So there are a lot of false positive A lot

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Speaker 1: of people get herpes tests that say they have herpes

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Speaker 1: when in fact they do not.

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Speaker 4: Right, Because we have people who got tested for whatever

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Speaker 4: reason for HSV two. They had a new partner, they

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Speaker 4: were anxious about it, and the test came back positive

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Speaker 4: for HSV two. I had somebody who didn't believe that

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Speaker 4: they have it and the gynecologists tell them to go

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Speaker 4: to therapy to accept it. She was subsequently tested with

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Speaker 4: an accurate test and the geynecologist was wrong. Right, So

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Speaker 4: we're giving people a false diagnosis.

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Speaker 1: You and your colleagues have developed a better test than

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Speaker 1: the common test.

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Speaker 3: Is that right?

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Speaker 4: My colleague who was here actually before me, did develop

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Speaker 4: a better test that is still available through University of Washington,

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Speaker 4: but it's only available here. It's what's called the Western blot,

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Speaker 4: which means that we look at the ability of the

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Speaker 4: immune system to respond to a very wide range of

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Speaker 4: proteins of not just one or two like the commercial assays.

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Speaker 4: So I get to tell a fair number of people

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Speaker 4: that I cured their herpes because they thought they have

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Speaker 4: it by the commercial assay, and then it turns out

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Speaker 4: that they don't.

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Speaker 1: The fact number four, Herpes is incurable. With lots of

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Speaker 1: other viral infections, the body figures out how to eliminate

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Speaker 1: the virus from the body entirely, but herpes isn't like that.

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Speaker 1: Herpes has evolved to have this really clever trick that

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Speaker 1: allows it to evade the human immune system.

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Speaker 4: Herpies hides in the cells of the nervous system, and

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Speaker 4: the nervous system is what's called immuneprivileged site. Is that

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Speaker 4: there's not a lot of immune cells there, so it

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Speaker 4: is able to hide in a form that's inactive. It's

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Speaker 4: called latent. It infects bundles of nerves that are along

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Speaker 4: your spinal accord, and at that point it doesn't elicit

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Speaker 4: much of an immune response.

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Speaker 1: And there are just kind of hangs out, not eliciting

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Speaker 1: an immune response, and then comes out of hiding at

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Speaker 1: some point later.

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Speaker 4: It elicits fair little immune response when it's there, and

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Speaker 4: then in response to triggers that are not very well defined,

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Speaker 4: it will come out and make its journey back inside

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Speaker 4: the nerve all the way down to the either genital

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Speaker 4: area or to the oral area, depending on whether you're

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Speaker 4: talking about oral or genital herpes.

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Speaker 1: Okay, now we come to the fifth and final key

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Speaker 1: herpes fact. HSV one, which has historically caused oral herpes,

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Speaker 1: has in the past few decades been causing more and

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Speaker 1: more cases of genital herpes.

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Speaker 4: And so they are susceptible to acquiring HSV one in

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Speaker 4: an area that probably before was not susceptible because they

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Speaker 4: were already infected at a different site. So now they

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Speaker 4: initiate sexual activity and they could acquire a genital h's view,

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Speaker 4: the other reason that people say is that people now

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Speaker 4: have more oral sex. But it's very hard for me

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Speaker 4: to believe that this generation invented oral sex. So I

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Speaker 4: am more a believer in the fact that people are

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Speaker 4: growing up without HSV one as an explanation.

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Speaker 1: Thanks to doctor Anna Wald, Queen of Herpes, when we return,

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Speaker 1: we'll hear more from Ella Dawson about what it was

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Speaker 1: like learning that she had herpes and what it's been

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Speaker 1: like living with it. Ever since that's in just a minute.

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Speaker 1: Ella Dawson is a writer. She writes a lot about

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Speaker 1: sex and culture, and she has also written a fair

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Speaker 1: bit about having her which turns out to be a

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Speaker 1: subject that has a lot to do with both sex

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Speaker 1: and culture.

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Speaker 2: So I woke up at the end of my junior

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Speaker 2: year of college. I remember it was supposed to be

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Speaker 2: the day of the big Spring Fling concert, uh, and

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Speaker 2: I just felt peculiar.

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Speaker 3: I had some uncomfortable symptoms.

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Speaker 2: I would say I had a smattering of raised sores

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Speaker 2: that were quite painful to touch around my genitals. And

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Speaker 2: I think my immediate thought.

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Speaker 3: Was, are these ingrown hairs? Is this some kind of rash?

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Speaker 2: Like I wanted desperately for it to be something normal

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Speaker 2: and easily treatable.

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Speaker 3: But when you google, you know.

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Speaker 2: Raised red sores herpes is pretty much the first thing

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Speaker 2: that you'll see. And so, yeah, it was not fun.

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Speaker 2: Herpees outbreaks, particularly your first outbreak, tend to be painful.

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Speaker 2: It's not my favorite experience in the world. And like

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Speaker 2: any panicked twenty year old, I went to Google and

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Speaker 2: kind of typed in what I was feeling, and the

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Speaker 2: Internet immediately told me I was going to die. So

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Speaker 2: I classic, and so I called the student health clinic

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Speaker 2: on campus, and thankfully the nurse who I saw there

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Speaker 2: was incredibly kind and gracious and took one look at

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Speaker 2: the symptoms I was expressing and said, you know, this

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Speaker 2: looks like genital herpes. We see this all the time,

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Speaker 2: particularly among female students. And that was very comforting.

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Speaker 3: As well as very terrible.

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Speaker 2: It was not a fun day, I would say, but

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Speaker 2: I got incredible medical care. And yeah, I would give

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Speaker 2: it two out of five stars. I would say it's

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Speaker 2: an experience.

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Speaker 1: I mean, it could be worse, given that it's a

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Speaker 1: diagnosis of a disease. Any more than zero stars is okay.

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Speaker 3: Right.

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Speaker 1: So the nurse, as you probably havees a rare case,

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Speaker 1: perhaps of a healthcare professional confirming a Google diagnosis. Do

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Speaker 1: you have a test? Is that it?

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Speaker 2: Like?

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Speaker 3: What?

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Speaker 4: Then?

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Speaker 3: Yeah?

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Speaker 2: So she took a culture directly from a sore, and

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Speaker 2: that tends to be, from my understanding, the most reliable

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Speaker 2: form of herpes testing. If you are not expressing symptoms,

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Speaker 2: you can take a blood test for herpes, but those

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Speaker 2: tend to be unreliable and expensive. So it was kind

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Speaker 2: of lucky that I immediately went in on day one

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Speaker 2: and had a culture taken because I was able to

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Speaker 2: get a very clear diagnosis within a few days when

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Speaker 2: the labs came back and I tested positive for genital

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Speaker 2: HSV one, which is usually associated with oral herpes, but

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Speaker 2: it's quite common these days for people to have genital

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Speaker 2: herpes from HSV one because of oral sex.

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Speaker 1: So you get the labs, they confirm that you in

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Speaker 1: fact have her bees, and then what.

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Speaker 4: Hello.

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Speaker 2: I had a lot of uncomfortable conversations. Called my mom

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Speaker 2: and I said, you know, I have some bad news,

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Speaker 2: and she immediately asked, are you pregnant. I was like, no, no, no, no, no,

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Speaker 2: I have herpes, and she goes, oh, that's fine. She was.

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Speaker 1: It was really nice.

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Speaker 2: I was so terrified and I was worried, so I

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Speaker 2: appreciate that she was just unflappable and she just wanted

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Speaker 2: to know that I was okay.

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Speaker 3: My parents were great.

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Speaker 2: The more difficult conversations I had to have were I

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Speaker 2: had to tell the person I was dating, who was

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Speaker 2: not the nicest person already and was a big jerk

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Speaker 2: about it. I think his immediate concern was for himself,

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Speaker 2: which is totally fair.

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Speaker 3: I also called.

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Speaker 2: Some exes just to say you know, Hey, I got

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Speaker 2: diagnosed with this. I don't know if you've been tested.

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Speaker 2: I don't know if you know your history. But for

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Speaker 2: the most part, people were really surprised, but gracious and

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Speaker 2: understanding that this is not something that anyone does maliciously.

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Speaker 3: Viruses happen.

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Speaker 1: Did What did you know about herpes when you got

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Speaker 1: diagnosed or just before you got diagnosed?

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Speaker 2: Next to nothing. I think herpes in particular is a

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Speaker 2: strange virus because everyone knows that herpes is a skin

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Speaker 2: condition that you can get and that is incurable, and

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Speaker 2: it's actually transmitted, but very few people know what the

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Speaker 2: symptoms actually are, how it's actually transmitted, how to prevent it,

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Speaker 2: what the testing looks like. I thought I knew a

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Speaker 2: lot about it, and then I very quickly realized, oh,

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Speaker 2: I am very ignorant. And I had absorbed a lot

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Speaker 2: of stigmatizing messages about it from pop culture, from sex education,

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Speaker 2: from the Hangover. And there's an infamous line in the

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Speaker 2: Hangover of what happens in Vegas stays in Vegas except

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Speaker 2: for herpes, that shit'll come back with you. So like,

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Speaker 2: that was what I knew of herpes before this, and

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Speaker 2: so I was really baffled as I learned more about

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Speaker 2: how the virus functions in the body, Like, when you

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Speaker 2: have herpes, you are not having symptoms the vast majority

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Speaker 2: of the time. I've had herpes for ten years now,

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Speaker 2: and I've maybe had active herpee symptoms outbreaks for four

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Speaker 2: weeks of those ten years. It's had a minimal impact

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Speaker 2: in my life. And that is not what I expected.

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Speaker 2: When I was diagnosed with herpes. I was like, am

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Speaker 2: I going to have an outbreak forever? Am I going

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Speaker 2: to be in this pain forever?

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Speaker 1: And no.

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Speaker 2: Viruses are weird and they don't behave the way you expect.

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Speaker 1: So at some point you go from talking about having

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Speaker 1: herpes with your friends and former partners and your family

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Speaker 1: to talking about herpes in public and writing and speaking.

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Speaker 1: How do you make that leap?

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Speaker 4: Oh?

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Speaker 3: Yeah, I mean in a nutshell.

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Speaker 2: What happened was I graduated college, I started writing a blog.

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Speaker 2: I started writing a little bit about having herpes on

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Speaker 2: that blog, and then a friend of a friend worked

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Speaker 2: for women's health and said, would you like to write

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Speaker 2: an article about this for SGI Awareness Month which is April?

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Speaker 2: And I said sure. That was called I think it

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Speaker 2: was why I love telling people, I have herpes, which

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Speaker 2: is a very clicky title, and then that went extremely

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Speaker 2: viral online. I was twenty two. I was completely unprepared

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Speaker 2: for that. I thought maybe a few hundred people would

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Speaker 2: read it. I got thousands of emails and Facebook messages

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Speaker 2: from people. It was aggregated all over the internet because

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Speaker 2: it was very unusual to see someone willingly say, Hey,

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Speaker 2: I have herpes and let's talk about it.

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Speaker 1: So you write this article it goes viral. What is

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Speaker 1: life after that immediate moment as a person who is

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Speaker 1: sort of internet famous for having herpes.

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Speaker 2: Yeah, I became the herpes Girl for a while, which

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Speaker 2: I didn't expect, and there's some pros and cons to that.

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Speaker 2: I was really delighted by how excited people were to

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Speaker 2: have this commonversation and to hear from other folks who

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Speaker 2: had herpes who read my work and felt very seen

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Speaker 2: and understood.

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Speaker 3: But it was also very strange.

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Speaker 2: To have that suddenly become what Google suggests when you

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Speaker 2: type in my name, it adds herpes at the end,

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Speaker 2: And like I would go back to my college campus

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Speaker 2: around that time and people be like, it's the herpes Girl.

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Speaker 2: I'd be like, Hi, you've heard.

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Speaker 1: So I want to talk more broadly about herpes in

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Speaker 1: popular culture, and in particular, there is this Time magazine

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Speaker 1: story from all the way back in nineteen eighty two

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Speaker 1: that people still talk about when they talk about herpes.

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Speaker 1: And I know you've written about this particular story, so

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Speaker 1: just to kind of give a flavor of it, I

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Speaker 1: want to read a line from that story from that

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Speaker 1: article here. It is also known as the Scourge, the

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Speaker 1: New Scarlet Letter, the VD of the Ivy League. It's

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Speaker 1: like they're introducing a boxer, the VD of the Ivy

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Speaker 1: League and Jerry Folwell's Revenge. Herpes has emerged from relative

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Speaker 1: obscurity and exploded into a full fledged epidemic.

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Speaker 3: It's giving chaos. It's giving panic.

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Speaker 1: Tell me about that story and the sort of broader

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Speaker 1: role it played in the public imagination of herpes.

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Speaker 2: That Time magazine story and cover are so iconic that

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Speaker 2: it's got like this woman in eighty shoulder pads and

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Speaker 2: a big scarlet H on it.

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Speaker 1: The H is like a New Scarlet Letter. It's an

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Speaker 1: allusion to the Scarlet Letter, right.

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Speaker 2: I think that's even the title of the article. That

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Speaker 2: article is the most Banana's hysterical science writing I've ever read,

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Speaker 2: and they interview all these people who say crazy things

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Speaker 2: about how herpes has impacted their life. Some people claim

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Speaker 2: that they're willfully infecting hundreds of people because they feel

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Speaker 2: bitter and they want revenge upon society.

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Speaker 3: Like it is.

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Speaker 2: It's like a Jerry Springer episode that's off the rail

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Speaker 2: on it. I shouldn't even insult the late Jerry Springer

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Speaker 2: like that. He would not talk about herpes like this.

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Speaker 3: It is just it's vile.

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Speaker 2: And a lot of folks point to that article as

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Speaker 2: being kind of this pivot where herpes went from being

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Speaker 2: something fairly normal and common to something that was incredibly

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Speaker 2: stigmatized because it was it was so bombastic and like

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Speaker 2: a cover of Time magazine that really impacts culture, especially

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Speaker 2: in the eighties.

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Speaker 1: Like in the eighties, it was a huge deal. It's

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Speaker 1: hard to think of now what would be like Taylor

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Speaker 1: Swift would have to like give a speech about it

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Speaker 1: or something, right like, it's hard to think of something

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Speaker 1: that's as big of a deal now as that would

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Speaker 1: have been then.

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Speaker 2: And even if you didn't read the article, even if

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Speaker 2: you didn't pick it up, just seeing that cover, that

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Speaker 2: big scarlet h stays in people's minds, And I love

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Speaker 2: the framing of it being like Scourge of the Ivy League,

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Speaker 2: Like there's so much in there about class and like

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Speaker 2: and about race, Like it's basically saying, hey, even affluent

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Speaker 2: white people, you can get this, and you should be

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Speaker 2: you should be afraid, like and again like Jerry Folwell's Revenge,

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Speaker 2: it's saying like, this is a consequence of us having

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Speaker 2: more liberal sexual feelings and values. This is this is punishment,

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Speaker 2: and that is still very cemented in the way we

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Speaker 2: think about STIs of this is a consequence. This is

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Speaker 2: a reflection of your value as a person. You have

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Speaker 2: messed up, and now you are ruined forever. It's like, actually, no,

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Speaker 2: this is a very normal thing. And viruses have nothing

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Speaker 2: to do with your character or your choices. They're just

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Speaker 2: a viruses.

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Speaker 1: Besides the hangover, do you have a like second least

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Speaker 1: favorite pop culture reference to herpes, or, for that matter,

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Speaker 1: any pop culture references surphees that you think are actually

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Speaker 1: helpful or good.

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Speaker 2: Herpies pops up all of the time in pop culture.

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Speaker 2: I think s A Saturday Night Live is an interesting,

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Speaker 2: interesting source text to put my academic hat on for

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Speaker 2: attitudes about herpes because SNL has had some horrible herpes

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Speaker 2: jokes and some great ones, even just in the last

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Speaker 2: few years.

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Speaker 1: So wait, what's a great herpes joke?

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Speaker 3: This is the thing.

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Speaker 2: Herpes is like a lot of taboo topics. You can

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Speaker 2: make a funny joke about them if you do it

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Speaker 2: in a way that is humanizing and informed. For example,

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Speaker 2: SNL did an amazing sketch about COVID nineteen. It was

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Speaker 2: about a family of the COVID virus in their home

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Speaker 2: and other viruses coming to visit, and like the herpes

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Speaker 2: virus lived next door, and there were just really funny

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Speaker 2: little bits in it that were not making fun of

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Speaker 2: people who have the virus, but just making fun of

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Speaker 2: the virus and how it functions.

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Speaker 4: Now, who is that?

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Speaker 1: It's your neighbors. We just wanted to out of nowhere

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Speaker 1: and say hello, well this is.

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Speaker 4: A surprise, honey.

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Speaker 3: Have you met the herpes?

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Speaker 1: I haven't, actually, even though statistically I probably should have.

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Speaker 1: I'm oral, and this is my wife genital, please please

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Speaker 1: call me jen.

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Speaker 3: I just howled laughing at it.

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Speaker 2: It was like Bo and Yang with like a big

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Speaker 2: herpes virus contraption on his head, and that made me

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Speaker 2: very happy.

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Speaker 1: It's ten years later. Now, are you still the herpes girl?

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Speaker 2: I would like to think I am no longer the

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Speaker 2: herpes girl. My career has taken me in different directions.

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Speaker 2: I think the thing about herpes is that you run

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Speaker 2: out of things to say about it. There are other

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Speaker 2: people who have more interesting stories to tell. Black women

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Speaker 2: are far more likely to be impacted by herpes and

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Speaker 2: to face different challenges when getting the treatment they need.

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Speaker 2: It can lead to or exacerbate abusive relationships. You might

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Speaker 2: be kind of vulnerable to being taken advantage of because

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Speaker 2: you think that your damaged goods. So that's where I

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Speaker 2: write a lot these days, is in that kind of area.

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Speaker 2: But yeah, I'm not embarrassed to be the herpes girl.

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Speaker 2: I just there are more herpes girls out there who

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Speaker 2: deserve their day in the sun.

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Speaker 3: Ella.

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Speaker 1: It's great to talk with you, and truly interesting, really interesting.

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Speaker 2: It's very fun to have a conversation about herpes.

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Speaker 3: It's not just like.

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Speaker 2: How did you get it?

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Speaker 3: Sad is.

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Speaker 2: Your life over herpes is fascinating, and I think if

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Speaker 2: we bring curiosity to these conversations as opposed to judgment,

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Speaker 2: we can learn so much. Thank you, so much, Thank

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Speaker 2: you so much for having me on. It's been a pleasure.

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Speaker 1: Ella Dawson's debut novel will be published in twenty twenty four.

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Speaker 1: It's called But How Are You Really? Thanks to my

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Speaker 1: guest today, Ella Dawson and Anna Wald. Next week on

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Speaker 1: our final episode of the season, a twist Viruses that

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Speaker 1: actually help human beings. I'm talking about phages, bacterial phages.

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Speaker 5: Life is evolved in a soup of viruses, and most

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Speaker 5: of those viruses are phages. And if a kind of

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Speaker 5: alien life form was to just pluck a random bit

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Speaker 5: of the Earth and look for life, they would probably

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Speaker 5: find phages and nothing else.

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Speaker 1: Incubation is a co production of Pushkin Industries and Ruby

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Speaker 1: Studio at iHeartMedia. It's produced by Gabriel Hunter Chang, Ariela Markowitz,

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Speaker 1: and Amy Gaines McQuaid. Our editors are Julia Barton and

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Speaker 1: Karen Schakerjie Mastering by Anne Pope, fact checking by Joseph Fridman.

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Speaker 1: Our executive producers are Katherine Girodeau and Matt Romano. I'm

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Speaker 1: Jacob Goldstein. Thanks for listening.