Tangent Time – Hiking with Herpes

On any given hike, you may find yourself alone, confronted with your own intrusive thoughts. This can quickly and easily spiral into a time to overanalyze yourself. Personally, I find myself on tangents, pondering certain words and whats they mean to me, dissecting my relationships—all that fun processing stuff. While hiking the PNT (Pacific Northwest Trail), I spent probably a week alone thinking about the word curiosity. What it means to be curious, to question, to form opinions or predictions on specific topics. So here we are with today’s episode of Tangent Time, with me your host, Flower. Today’s topic is herpes, so it’s about to get real vulnerable, y’all.

Let’s start with the basics.

First of all, what is herpes? HSV (Herpes Simplex Virus) is a virus causing contagious sores, most often around the mouth or on the genitals. You might hear it referred to as cold sores or genital herpes, or maybe HSV-1 or HSV-2. Typically people with HSV-1 will present in cold sores (oral sores) if they have an outbreak, and typically people with HSV-2 will present in genital sores if they have an outbreak. This is not the case for everyone, however. Both types of the virus can present in either area and can also remain dormant. Meaning, many people can go months, or even years, without even realizing they have it.

According to the CDC (Centers for Disease Control and Prevention), more than one out of every six people (roughly 17%) aged 14 to 49 years have genital herpes, in the US. Furthermore, in 2016, an estimated 3.7 billion people under the age of 50, or 67% of the population, had HSV-1 infection (oral or genital). The estimated prevalence of the infection was highest in Africa (88%) and lowest in the Americas (45%) (as disclosed by WHO, World Health Organization).

To recap, having herpes is a very common experience yet often goes undiagnosed due to most oral and genital infections being asymptomatic. Additionally, the CDC does not recommend herpes testing for people without symptoms. According to Planned Parenthood, it is estimated that only 10 to 15 percent of people with herpes exhibit symptoms. With this in mind, if two-thirds of the population has HSV-1 and only 10 to 15 percent of that population knows they have it, it is very likely that the virus is spread unknowingly all the time.

Basically, two-thirds of the world has HSV-1, and yet we still see massive stigma attached to having the virus.

So why does this matter, and how does it relate to hiking?

Backpacking is objectively hard. Whether it be the terrain, the weight, finding what gear works or doesn’t work for you, planning out food proportions, shipping yourself resupply boxes, digging cat holes, blisters, injuries, the list goes on. We talk about these things, often. It is normal to talk about these things. Nobody is going to give you weird looks for ranting about how the post office lost your resupply box, or how you twisted your ankle stepping over a blowdown. It’s just stuff that happens on trail, right?

Imagine if we talked about herpes in the same way we talked about chafing, if we broke free of the confinements of shame and embarrassment. If 67% of the population has HSV-1 and 17% has HSV-2, then certainly there’s gotta be people on trail dealing with an outbreak.  It’s time to normalize talking about outbreaks.

Sore-ing to new heights on trail.

Living in a body that struggles with chronic pain or illnesses means that I’ve got to take a few extra steps to keep myself cozy on trail. And sometimes, no matter how much preparation or proactive steps I take, shit happens anyways. Hiking 20+ miles a day in 100-degree (F) weather, teetering the line of being dehydrated, constantly trying to adjust my shorts and underwear, itching, burning, pain while peeing, trying to focus on the beauty of the trail but being so distracted by my discomfort. Or on the other hand, dealing with an aggravated sore on my lip, feeling self-conscious, bleeding everywhere, pain while eating.  It all sucks. But we manage, we move forward, and often in silence for fear of being ostracized.

What’s in your first-aid kit?

I can’t tell you how many times I’ve seen the UL (ultralight) community bring nothing but band-aids and Ibuprofen. It’s bewildering to me what people are willing to leave at home for the sake of shaving a few ounces. Maybe it’s that these people live relatively “healthy” lives, so bringing meds or creams just doesn’t feel applicable. Or maybe it’s my background working in outdoor education or trip guiding that just has me extra prepared. To each their own I guess.

Regardless, I come locked and loaded with things I may need. This includes the typical band-aids, antibiotic ointment packets, a couple of gauze pads, Leukotape (arguably the best bandage tape), KT tape (Therapeutic Kinesiology Tape), y’know, the basics. Additionally, I bring a full prescription of antibiotics (I’m personally very susceptible to UTIs), a tube of Ketoconazole (antifungal cream for my face), and a couple of weeks’ worth of an antiviral.

What can I do on trail if I am susceptible to outbreaks?

Ed. Note: We are hikers, not doctors. This advice is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health care provider with any questions you may have regarding a medical condition. 

Being in the backcountry with an outbreak adds an extra challenging element. There are things you can do to set yourself up for success beforehand, and things you can do to help comfort you while having active sores. If you have access to medication, bring it. That way you can help mitigate an outbreak if you feel one on the way. Additionally, it can be helpful to get rid of sores that have managed to pop up.

If you find yourself with an oral sore, make sure to change out your water bottles frequently. Don’t hoard your old Smartwater bottles. If you use a lip balm or chapstick to help soothe or keep your sore from cracking, it then becomes infected and needs to be changed out when your sores go away. Continuing to use things after an outbreak can reinfect you, so make sure to wash your hands as much as possible when interacting with a sore. If you have an active outbreak on your genitals, carry wipes and try to keep the area clean. Try to wear clean underwear if you can; do some ziplock laundry if you’re far from town.

Why should I care if it doesn’t affect me?

Have you ever had a really hard day where all you want is a nonjudgmental listening ear? Everybody deserves a space to feel heard and not made to feel gross for their body or things pertaining to their health. If we can have regular conversations about pooping in the woods while eating a ramen bomb (ramen mixed with instant mash potatoes, an infamous trail dish), then we should be able to normalize talking about cold sores or sores on our bits.

We should be talking more about STIs, even on trail (everybody knows sex happens, we can’t deny the trail-ationships). Know your status, avoid using language like “clean” or “dirty,” get tested regularly (OK, maybe on trail might not be the most accessible for this, but off-trail!), and use protection.

If you find yourself joking about herpes, insinuating that people with herpes are dirty, or furthering this idea that it’s such a scary thing to have, maybe think about how that can affect those around you. Will your joke or statement potentially cause more harm or will it uplift those around you? Are you actively working towards breaking the stigma or are you perpetuating it? Language is everything. 

Works Cited:

“Herpes Simplex Virus.” World Health Organization, World Health Organization, https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus.

Planned Parenthood. “Std Awareness: Asymptomatic Shedding of Herpes.” Planned Parenthood Advocates of Arizona, https://www.plannedparenthoodaction.org/planned-parenthood-advocates-arizona/blog/std-awareness-asymptomatic-shedding-of-herpes.

“STD Facts – Genital Herpes (Detailed Version).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 22 July 2021, https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm.