Why Isn't Everyone Tested for Herpes?
One of my favorite myths to bust as a sex educator is about STI testing. When someone says they were “tested for everything,” the truth is—everything doesn’t actually mean everything.
What’s standard for some isn’t standard for everyone. What’s considered standard can vary; It’s often based on your conversation with your healthcare provider and tailored to your individual experiences and health history. There will likely be recommendations made based on your sex assigned at birth, number of sexual partners, and any other sexual behaviors you feel comfortable sharing. If you disclose a potential exposure to a certain infection, your provider may add an additional test.
The biggest surprise for many people is that herpes isn’t typically included in a standard testing panel. And, understandably, people are big mad when they find this out.
My Diagnosis Story: Confusion, Shame, and the Search for Answers
When my herpes diagnosis was fresh, I was so confused and overwhelmed. Like many, I found myself up late Googling for some kind of direction or answer. Who gave it to me? When did I get it? How long have I had it? But each search effort inevitably left me with even more questions.
I didn't have sex with a lot of partners. In my mind, I wasn’t the type of girl to get herpes. As I later learned, that was my internalized stigma talking. For so long, I couldn’t integrate Emily before herpes and Emily after herpes. Each morning I'd wake up and remember all over again, feeling like I'd lost the person I thought I was, as if there were now two versions of me with a clear dividing line between them.
For me, my herpes diagnosis meant I had to start anew. For a period of time, I became my diagnosis. The morality I associated with STIs became what I felt like I had to wear. Marked, discarded before I even felt I had a chance at love or a future.
When I talked to the only guy I was sleeping with at the time, he shared he had been tested and treated for gonorrhea in the past, but never herpes. The plot thickened, as did my anger.
While my confusion grew then, I came to realize years later that because people aren't regularly screened for herpes, he probably didn’t know he had it. Add in a lack of symptoms, which is contrary to what most people learn in school, and the mystery starts to make even more sense.
The Hidden Reality of Herpes Transmission
Sometimes, it is simple. Herpes transmission isn’t always intentional. Some people never have symptoms. They’ve likely never been tested. Many may not even realize that cold sores can transmit via oral sex. All of this lack of education adds up to increased transmissions. We see that in the latest data from the World Health Organization showing an increase in genital HSV-1 infections.
Herpes is tricky, and the lack of recommended screening is frustration point for nearly everyone I talk to that has herpes. When I was newly diagnosed and in my early herpes writing days, I passionately believed everyone should be tested for herpes.
My reasoning seemed obvious: if everyone knew their status, disclosure would become normalized, transmission could be reduced, and the stigma might finally begin to dissipate. It seemed like the solution to herpes stigma had been neatly wrapped in a bow in front of me, begging me to share it with the world.
I carried this conviction into my early advocacy work. My personal pain fueled a mission to prevent others from experiencing the same shock and confusion I had. Something I know is relevant to many with herpes.
But as I continued to research, speak with healthcare professionals, and connect with more people in the herpes community, the complexities of testing and diagnosis revealed themselves.
I began to understand the medical rationale behind testing protocols, the psychological impact of positive results (which I knew well), and the limitations of available, accurate, and affordable tests. My black-and-white perspective gradually gave way to a more nuanced understanding—and I realize most people don’t enjoy grey area.
Why Universal Testing Isn't the Answer
Now, ten years since my diagnosis, I don't believe everyone should be tested for herpes. I know that statement may frustrate and surprise a lot of people. But bear with me.
The reality is that herpes testing is far more complex than most people realize. It’s not as clear cut as getting a test and receiving a result. There are numerous available testing types for herpes, including blood testing and PCR testing. I won’t get into all of the nuances of the testing methods themselves, but standard blood tests are known to produce false positives. This means someone could receive, what they believe to be a life-altering diagnosis that may not even be accurate.
Beyond the test’s questionable reliability and high cost, we also have to consider the psychological impact of a diagnosis—especially when the results may not be clear-cut or even accurate.. I know that impact, as do many others. The attending nurse at urgent care scraping the sample of lesions from my vagina was bad enough, but I still had hope before the moment of truth. The nurse’s confidence that it was herpes, and later confirmed via a separate phone call, propelled me further into distress.
Not only did my sample return positive, the nurse further shamed me—and I’m not alone. The stigma isn’t applicable just to those who test positive, it’s even reinforced by some providers who infuse diagnostic results with their own beliefs or misinformation about sex education.
Yet many people who test positive may never experience symptoms or transmit the virus to their partners. The mental health burden of a diagnosis may outweigh the benefits for many, especially when current tests cannot distinguish between new or long-standing infections or locations.
The Centers for Disease Control and Prevention and many sexual health experts actually don't recommend routine herpes screening for asymptomatic people for these very reasons. Instead, they recommend testing when someone has symptoms, has a partner with herpes, or is at higher likelihood of transmission due to specific factors.
Of course, if you are concerned or want to be tested for herpes, you can certainly request testing, but also keep in mind the other variables I discuss and why your provider may recommend against it.
These days, I don’t advocate for universal herpes testing. What I do advocate for is better sex and STI education.
People should understand how herpes is transmitted, what symptoms might look like (or not look like), and the limitations of current testing. They should know that cold sores are herpes and can be transmitted to a partner's genitals through oral sex. And most importantly, they should understand that having herpes—genital or oral—is more common than they think.
My own journey taught me that the real problem wasn't the herpes virus itself, but the shame I associated with it. Ten years after my diagnosis, I no longer see herpes as the scarlet letter I once feared. It's simply one aspect of my sexual health—not a moral judgment, not a barrier to love, and certainly not my defining characteristic.
If you are someone who believes in universal herpes testing and finds yourself frustrated with my position, I understand. Your stance likely comes from the desire to reduce pain from your diagnosis experience or someone close to you—to create a world where fewer people experience the isolation and confusion I felt. You want to reduce the pain and suffering in the world, and that desire is both beautiful and valid—especially now.
While I respect this perspective, my experience has led me to believe there's a more effective path forward. I think it’s actually more realistic to operate under the assumption that we will encounter herpes in our sex and dating lives at some point, whether we realize it or not. It’s inevitable when we look at the recent data. With education and reflection on our own belief systems, we can parse out stigma rather than unnecessary and unreliable testing.
But reducing stigma isn’t neatly wrapped in a bow of herpes testing. It’s complex, layered, and laced with misinformation and beliefs systems. The journey toward destigmatization requires us to challenge our own assumptions about what STI test results mean, to question why we fear certain diagnoses, and to recognize the humanity in everyone navigating their sexual health.
The true path forward requires comprehensive education, compassionate healthcare, and a fundamental shift in how we view STIs—not as moral failings, but as common realities of human sexuality.
That's the message I wish I'd found during those late-night Google searches years ago. And it's the message I hope reaches someone else when they need it most.