Genital herpes is more common than people like to think: there’s no reporting system in Canada for herpes, but a U.S. survey estimates that one in six people has the virus, with eight out of every 10 infected people unaware of their condition.

And of the estimated 20 per cent of adult Americans who have Herpes Simplex Virus-2 (the herpes strain that causes genital herpes, as opposed to HSV-1, the strain that causes cold sores on the mouth), about 90 per cent don’t even know they have it. (Again, widespread statistics for Canada aren’t available, but at least one Alberta study produced similar stats.) This is partly because between 60 and 90 per cent of those with herpes don’t show symptoms, don’t recognize the symptoms, or were told they had something else.

While most of us have been taught to look for blister-like lesions as a sign of herpes, additional symptoms are often mistaken for other conditions. Like urinary tract infections. Or a latex allergy, razor burn, or jock itch.

So a woman who thinks she has a yeast infection will treat it and the symptoms will go away, reinforcing that that was the problem. But if it’s actually a herpes symptom, it often heals on its own after a few days anyway, so she wouldn’t know the difference.

And, as if that weren’t complicated enough, even if symptoms do show up and are identifiable as herpes, have fun figuring out if it’s Type 1 or 2 because Type 1 can show up genitally while Type 2 can break out orally.

But if your primary outbreak is severe and obvious (for example, if it hurts like hell, looks like a bomb went off on your face or genitals, or if you have a high fever and you’re puking your guts up), chances are you’ve got the corresponding strain. If the first outbreak is less severe, it may be that it’s genital herpes showing up for the first time on your face or vice versa. And then it usually only happens once at this sight. Subsequent outbreaks tend to stick to their designated region. They don’t know why this is. It’s just one of the many, maddeningly complex things about the ironically named Herpes Simplex Virus.

Like the fact that 70 per cent of all transmission happens with no visible symptoms. Meaning you can have it, not know it, and pass it along without being any wiser. Genital herpes is spread through skin-to-skin contact with an infected area, typically during oral, anal, or vaginal sex. And while condoms or dental dams can eliminate some skin-to-skin contact, lesions can appear outside these covered areas. And, added bonus: it can also be transmitted when no outbreak is present. So unless you’re wearing a latex bodysuit, it’s impossible to avoid all skin-to-skin contact with someone carrying the virus.

There is no cure for genital herpes and often people will have recurring outbreaks. The number of outbreaks and the amount of time between outbreaks varies from person to person. New anti-viral drugs can help reduce outbreaks and it is estimated that the combination of condom use and drug therapy can reduce transmission rates by 75 per cent.

Also, testing for herpes is improving. Traditional herpes culture tests — which involve swabbing an active lesion — require, well, an obvious lesion to swab. New blood antibody tests are more effective, but most doctors don’t offer them, they aren’t easily available, and the $150 cost isn’t usually covered by medical insurance.

Before you all run out in a panic and start shelling out money to get tested, you may wish to be tested if: (1) you have symptoms but haven’t been able to get a diagnosis through a culture test; (2) you’ve been in contact with other sexually transmitted infections or have HIV or (3) your partner has genital herpes and you’re wondering if you may already have it. This is particularly important if a woman is pregnant and her partner has herpes, as acquiring herpes for the first time during pregnancy can cause things like blindness and mental illness in the baby.

Herpes symptoms typically appear within two to 20 days of infection. Itchiness of the genitals and a slight tingling or burning may be a sign that an active outbreak is coming. Outbreaks usually show up in the form of small blisters in the vagina or on the vulva or cervix; on or around the penis or testicles; on or around the anus; or on the thighs or bum. These blisters eventually burst (usually the most painful stage), then dry up and scab over.

Oh, and despite rumours, the herpes virus can’t survive outside the body and therefore can’t be spread through shared toilet seats, swimming pools, hot tubs, or bathtubs.

And before you think your partner’s a big cheater because you suddenly got herpes after 10 years together, remember that the virus can remain dormant in a person’s system and show up after 10, 15, or even 25 years with the same partner.

Herpes: yep, it’s the STI that keeps on giving.