0:05

I'm Jacob Goldstein. This is incubation on

0:08

today's show Herpes.

0:11

Yeah, I became the Herpes Girl for a while,

0:14

which I didn't expect, and

0:17

there's some pros and cons to that. I

0:20

was really delighted by how excited

0:22

people were to have this conversation, but

0:24

it was also very strange and like I would

0:27

go back to my college campus around

0:29

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

0:31

I'd be like, Hi, you've.

0:34

Heard Ella

0:38

Dawson writes about sex and culture and

0:40

she's also one of the billions of

0:42

people billions with a bee living

0:45

with herpes. We'll hear a lot more from

0:47

Ella later on, but first let's

0:49

do a little herpes one on one For this

0:51

part of the show, I called up a herpes

0:53

authority on a wault. Is

0:57

it true that you're the Queen of Herpes?

0:59

Yes, that's my less

1:01

formal title. Let's just say

1:04

I was introduced like that about

1:06

now twenty years ago, and I decided to adopt

1:09

that namucher and I've been doing

1:11

herpes work now for thirty years.

1:15

There are not a lot of experts

1:17

in this field, and I've stuck

1:19

with it.

1:20

In addition to being Herpe's royalty. Anna

1:22

is also a professor of epidemiology

1:25

at the University of Washington, and

1:27

today we're turning to Anna to explain

1:29

five key things to know about herpes.

1:31

By the way, Anna talks about the two types

1:34

of herpes that we usually hear about, which

1:36

are known as HSV one and HSV

1:38

two. So thing

1:41

number one to know about herpes, most

1:44

people have it. How many people in

1:46

the world are infected with

1:48

herpes.

1:50

Well, it depends if you're talking about HSV one

1:52

or HSV two. HSV

1:55

one about two thirds of people

1:57

in the world have HSV one infection

2:00

and most of its oral, but not

2:02

all. Some of it is genital, and

2:06

about fourteen percent or

2:08

so have genital HSV two infection.

2:11

Wow, So that's thing number

2:13

one to know about herpes. Thing

2:15

number two, it's really common

2:17

to have herpes and not even know it.

2:19

Only about twenty percent of people

2:21

who have HSV

2:24

two infection, which is the main cause of

2:26

genital herpes, at least historically

2:29

know that they have genital herpes.

2:31

Next thing to know. Part of the reason so many

2:33

people don't know they have herpes is that

2:36

testing is notoriously unreliable.

2:38

The problem is that many of these

2:41

essays that are now commercially

2:43

available, they're not that accurate.

2:46

And what's happened because the

2:48

frequency of herpes has gone down, but

2:51

the frequency of testing has gone up, the

2:53

proportion that's actually diagnosed

2:56

incorrectly has increased.

2:58

So there are a lot of false positive A lot of

3:00

people get herpes tests that say they have herpes

3:02

when in fact they do not.

3:04

Right, Because we have people who got

3:07

tested for whatever reason for HSV two. They

3:09

had a new partner, they were anxious about it, and

3:12

the test came back positive for HSV

3:14

two. I had somebody

3:16

who didn't believe

3:18

that they have it and the gynecologists

3:21

tell them to go to therapy to accept

3:23

it. She was subsequently tested

3:25

with an accurate test and the geynecologist

3:28

was wrong. Right, So we're giving

3:30

people a false diagnosis.

3:32

You and your colleagues have developed

3:35

a better test than the common test.

3:37

Is that right?

3:39

My colleague who was here actually before me, did

3:42

develop a better test that is still

3:44

available through University of Washington,

3:48

but it's only available here. It's what's

3:50

called the Western blot, which

3:52

means that we look at the ability

3:55

of the immune system to respond to a very

3:57

wide range of proteins

3:59

of not just one or two

4:01

like the commercial assays. So

4:04

I get to tell a fair number of people that

4:06

I cured their herpes because they thought

4:08

they have it by the commercial assay,

4:11

and then it turns out that they don't.

4:13

The fact number four, Herpes

4:15

is incurable. With lots of other viral

4:18

infections, the body figures out

4:20

how to eliminate the virus from

4:22

the body entirely, but herpes

4:24

isn't like that. Herpes has evolved to

4:26

have this really clever trick that allows

4:28

it to evade the human immune system.

4:31

Herpies hides in

4:33

the cells of the nervous system, and

4:36

the nervous system is what's called immuneprivileged

4:39

site. Is that there's not a lot of

4:42

immune cells there, so

4:44

it is able to hide in a form

4:46

that's inactive. It's called latent.

4:50

It infects bundles of nerves that

4:52

are along your spinal accord,

4:54

and at that point it doesn't elicit

4:57

much of an immune response.

4:59

And there are just kind of hangs out, not

5:01

eliciting an immune response, and then comes

5:03

out of hiding at some point later.

5:06

It elicits fair little immune response

5:08

when it's there, and then

5:11

in response to triggers that are not very

5:13

well defined, it

5:16

will come out and make its journey

5:18

back inside the nerve all

5:21

the way down to the either genital area

5:24

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

5:26

talking about oral or genital herpes.

5:29

Okay, now we come to the fifth

5:31

and final key herpes fact. HSV

5:34

one, which has historically caused

5:36

oral herpes, has in the past few

5:39

decades been causing more and more cases

5:41

of genital herpes.

5:43

And so they are susceptible to

5:45

acquiring HSV one in an area

5:48

that probably before was not susceptible

5:50

because they were already infected at a different

5:52

site. So now they

5:54

initiate sexual activity and

5:57

they could acquire a genital

5:59

h's view, the other reason

6:03

that people say is

6:05

that people now have more oral sex.

6:09

But it's very hard for me to believe that

6:11

this generation invented oral sex.

6:14

So I am more a

6:17

believer in the fact that

6:19

people are growing up without HSV one

6:22

as an explanation.

6:27

Thanks to doctor Anna Wald, Queen

6:29

of Herpes, when we

6:32

return, we'll hear more from Ella Dawson

6:34

about what it was like learning that she had herpes

6:37

and what it's been like living with it. Ever

6:39

since that's in just a minute.

6:53

Ella Dawson is a writer. She writes

6:55

a lot about sex and culture, and

6:57

she has also written a fair bit about having

6:59

her which turns out to be a

7:01

subject that has a lot to do with both sex

7:04

and culture.

7:05

So I woke up at the end of my

7:07

junior year of college. I remember it was supposed

7:10

to be the day of the big Spring Fling concert,

7:13

uh, and I just felt peculiar.

7:16

I had some uncomfortable

7:18

symptoms.

7:19

I would say I had a

7:21

smattering of raised sores

7:24

that were quite painful to touch around

7:26

my genitals. And I

7:29

think my immediate thought.

7:32

Was, are these ingrown hairs? Is

7:34

this some kind of rash?

7:35

Like I wanted desperately for it to

7:37

be something normal and easily treatable.

7:40

But when you google, you know.

7:42

Raised red sores herpes

7:45

is pretty much the first thing that you'll see. And

7:47

so, yeah, it was not fun. Herpees

7:50

outbreaks, particularly your first outbreak, tend

7:53

to be painful. It's not my favorite

7:55

experience in the world. And

7:58

like any panicked twenty year old, I went

8:00

to Google and kind of typed

8:02

in what I was feeling, and

8:05

the Internet immediately told me I was going to

8:07

die. So I

8:10

classic, and so I called the

8:12

student health clinic on campus, and

8:15

thankfully the nurse who

8:17

I saw there was incredibly kind and gracious

8:20

and took one look at the symptoms

8:22

I was expressing and said, you know, this looks

8:25

like genital herpes. We see

8:27

this all the time, particularly among

8:29

female students. And

8:31

that was very comforting.

8:33

As well as very terrible.

8:36

It was not a fun day, I would say,

8:38

but I got incredible medical care. And

8:42

yeah, I would give it two out of five stars.

8:44

I would say it's an experience.

8:49

I mean, it could be worse, given that it's a diagnosis

8:51

of a disease. Any more than zero

8:53

stars is okay.

8:54

Right.

8:57

So the nurse, as you

8:59

probably havees a rare

9:01

case, perhaps of a healthcare professional confirming

9:04

a Google diagnosis. Do

9:08

you have a test? Is that it?

9:10

Like?

9:10

What?

9:11

Then?

9:12

Yeah?

9:13

So she took a culture directly

9:15

from a sore, and that tends to be,

9:17

from my understanding, the most reliable form

9:20

of herpes testing. If you are not expressing

9:22

symptoms, you can take a blood test

9:25

for herpes, but those tend to be

9:27

unreliable and expensive. So

9:30

it was kind of lucky that I immediately

9:32

went in on day one and had a culture taken

9:34

because I was able to get a very

9:36

clear diagnosis within a few days when

9:39

the labs came back and I tested positive

9:41

for genital HSV one, which

9:44

is usually associated with oral herpes,

9:46

but it's quite common these days for

9:48

people to have genital herpes

9:51

from HSV one because of oral sex.

9:53

So you get the labs, they

9:55

confirm that you in fact have her bees, and

9:59

then what.

10:01

Hello.

10:02

I had a lot of uncomfortable conversations.

10:04

Called my mom and I said, you

10:06

know, I have some bad news, and she immediately

10:09

asked, are you pregnant. I was like, no, no, no, no, no,

10:11

I have herpes, and she goes, oh, that's fine.

10:15

She was.

10:17

It was really nice.

10:19

I was so terrified and I

10:21

was worried, so I appreciate that she was

10:23

just unflappable and she just

10:25

wanted to know that I was okay.

10:28

My parents were great.

10:29

The more difficult conversations I had to have

10:31

were I had to tell the person I was

10:33

dating, who was

10:36

not the nicest person already and

10:38

was a big jerk about it. I

10:40

think his immediate concern was for himself,

10:43

which is totally fair.

10:45

I also called.

10:46

Some exes just to say you

10:48

know, Hey, I got diagnosed with this. I

10:51

don't know if you've been tested. I don't know if

10:53

you know your history. But for

10:55

the most part, people were really surprised,

10:58

but gracious and understanding that this is not

11:00

something that anyone does maliciously.

11:02

Viruses happen.

11:04

Did What did you know about herpes

11:08

when you got diagnosed or just before

11:10

you got diagnosed?

11:12

Next to nothing. I think herpes in particular

11:15

is a strange virus because everyone

11:17

knows that herpes is a skin

11:19

condition that you can get and that is incurable,

11:21

and it's actually transmitted, but very few

11:24

people know what the symptoms actually are,

11:26

how it's actually transmitted, how to prevent

11:29

it, what the testing looks like. I

11:31

thought I knew a lot about it, and then I very quickly

11:33

realized, oh, I am very ignorant.

11:37

And I had absorbed a lot of

11:39

stigmatizing messages about it from pop

11:42

culture, from sex education, from

11:45

the Hangover. And there's an infamous line

11:47

in the Hangover of what happens in

11:50

Vegas stays in Vegas except for herpes, that

11:52

shit'll come back with you. So like, that

11:54

was what I knew of herpes before this,

11:57

and so I was really baffled

12:00

as I learned more about how

12:02

the virus functions in the body,

12:04

Like, when you have herpes, you

12:07

are not having symptoms the vast majority

12:09

of the time. I've had herpes for

12:11

ten years now, and I've maybe had

12:13

active herpee symptoms outbreaks for

12:16

four weeks of those ten years. It's

12:19

had a minimal impact in my life. And

12:22

that is not what I expected. When I was diagnosed

12:24

with herpes. I was like, am I going to have an outbreak forever?

12:27

Am I going to be in this pain forever?

12:29

And no.

12:30

Viruses are weird and

12:33

they don't behave the way you expect.

12:35

So at some point you go

12:37

from talking about having herpes

12:40

with your friends and former

12:42

partners and your family to talking about

12:44

herpes in public and

12:46

writing and speaking. How do

12:48

you make that leap?

12:50

Oh?

12:50

Yeah, I mean in a nutshell.

12:52

What happened was I graduated college, I started

12:55

writing a blog. I started writing

12:57

a little bit about having herpes on that blog, and

13:00

then a friend of a friend worked for women's health and

13:02

said, would you like to write an article about

13:04

this for SGI Awareness Month which is April?

13:07

And I said sure. That was

13:09

called I think it was why I love

13:11

telling people, I have herpes, which

13:13

is a very clicky title, and then that

13:15

went extremely viral online.

13:19

I was twenty two. I was

13:21

completely unprepared for that. I thought maybe

13:23

a few hundred people would read it. I got

13:26

thousands of emails and Facebook messages

13:28

from people. It was aggregated

13:30

all over the internet because it was very

13:33

unusual to see someone

13:35

willingly say, Hey, I have herpes and let's talk

13:37

about it.

13:38

So you write this article it

13:40

goes viral. What is life after

13:42

that immediate moment as a

13:44

person who is sort of internet famous

13:46

for having herpes.

13:48

Yeah, I became the herpes Girl for a while,

13:51

which I didn't expect, and

13:54

there's some pros and cons to that. I

13:56

was really delighted by how excited

13:58

people were to have this commonversation and

14:01

to hear from other folks who had herpes who

14:03

read my work and felt very seen and understood.

14:07

But it was also very strange.

14:08

To have that suddenly become what

14:11

Google suggests when you type in my name,

14:14

it adds herpes at the end,

14:16

And like I would go back to my college campus around

14:19

that time and people be like, it's the herpes Girl. I'd

14:22

be like, Hi, you've

14:24

heard.

14:30

So I want to talk more broadly about herpes

14:33

in popular culture, and in particular,

14:35

there is this Time magazine story

14:38

from all the way back in nineteen eighty two

14:41

that people still talk about when they

14:43

talk about herpes. And I know you've written

14:45

about this particular story, so just

14:48

to kind of give a flavor of it, I want

14:50

to read a line from

14:53

that story from that article here.

14:55

It is also known as the

14:57

Scourge, the New Scarlet Letter,

14:59

the VD of the Ivy League. It's

15:01

like they're introducing a boxer, the

15:04

VD of the Ivy League and Jerry

15:06

Folwell's Revenge. Herpes

15:08

has emerged from relative obscurity and

15:10

exploded into a full fledged

15:12

epidemic.

15:16

It's giving chaos. It's giving

15:18

panic.

15:19

Tell me about that story and the sort of broader

15:22

role it played in the public imagination

15:24

of herpes.

15:26

That Time magazine story and cover

15:29

are so iconic that it's

15:31

got like this woman in eighty shoulder pads

15:33

and a big scarlet H on it.

15:35

The H is like a New Scarlet Letter.

15:37

It's an allusion to the Scarlet Letter, right.

15:40

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

15:42

article is the most Banana's

15:46

hysterical science writing I've

15:48

ever read, and they interview

15:50

all these people who say crazy

15:53

things about how herpes has impacted their life. Some

15:55

people claim that they're willfully

15:57

infecting hundreds of people because they feel

15:59

bitter and they want revenge

16:01

upon society.

16:02

Like it is.

16:03

It's

16:05

like a Jerry Springer episode that's

16:08

off the rail on it. I shouldn't even insult

16:10

the late Jerry Springer like that. He would not talk about

16:13

herpes like this.

16:15

It is just it's vile.

16:17

And a lot of folks point to that article

16:19

as being kind of this pivot

16:22

where herpes went from being something

16:24

fairly normal and common to something

16:26

that was incredibly stigmatized because

16:29

it was it was so bombastic

16:32

and like a cover of Time

16:34

magazine that really impacts culture, especially

16:36

in the eighties.

16:37

Like in the eighties, it was a huge deal. It's hard

16:39

to think of now what would be

16:42

like Taylor Swift would have to like give a speech

16:45

about it or something, right like, it's hard

16:47

to think of something that's as big of a deal now as that would

16:49

have been then.

16:50

And even if you didn't read the article, even

16:52

if you didn't pick it up, just seeing that cover,

16:54

that big scarlet h stays in people's

16:57

minds, And I love the framing

16:59

of it being like Scourge of the Ivy

17:01

League, Like there's so much in there about class

17:03

and like and about

17:06

race, Like it's basically saying,

17:08

hey, even affluent white people, you can

17:10

get this, and you should be you should be afraid,

17:12

like and again like Jerry

17:14

Folwell's Revenge, it's saying like, this

17:17

is a consequence of us having more liberal sexual

17:20

feelings and values. This is this is punishment,

17:23

and that is still very cemented in the way

17:25

we think about STIs of this is a consequence.

17:28

This is a reflection of your value as a person.

17:31

You have messed up, and now you are ruined

17:33

forever. It's like, actually, no,

17:35

this is a very normal thing. And viruses have nothing

17:38

to do with your character or your choices. They're

17:40

just a viruses.

17:41

Besides the hangover, do

17:43

you have a like second least

17:46

favorite pop culture reference to herpes,

17:48

or, for that matter, any pop culture references surphees

17:50

that you think are actually helpful or good.

17:54

Herpies pops up all of the

17:56

time in pop culture. I

17:59

think s A Saturday Night

18:01

Live is an interesting, interesting

18:05

source text to put my academic hat

18:07

on for attitudes

18:09

about herpes because SNL has had some horrible

18:12

herpes jokes and some great ones,

18:14

even just in the last few years.

18:16

So wait, what's

18:18

a great herpes joke?

18:21

This is the thing.

18:22

Herpes is like a lot of taboo

18:25

topics. You can make a funny joke about

18:27

them if you do it in a way that is

18:30

humanizing and informed. For

18:32

example, SNL did an amazing sketch

18:34

about COVID nineteen. It

18:37

was about a family of the COVID virus

18:39

in their home and other viruses

18:41

coming to visit, and like the herpes virus

18:43

lived next door, and there were just

18:45

really funny little bits in it that were

18:48

not making fun of people who have the virus,

18:50

but just making fun of the virus and how it functions.

18:54

Now, who is that?

18:58

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

19:00

and say hello, well this is.

19:02

A surprise, honey.

19:04

Have you met the herpes?

19:05

I haven't, actually, even though statistically

19:07

I probably should have. I'm

19:10

oral, and this is my wife genital, please

19:12

please call me jen.

19:16

I just howled laughing at it.

19:18

It was like Bo and Yang with like a big herpes

19:21

virus contraption on

19:23

his head, and that made me

19:25

very happy.

19:28

It's ten years later. Now, are you still

19:30

the herpes girl?

19:33

I would like to think I am no longer the herpes

19:35

girl. My career has taken

19:37

me in different directions. I think the thing about herpes

19:40

is that you run out of things to say about

19:42

it. There are other people who have more interesting

19:44

stories to tell. Black women are far more likely

19:46

to be impacted by herpes and to face different

19:48

challenges when getting the treatment they need. It

19:51

can lead to or exacerbate

19:53

abusive relationships. You might be

19:56

kind of vulnerable to being taken advantage of because

19:58

you think that your damaged goods. So

20:01

that's where I write a lot these

20:03

days, is in that kind of area. But

20:05

yeah, I'm not embarrassed to be the herpes

20:08

girl. I just there are more herpes girls

20:10

out there who deserve their day in the sun.

20:15

Ella.

20:16

It's great to talk with you, and truly interesting,

20:19

really interesting.

20:20

It's very fun to have a conversation about

20:22

herpes.

20:22

It's not just like.

20:24

How did you get it?

20:25

Sad is.

20:26

Your life over herpes is fascinating,

20:29

and I think if we bring curiosity to these

20:32

conversations as opposed to judgment, we can learn

20:34

so much. Thank you, so much,

20:37

Thank you so much for having me on. It's been a pleasure.

20:42

Ella Dawson's debut novel will be published

20:44

in twenty twenty four. It's called But

20:46

How Are You Really? Thanks

20:50

to my guest today, Ella Dawson and Anna

20:52

Wald. Next week on our final

20:55

episode of the season, a twist

20:58

Viruses that actually help human

21:00

beings. I'm talking about phages,

21:03

bacterial phages.

21:05

Life is evolved in a soup of viruses,

21:08

and most of those viruses are phages. And

21:11

if a kind of alien life form

21:14

was to just pluck a

21:16

random bit of the Earth and

21:18

look for life, they would

21:20

probably find phages and nothing else.

21:26

Incubation is a co production of Pushkin

21:28

Industries and Ruby Studio at iHeartMedia.

21:31

It's produced by Gabriel Hunter Chang, Ariela

21:33

Markowitz, and Amy Gaines McQuaid. Our

21:36

editors are Julia Barton and Karen Schakerjie

21:39

Mastering by Anne Pope, fact checking

21:41

by Joseph Fridman. Our executive

21:43

producers are Katherine Girodeau and Matt

21:45

Romano. I'm Jacob Goldstein.

21:48

Thanks for listening.