All of this can be a tough pill to swallow, so to speak. There is significant social stigma and shame associated with herpes. In addition, there are occasionally false-positive tests. Labeling someone with the diagnosis can be devastating to their future relationships, and asking someone to take a pill for a condition they may or may not have and may or may not spread seems unreasonable.
However, many experts disagree with the official guidelines. I wrote to Dr. John Gnann, professor of infectious disease at the Medical University of South Carolina and co-author of the New England Journal of Medicine article. He has suggested the below guidelines, and outlines the rationale:
“For herpes viruses, there is no ‘past exposure only’ scenario. If a person is HSV-2 seropositive, then that person is HSV-2 infected and will carry the virus forever. That means one of three things:
The person has had herpes with symptoms.
The person has had herpes with symptoms but didn’t realize the cause.
The person has the herpes virus that from time to time can appear in genital fluids. The only way to know if a person is shedding the virus is with daily tests. That’s just not practical.
A lot of people fall into the second and third categories — again, that’s why so many people still get the virus. Dr. Gnann suggests herpes testing for people with any other sexually transmitted infection including chlamydia, human papilloma virus (HPV), etc.