Although it may be difficult for some people to believe -- particularly those people who have extremely painful herpes symptoms -- it is quite possible for a person to have genital herpes and not know it.
There are two ways that someone can have genital herpes without realizing they're infected.
- They could have an asymptomatic infection -- meaning, an infection with no symptoms. Doctors believe that the vast majority of genital herpes infections never cause patients to have noticeable symptoms.
- They may not recognize that the symptoms they're having are herpes symptoms.
In recent years, several studies have been published which suggest that unrecognized genital herpes symptoms may be a significant problem. One found that as many as half of the people who have herpes without knowing it may actually be aware of their symptoms, but not know that they are related to an STD infection.
This, to me, seems like an education problem, which is very different from the problem of dealing with actually asymptomatic genital herpes infections. People with truly asymptomatic genital herpes have infections that are only detectable by a blood test -- or when they infect a sexual partner who develops symptoms. That's a problem that no amount of education can solve.
However, while a person's awareness of their body is important, it's extremely difficult for someone to diagnose their own sexual health problems. For that reason, and many others, it's a good idea to talk to your doctor about STD screening if you have recurrent genital pain or any other symptoms that might be related to an STD. Not only can testing help you make sure that nothing's wrong, but if something IS wrong, then your doctor may be able to help you do something about it.
Although not every person in the field agrees with me, the combination of asymptomatic and unrecognized herpes infections is one of the reasons why I generally recommend regular herpes testing for people with multiple partners or for people who are about to become intimate with a new sexual partner. It is far better to start a relationship with any risk information that you need than to not discover an infection until you're two years in -- something that can lead to unjustified accusations of infidelity and a prolonged lack of trust.
Note: It is not possible for someone to diagnose your STD over the Internet. Diagnosing an STD requires testing and/or a visit to a trained medical professional.
Löwhagen GB, Berntsson M, Bonde E, Tunbäck P, Krantz I. Acceptance and outcome of herpes simplex virus type 2 antibody testing in patients attending an STD clinic--recognized and unrecognized infections. Acta Derm Venereol. 2005;85(3):248-52.
Sizemore JM Jr, Lakeman F, Whitley R, Hughes A, Hook EW 3rd. The spectrum of genital herpes simplex virus infection in men attending a sexually transmitted disease clinic. J Infect Dis. 2006 Apr 1;193(7):905-11. Epub 2006 Feb 27.