Speaker 1: I'm Jacob Goldstein. This is incubation on today's show Herpes.
Speaker 2: Yeah, I became the Herpes Girl for a while, which
Speaker 2: I didn't expect, and there's some pros and cons to that.
Speaker 2: I was really delighted by how excited people were to
Speaker 2: have this conversation, but it was also very strange and
Speaker 2: like I would go back to my college campus around
Speaker 2: that time and people would be like, it's the herpes girl.
Speaker 3: I'd be like, Hi, you've.
Speaker 1: Heard Ella Dawson writes about sex and culture and she's
Speaker 1: also one of the billions of people billions with a
Speaker 1: bee living with herpes. We'll hear a lot more from
Speaker 1: Ella later on, but first let's do a little herpes
Speaker 1: one on one For this part of the show, I
Speaker 1: called up a herpes authority on a wault. Is it
Speaker 1: true that you're the Queen of Herpes?
Speaker 4: Yes, that's my less formal title. Let's just say I
Speaker 4: was introduced like that about now twenty years ago, and
Speaker 4: I decided to adopt that namucher and I've been doing
Speaker 4: herpes work now for thirty years. There are not a
Speaker 4: lot of experts in this field, and I've stuck with it.
Speaker 1: In addition to being Herpe's royalty. Anna is also a
Speaker 1: professor of epidemiology at the University of Washington, and today
Speaker 1: we're turning to Anna to explain five key things to
Speaker 1: know about herpes. By the way, Anna talks about the
Speaker 1: two types of herpes that we usually hear about, which
Speaker 1: are known as HSV one and HSV two. So thing
Speaker 1: number one to know about herpes, most people have it.
Speaker 1: How many people in the world are infected with herpes.
Speaker 4: Well, it depends if you're talking about HSV one or
Speaker 4: HSV two. HSV one about two thirds of people in
Speaker 4: the world have HSV one infection and most of its oral,
Speaker 4: but not all. Some of it is genital, and about
Speaker 4: fourteen percent or so have genital HSV two infection.
Speaker 1: Wow, So that's thing number one to know about herpes.
Speaker 1: Thing number two, it's really common to have herpes and
Speaker 1: not even know it.
Speaker 4: Only about twenty percent of people who have HSV two infection,
Speaker 4: which is the main cause of genital herpes, at least
Speaker 4: historically know that they have genital herpes.
Speaker 1: Next thing to know. Part of the reason so many
Speaker 1: people don't know they have herpes is that testing is
Speaker 1: notoriously unreliable.
Speaker 4: The problem is that many of these essays that are
Speaker 4: now commercially available, they're not that accurate. And what's happened
Speaker 4: because the frequency of herpes has gone down, but the
Speaker 4: frequency of testing has gone up, the proportion that's actually
Speaker 4: diagnosed incorrectly has increased.
Speaker 1: So there are a lot of false positive A lot
Speaker 1: of people get herpes tests that say they have herpes
Speaker 1: when in fact they do not.
Speaker 4: Right, Because we have people who got tested for whatever
Speaker 4: reason for HSV two. They had a new partner, they
Speaker 4: were anxious about it, and the test came back positive
Speaker 4: for HSV two. I had somebody who didn't believe that
Speaker 4: they have it and the gynecologists tell them to go
Speaker 4: to therapy to accept it. She was subsequently tested with
Speaker 4: an accurate test and the geynecologist was wrong. Right, So
Speaker 4: we're giving people a false diagnosis.
Speaker 1: You and your colleagues have developed a better test than
Speaker 1: the common test.
Speaker 3: Is that right?
Speaker 4: My colleague who was here actually before me, did develop
Speaker 4: a better test that is still available through University of Washington,
Speaker 4: but it's only available here. It's what's called the Western blot,
Speaker 4: which means that we look at the ability of the
Speaker 4: immune system to respond to a very wide range of
Speaker 4: proteins of not just one or two like the commercial assays.
Speaker 4: So I get to tell a fair number of people
Speaker 4: that I cured their herpes because they thought they have
Speaker 4: it by the commercial assay, and then it turns out
Speaker 4: that they don't.
Speaker 1: The fact number four, Herpes is incurable. With lots of
Speaker 1: other viral infections, the body figures out how to eliminate
Speaker 1: the virus from the body entirely, but herpes isn't like that.
Speaker 1: Herpes has evolved to have this really clever trick that
Speaker 1: allows it to evade the human immune system.
Speaker 4: Herpies hides in the cells of the nervous system, and
Speaker 4: the nervous system is what's called immuneprivileged site. Is that
Speaker 4: there's not a lot of immune cells there, so it
Speaker 4: is able to hide in a form that's inactive. It's
Speaker 4: called latent. It infects bundles of nerves that are along
Speaker 4: your spinal accord, and at that point it doesn't elicit
Speaker 4: much of an immune response.
Speaker 1: And there are just kind of hangs out, not eliciting
Speaker 1: an immune response, and then comes out of hiding at
Speaker 1: some point later.
Speaker 4: It elicits fair little immune response when it's there, and
Speaker 4: then in response to triggers that are not very well defined,
Speaker 4: it will come out and make its journey back inside
Speaker 4: the nerve all the way down to the either genital
Speaker 4: area or to the oral area, depending on whether you're
Speaker 4: talking about oral or genital herpes.
Speaker 1: Okay, now we come to the fifth and final key
Speaker 1: herpes fact. HSV one, which has historically caused oral herpes,
Speaker 1: has in the past few decades been causing more and
Speaker 1: more cases of genital herpes.
Speaker 4: And so they are susceptible to acquiring HSV one in
Speaker 4: an area that probably before was not susceptible because they
Speaker 4: were already infected at a different site. So now they
Speaker 4: initiate sexual activity and they could acquire a genital h's view,
Speaker 4: the other reason that people say is that people now
Speaker 4: have more oral sex. But it's very hard for me
Speaker 4: to believe that this generation invented oral sex. So I
Speaker 4: am more a believer in the fact that people are
Speaker 4: growing up without HSV one as an explanation.
Speaker 1: Thanks to doctor Anna Wald, Queen of Herpes, when we return,
Speaker 1: we'll hear more from Ella Dawson about what it was
Speaker 1: like learning that she had herpes and what it's been
Speaker 1: like living with it. Ever since that's in just a minute.
Speaker 1: Ella Dawson is a writer. She writes a lot about
Speaker 1: sex and culture, and she has also written a fair
Speaker 1: bit about having her which turns out to be a
Speaker 1: subject that has a lot to do with both sex
Speaker 1: and culture.
Speaker 2: So I woke up at the end of my junior
Speaker 2: year of college. I remember it was supposed to be
Speaker 2: the day of the big Spring Fling concert, uh, and
Speaker 2: I just felt peculiar.
Speaker 3: I had some uncomfortable symptoms.
Speaker 2: I would say I had a smattering of raised sores
Speaker 2: that were quite painful to touch around my genitals. And
Speaker 2: I think my immediate thought.
Speaker 3: Was, are these ingrown hairs? Is this some kind of rash?
Speaker 2: Like I wanted desperately for it to be something normal
Speaker 2: and easily treatable.
Speaker 3: But when you google, you know.
Speaker 2: Raised red sores herpes is pretty much the first thing
Speaker 2: that you'll see. And so, yeah, it was not fun.
Speaker 2: Herpees outbreaks, particularly your first outbreak, tend to be painful.
Speaker 2: It's not my favorite experience in the world. And like
Speaker 2: any panicked twenty year old, I went to Google and
Speaker 2: kind of typed in what I was feeling, and the
Speaker 2: Internet immediately told me I was going to die. So
Speaker 2: I classic, and so I called the student health clinic
Speaker 2: on campus, and thankfully the nurse who I saw there
Speaker 2: was incredibly kind and gracious and took one look at
Speaker 2: the symptoms I was expressing and said, you know, this
Speaker 2: looks like genital herpes. We see this all the time,
Speaker 2: particularly among female students. And that was very comforting.
Speaker 3: As well as very terrible.
Speaker 2: It was not a fun day, I would say, but
Speaker 2: I got incredible medical care. And yeah, I would give
Speaker 2: it two out of five stars. I would say it's
Speaker 2: an experience.
Speaker 1: I mean, it could be worse, given that it's a
Speaker 1: diagnosis of a disease. Any more than zero stars is okay.
Speaker 3: Right.
Speaker 1: So the nurse, as you probably havees a rare case,
Speaker 1: perhaps of a healthcare professional confirming a Google diagnosis. Do
Speaker 1: you have a test? Is that it?
Speaker 2: Like?
Speaker 3: What?
Speaker 4: Then?
Speaker 3: Yeah?
Speaker 2: So she took a culture directly from a sore, and
Speaker 2: that tends to be, from my understanding, the most reliable
Speaker 2: form of herpes testing. If you are not expressing symptoms,
Speaker 2: you can take a blood test for herpes, but those
Speaker 2: tend to be unreliable and expensive. So it was kind
Speaker 2: of lucky that I immediately went in on day one
Speaker 2: and had a culture taken because I was able to
Speaker 2: get a very clear diagnosis within a few days when
Speaker 2: the labs came back and I tested positive for genital
Speaker 2: HSV one, which is usually associated with oral herpes, but
Speaker 2: it's quite common these days for people to have genital
Speaker 2: herpes from HSV one because of oral sex.
Speaker 1: So you get the labs, they confirm that you in
Speaker 1: fact have her bees, and then what.
Speaker 4: Hello.
Speaker 2: I had a lot of uncomfortable conversations. Called my mom
Speaker 2: and I said, you know, I have some bad news,
Speaker 2: and she immediately asked, are you pregnant. I was like, no, no, no, no, no,
Speaker 2: I have herpes, and she goes, oh, that's fine. She was.
Speaker 1: It was really nice.
Speaker 2: I was so terrified and I was worried, so I
Speaker 2: appreciate that she was just unflappable and she just wanted
Speaker 2: to know that I was okay.
Speaker 3: My parents were great.
Speaker 2: The more difficult conversations I had to have were I
Speaker 2: had to tell the person I was dating, who was
Speaker 2: not the nicest person already and was a big jerk
Speaker 2: about it. I think his immediate concern was for himself,
Speaker 2: which is totally fair.
Speaker 3: I also called.
Speaker 2: Some exes just to say you know, Hey, I got
Speaker 2: diagnosed with this. I don't know if you've been tested.
Speaker 2: I don't know if you know your history. But for
Speaker 2: the most part, people were really surprised, but gracious and
Speaker 2: understanding that this is not something that anyone does maliciously.
Speaker 3: Viruses happen.
Speaker 1: Did What did you know about herpes when you got
Speaker 1: diagnosed or just before you got diagnosed?
Speaker 2: Next to nothing. I think herpes in particular is a
Speaker 2: strange virus because everyone knows that herpes is a skin
Speaker 2: condition that you can get and that is incurable, and
Speaker 2: it's actually transmitted, but very few people know what the
Speaker 2: symptoms actually are, how it's actually transmitted, how to prevent it,
Speaker 2: what the testing looks like. I thought I knew a
Speaker 2: lot about it, and then I very quickly realized, oh,
Speaker 2: I am very ignorant. And I had absorbed a lot
Speaker 2: of stigmatizing messages about it from pop culture, from sex education,
Speaker 2: from the Hangover. And there's an infamous line in the
Speaker 2: Hangover of what happens in Vegas stays in Vegas except
Speaker 2: for herpes, that shit'll come back with you. So like,
Speaker 2: that was what I knew of herpes before this, and
Speaker 2: so I was really baffled as I learned more about
Speaker 2: how the virus functions in the body, Like, when you
Speaker 2: have herpes, you are not having symptoms the vast majority
Speaker 2: of the time. I've had herpes for ten years now,
Speaker 2: and I've maybe had active herpee symptoms outbreaks for four
Speaker 2: weeks of those ten years. It's had a minimal impact
Speaker 2: in my life. And that is not what I expected.
Speaker 2: When I was diagnosed with herpes. I was like, am
Speaker 2: I going to have an outbreak forever? Am I going
Speaker 2: to be in this pain forever?
Speaker 1: And no.
Speaker 2: Viruses are weird and they don't behave the way you expect.
Speaker 1: So at some point you go from talking about having
Speaker 1: herpes with your friends and former partners and your family
Speaker 1: to talking about herpes in public and writing and speaking.
Speaker 1: How do you make that leap?
Speaker 4: Oh?
Speaker 3: Yeah, I mean in a nutshell.
Speaker 2: What happened was I graduated college, I started writing a blog.
Speaker 2: I started writing a little bit about having herpes on
Speaker 2: that blog, and then a friend of a friend worked
Speaker 2: for women's health and said, would you like to write
Speaker 2: an article about this for SGI Awareness Month which is April?
Speaker 2: And I said sure. That was called I think it
Speaker 2: was why I love telling people, I have herpes, which
Speaker 2: is a very clicky title, and then that went extremely
Speaker 2: viral online. I was twenty two. I was completely unprepared
Speaker 2: for that. I thought maybe a few hundred people would
Speaker 2: read it. I got thousands of emails and Facebook messages
Speaker 2: from people. It was aggregated all over the internet because
Speaker 2: it was very unusual to see someone willingly say, Hey,
Speaker 2: I have herpes and let's talk about it.
Speaker 1: So you write this article it goes viral. What is
Speaker 1: life after that immediate moment as a person who is
Speaker 1: sort of internet famous for having herpes.
Speaker 2: Yeah, I became the herpes Girl for a while, which
Speaker 2: I didn't expect, and there's some pros and cons to that.
Speaker 2: I was really delighted by how excited people were to
Speaker 2: have this commonversation and to hear from other folks who
Speaker 2: had herpes who read my work and felt very seen
Speaker 2: and understood.
Speaker 3: But it was also very strange.
Speaker 2: To have that suddenly become what Google suggests when you
Speaker 2: type in my name, it adds herpes at the end,
Speaker 2: And like I would go back to my college campus
Speaker 2: around that time and people be like, it's the herpes Girl.
Speaker 2: I'd be like, Hi, you've heard.
Speaker 1: So I want to talk more broadly about herpes in
Speaker 1: popular culture, and in particular, there is this Time magazine
Speaker 1: story from all the way back in nineteen eighty two
Speaker 1: that people still talk about when they talk about herpes.
Speaker 1: And I know you've written about this particular story, so
Speaker 1: just to kind of give a flavor of it, I
Speaker 1: want to read a line from that story from that
Speaker 1: article here. It is also known as the Scourge, the
Speaker 1: New Scarlet Letter, the VD of the Ivy League. It's
Speaker 1: like they're introducing a boxer, the VD of the Ivy
Speaker 1: League and Jerry Folwell's Revenge. Herpes has emerged from relative
Speaker 1: obscurity and exploded into a full fledged epidemic.
Speaker 3: It's giving chaos. It's giving panic.
Speaker 1: Tell me about that story and the sort of broader
Speaker 1: role it played in the public imagination of herpes.
Speaker 2: That Time magazine story and cover are so iconic that
Speaker 2: it's got like this woman in eighty shoulder pads and
Speaker 2: a big scarlet H on it.
Speaker 1: The H is like a New Scarlet Letter. It's an
Speaker 1: allusion to the Scarlet Letter, right.
Speaker 2: I think that's even the title of the article. That
Speaker 2: article is the most Banana's hysterical science writing I've ever read,
Speaker 2: and they interview all these people who say crazy things
Speaker 2: about how herpes has impacted their life. Some people claim
Speaker 2: that they're willfully infecting hundreds of people because they feel
Speaker 2: bitter and they want revenge upon society.
Speaker 3: Like it is.
Speaker 2: It's like a Jerry Springer episode that's off the rail
Speaker 2: on it. I shouldn't even insult the late Jerry Springer
Speaker 2: like that. He would not talk about herpes like this.
Speaker 3: It is just it's vile.
Speaker 2: And a lot of folks point to that article as
Speaker 2: being kind of this pivot where herpes went from being
Speaker 2: something fairly normal and common to something that was incredibly
Speaker 2: stigmatized because it was it was so bombastic and like
Speaker 2: a cover of Time magazine that really impacts culture, especially
Speaker 2: in the eighties.
Speaker 1: Like in the eighties, it was a huge deal. It's
Speaker 1: hard to think of now what would be like Taylor
Speaker 1: Swift would have to like give a speech about it
Speaker 1: or something, right like, it's hard to think of something
Speaker 1: that's as big of a deal now as that would
Speaker 1: have been then.
Speaker 2: And even if you didn't read the article, even if
Speaker 2: you didn't pick it up, just seeing that cover, that
Speaker 2: big scarlet h stays in people's minds, And I love
Speaker 2: the framing of it being like Scourge of the Ivy League,
Speaker 2: Like there's so much in there about class and like
Speaker 2: and about race, Like it's basically saying, hey, even affluent
Speaker 2: white people, you can get this, and you should be
Speaker 2: you should be afraid, like and again like Jerry Folwell's Revenge,
Speaker 2: it's saying like, this is a consequence of us having
Speaker 2: more liberal sexual feelings and values. This is this is punishment,
Speaker 2: and that is still very cemented in the way we
Speaker 2: think about STIs of this is a consequence. This is
Speaker 2: a reflection of your value as a person. You have
Speaker 2: messed up, and now you are ruined forever. It's like, actually, no,
Speaker 2: this is a very normal thing. And viruses have nothing
Speaker 2: to do with your character or your choices. They're just
Speaker 2: a viruses.
Speaker 1: Besides the hangover, do you have a like second least
Speaker 1: favorite pop culture reference to herpes, or, for that matter,
Speaker 1: any pop culture references surphees that you think are actually
Speaker 1: helpful or good.
Speaker 2: Herpies pops up all of the time in pop culture.
Speaker 2: I think s A Saturday Night Live is an interesting,
Speaker 2: interesting source text to put my academic hat on for
Speaker 2: attitudes about herpes because SNL has had some horrible herpes
Speaker 2: jokes and some great ones, even just in the last
Speaker 2: few years.
Speaker 1: So wait, what's a great herpes joke?
Speaker 3: This is the thing.
Speaker 2: Herpes is like a lot of taboo topics. You can
Speaker 2: make a funny joke about them if you do it
Speaker 2: in a way that is humanizing and informed. For example,
Speaker 2: SNL did an amazing sketch about COVID nineteen. It was
Speaker 2: about a family of the COVID virus in their home
Speaker 2: and other viruses coming to visit, and like the herpes
Speaker 2: virus lived next door, and there were just really funny
Speaker 2: little bits in it that were not making fun of
Speaker 2: people who have the virus, but just making fun of
Speaker 2: the virus and how it functions.
Speaker 4: Now, who is that?
Speaker 1: It's your neighbors. We just wanted to out of nowhere
Speaker 1: and say hello, well this is.
Speaker 4: A surprise, honey.
Speaker 3: Have you met the herpes?
Speaker 1: I haven't, actually, even though statistically I probably should have.
Speaker 1: I'm oral, and this is my wife genital, please please
Speaker 1: call me jen.
Speaker 3: I just howled laughing at it.
Speaker 2: It was like Bo and Yang with like a big
Speaker 2: herpes virus contraption on his head, and that made me
Speaker 2: very happy.
Speaker 1: It's ten years later. Now, are you still the herpes girl?
Speaker 2: I would like to think I am no longer the
Speaker 2: herpes girl. My career has taken me in different directions.
Speaker 2: I think the thing about herpes is that you run
Speaker 2: out of things to say about it. There are other
Speaker 2: people who have more interesting stories to tell. Black women
Speaker 2: are far more likely to be impacted by herpes and
Speaker 2: to face different challenges when getting the treatment they need.
Speaker 2: It can lead to or exacerbate abusive relationships. You might
Speaker 2: be kind of vulnerable to being taken advantage of because
Speaker 2: you think that your damaged goods. So that's where I
Speaker 2: write a lot these days, is in that kind of area.
Speaker 2: But yeah, I'm not embarrassed to be the herpes girl.
Speaker 2: I just there are more herpes girls out there who
Speaker 2: deserve their day in the sun.
Speaker 3: Ella.
Speaker 1: It's great to talk with you, and truly interesting, really interesting.
Speaker 2: It's very fun to have a conversation about herpes.
Speaker 3: It's not just like.
Speaker 2: How did you get it?
Speaker 3: Sad is.
Speaker 2: Your life over herpes is fascinating, and I think if
Speaker 2: we bring curiosity to these conversations as opposed to judgment,
Speaker 2: we can learn so much. Thank you, so much, Thank
Speaker 2: you so much for having me on. It's been a pleasure.
Speaker 1: Ella Dawson's debut novel will be published in twenty twenty four.
Speaker 1: It's called But How Are You Really? Thanks to my
Speaker 1: guest today, Ella Dawson and Anna Wald. Next week on
Speaker 1: our final episode of the season, a twist Viruses that
Speaker 1: actually help human beings. I'm talking about phages, bacterial phages.
Speaker 5: Life is evolved in a soup of viruses, and most
Speaker 5: of those viruses are phages. And if a kind of
Speaker 5: alien life form was to just pluck a random bit
Speaker 5: of the Earth and look for life, they would probably
Speaker 5: find phages and nothing else.
Speaker 1: Incubation is a co production of Pushkin Industries and Ruby
Speaker 1: Studio at iHeartMedia. It's produced by Gabriel Hunter Chang, Ariela Markowitz,
Speaker 1: and Amy Gaines McQuaid. Our editors are Julia Barton and
Speaker 1: Karen Schakerjie Mastering by Anne Pope, fact checking by Joseph Fridman.
Speaker 1: Our executive producers are Katherine Girodeau and Matt Romano. I'm
Speaker 1: Jacob Goldstein. Thanks for listening.