Virus (HSV-2)
Most carriers; sheds silently
No, lifelong but manageable
No
Herpes simplex virus type 2 (HSV-2) is the main cause of genital herpes (HSV-1, the usual cause of cold sores, increasingly causes genital infections too). Worldwide around 13% of adults aged 15 to 49 carry HSV-2, and it is markedly more common in women. After the first episode the virus stays in the body for life, with outbreaks that typically become milder and less frequent over time. Crucially, it spreads skin-to-skin and can be passed on even when there are no visible sores (asymptomatic shedding), so condoms reduce but do not remove the risk. Per-act transmission is low, but it adds up over a relationship.
Skin-to-skin genital contact during vaginal or anal sex
Contact during asymptomatic shedding (no visible sores), a major route
Oral sex can transmit between mouth and genitals (often HSV-1)
Mother to baby during vaginal birth (uncommon but serious)
Many people have no symptoms or very mild ones
Painful blisters or ulcers around the genitals or anus
Itching, tingling, or burning before an outbreak
Flu-like symptoms during the first episode
Recurrences that are usually milder than the first
Herpes is not curable, but antiviral medicines (aciclovir, valaciclovir) shorten and reduce outbreaks, and taken daily (suppressive therapy) they also cut the chance of passing it on. For most people it is a manageable skin condition rather than a serious health threat.