This summer, numerous people came forward to accuse R&B legend Usher of exposing them to herpes. One of them said they positively contracted the infection from the singer, while another, Quantasia Sharpton, is claiming to have video footage of engaging in sexual relations with Usher. This comes after Usher reportedly denied being intimate with Sharpton.
Since then, the word "herpes" has been plastered across headlines in publications as far as the eye can see. The much-maligned STD was already taboo to address in public, so the widespread accusations now taking place are pushing the extremely common infection further away from being understood through meaningful discourse.
While the aspiring comedians among us are busy roasting Usher on social media, they, and maybe even you, might not realize how many people you know are getting caught in the crossfire. This becomes even more dicey when you factor in the latest statistic from the Centers for Disease Control, which estimates one out of six people in the United States aged 14 to 49 have genital herpes, which is commonly referred to as herpes simplex virus type 2, or HSV-2. (This statistic is a little hairy, but we'll dig into why soon.)
In 2015, the World Health Organization reported that "more than 3.7 billion people under the age of 50—or 67 percent of the population—are infected with herpes simplex virus type 1," or HSV-1. The line between HSV-1 and 2 is extraordinarily fuzzy, and it complicates the conversation about herpes because there's often an inaccurate separation of herpes into type 1—"cold sores"—and type 2—"genital herpes." But as the CDC also reports, both viruses can be contracted in either region. The siloing of the two just makes the world feel better about who has what and where.
Nanette Tincher is the vice president and co-founder of Project Accept, a "united campaign to raise awareness, increase acceptance and fund independent cure research to eradicate HSV and HPV." She's also a registered nurse working in Stafford, Virginia. As a health professional and administrator for Project Accept, Tincher is well-versed in both the statistics and the stigma surrounding herpes. She spoke to Complex about some of the common misconceptions about herpes, misleading statistics, the goal of Project Accept, and why being vocal about the unknown ubiquitousness of the STD is so important.
Can you briefly tell me about Project Accept?
Project Accept was founded in 2012. The ultimate goal is to provide updated and current information and education to the public, health professionals to reduce the stigma around it just being herpes. It’s a big project. When we started Project Accept, I don’t think I realized the magnitude of the situation. You learn as you grow, and we have learned what we didn’t know before and I think that is going to help our organization be that much better and active in the future.
According to the CDC, one out of every six people in the United States ages 14 to 49 have herpes. I’ve seen on the Project Accept site that you guys dispute those statistics. How do you know they are inaccurate and where are you getting your statistics from?
We have a page on our website that explains that. A lot of it is how you interpret your numbers. The CDC at one time said that 16.2 percent of people have genital herpes. Then on another page, they said that 16.2 percent of Americans have HSV-2. You have to better understand the testing and the serology around the testing to understand how that would not be applicable.
HSV-2 can be anywhere in your body—we do have people that have HSV-2 oral, and it has been confirmed with a swab test, which is the most definitive. So if 16.2 percent of people have HSV-2, and 16.2 percent of those people have genital herpes, where is the statistic for the people who have HSV oral? Just by default, one of those statistics has to be incorrect.
Do you guys have a definitive number listed? Have you come to a consensus about what is right?
I am also involved in online support groups that are secret, before Project Accept happened, that started in October 2010. The more people came in, the more they started talking about their personal situations. I started to become aware that the statistics were not reflecting what I was hearing and reading about. We do our best to try and take in information from a variety of sources, because the majority of new HSV genital cases are contributed to HSV-1. The issue is first: is HSV-1 a sexually transmitted disease? Because the majority of the population that has HSV-1 have probably had it since childhood, and people didn’t know that a cold sore equals herpes. That’s huge.
Some people, to this day, refuse to admit that cold sores are herpes, so we just call it HSV outbreak or lesions to bring it to what it is—it’s not a cold sore, it’s a herpes lesion. So, you have to look at, do we include HSV-1 in our statistics? Do we only talk about HSV-2 in our statistics? Do we only talk about genital herpes or oral herpes in our statistics? Really, you can’t have a conversation about one without the other because they are so intertwined.
Back before the onset of blood testing, your doctor would only visually diagnose you. If you had a lesion on your genitals, you had HSV-2. They didn’t swab test it or do the serology test. If you had it on your lips, it was HSV-1. That was just probably 20 to 25 years ago. So the people that are older aren’t necessarily certain about their diagnosis, besides a visual. Now, we have so much more technology in place to identify HSV-1 and HSV-2, and where it is located. It will be able to be identified a little bit better now that new information is coming out.
We chose not to specify one or the other and do an encompass of all. Looking at statistics worldwide, at all adults over the age of 18, in some countries, they are up to 90 to 100 percent HSV infection rate of HSV-1, 2 or both. It’s between 65 and 80 percent in the United States, depending on which statistic you use. So, it’s always safe to say over 65 percent of adults have HSV. One of our goals is to destigmatize.
In the Project Accept statement posted to Facebook, you mentioned that this Usher lawsuit is kind of tricky because patients are typically told by doctors to not disclose their status to their partners. Is that true?
I have had people come into our support groups and say that, yes. In three different support groups, people told me the exact claim that I had posted on the Facebook page, and that’s not uncommon. I also moderate the D.C. Metro support area meeting that meets once a month at the NIH in Maryland, and we have had people come in there and say the exact same thing. So it’s not every doctor, but it’s not uncommon, either.
Are you familiar with any other cases like this from the past?
I don’t want to name drop, but I know that herpes has been related to a lot celebrities, including [in] lawsuits. And each lawsuit has their own merit. When people were asking me about this specific one, I just so happened to turn on my TV, and I was watching TMZ. What I caught as the complaint in this case was that Usher hadn’t disclosed his status with his partner. And that is a huge topic of conversation in the support groups, because many of us end up acquiring HSV infections because our partners didn’t know they had the infection, or knew about it and chose not to tell us.
This is why I wasn’t paying as much attention to Usher’s accusers as much as I was focused on this as a topic of daily conversation in our support groups. It is a problem, but where is the root of the problem? Is it personal, or are people being told by their physicians that they don’t need to disclose their status because it is so common that nobody cares about it? I wanted to focus on what the community I am engaged in is focusing on.
So how does a highly publicized case like this affect the community of people who live with herpes?
It affects us in many different ways. It brings to light the conversation of disclosure and discussion, but also the stigma of “if he wasn’t rich, they wouldn’t sue him.” Because they wouldn’t get any money out of it. We have people in our community that want to sue their “gifters” every day, but you have to understand the testing and the complexity of the testing. You have to prove beyond a shadow of a doubt that you did acquire it from this person. Because, depending on if it’s specific enough, the testing that it requires at that level is exorbitantly priced. So does the everyday person not get to sue because they can’t afford that? Or is it OK because this is a celebrity, so they can sue? People juggle with that.
In regards to the legalities of the Usher situation, you have to know the laws in your state. Every jurisdiction is different and you have to check the laws in your state and see if it’s even an offense. In most places, if it is an offense, it is usually a misdemeanor because it is not life threatening. Those type of laws are usually left over from the HIV criminalization laws, because they will say a crime is a non-curable condition—but they don’t specify HIV or HSV. So, HSV can just be blanketed in there, because it doesn’t have a cure at this time.
Off the top of your head, what are the most common misconceptions about herpes?
With regard to testing, when a doctor runs a test scanning for an STD, patients think they are getting tested for everything, which includes herpes—and they’re not. So when you’re dating, you have done your due diligence to get checked and your partner has too, but then something comes up and it leads to questions: “Have you been cheating on me?” But they haven’t been cheating; the virus can lay dormant without having an outbreak for so long.
That’s another misconception: that as soon as you have an outbreak, you [can] expose [people] to it. It is estimated that roughly 80 percent of those that do have it, do not know it, because they don’t get symptoms. Sometimes, the doctor will say you have been exposed to the virus, but you don’t have herpes, which is very true. You have been exposed to the virus, which means your body has created antibodies, which means the virus is in your body and you can transmit it. There is what is called asymptomatic shedding, which means you have absolutely no outward symptoms, but the virus is active and can be transmitted and you can’t tell.
Condoms do not cover sexual transmission 100 percent. They do protect from transmission, but because it is skin-to-skin contact, they do not completely prevent it. You have one person who has an active outbreak going on or the virus is active—if that person touches the other person’s skin through any entry that the virus can get in, that is how the transmission takes place. It lives in the nerves and can happen, if we are talking about genital herpes, anywhere. Some people get outbreaks on their thighs, their buttocks, on the scrotum. You can have outbreaks on your forehead, arms, legs, feet, anywhere. So it’s not necessarily just on the vagina or just on the penis. So if those areas start to touch somebody else’s area where they have shaved or have an ingrown hair or something like that, you can definitely transmit it that way.
Do you know if there are any efforts to make a cure for this?
There are various vaccines in the works. I do know of some methods of treatment. Curing HSV is very difficult.