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Dear Dr. Roach: I’m 73 years old and just found out I have herpes. How can I have herpes when it has been at least 10 years since I last had sex?

Anon.

Dear Anon.: Genital herpes infections may be caused by two viruses: herpes simplex viruses 1 and 2. In recent years, HSV-1 increasingly has been the cause of genital herpes in younger people. However, most cases of recurrent genital herpes are caused by HSV-2.

Once someone has acquired genital herpes, the virus is with the person for life. Not everyone with genital herpes has symptoms. It is possible that the person you acquired the infection from 10 or more years ago was unaware of being infected. People can shed the virus without any symptoms, but are more likely to be infectious when they have symptoms. Recurrences can be treated with antiviral drugs, and people with frequent outbreaks benefit from taking preventive medication.

Sometimes people can jump to the wrong conclusion. For example, if you happened to have had a sexual partner a month before you noticed symptoms of herpes, you would be likely to suspect that partner of being the source. In fact, it may have been from an exposure in the distant past. This situation has led to difficulties in many relationships, including marriages.

Many people needlessly feel embarrassment or shame about a herpes diagnosis. You can find support group information, as well as much more information about herpes, at ashastd.org.

A person who knows he or she has genital herpes should tell any future partners about the diagnosis, use a condom for sex every time and avoid sex during times of symptoms.

Email questions to ToYourGoodHealth@med.cornell.edu.

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