Genital Herpes in South Africa: HSV-1 vs HSV-2, Testing & Management | Epicentre
🧬 Herpes Simplex Virus · HSV-1 & HSV-2

Genital Herpes: Lifelong, Common, and More Manageable Than You Think

3.7 billion people carry HSV-1. 491 million carry HSV-2. Herpes is not curable, but with treatment from your doctor, most people live with infrequent or no outbreaks. The stigma is far worse than the condition itself.

♾ Lifelong but manageable 🧬 PCR swab or blood test 🏥 No referral needed 🤫 Many people never know they carry it
3.7B
people carry HSV-1
worldwide (WHO)
🩺
Medically Reviewed
Dr. Samantha Naidoo
MB ChB, FCP (SA) · Medical Director, Epicentre Laboratories
Published: 2 August 2025 · Last reviewed: 1 March 2026
Key facts

How common is herpes in South Africa?

3.7B
people carry HSV-1 globally
WHO, 2021
491M
people carry HSV-2 globally
WHO, 2021
43.6%
of SA genital ulcers are HSV-2
NICD Surveillance
2-3×
higher HIV risk with active herpes
WHO, 2022
Lifelong, but very manageable
Treatment controls outbreaks
5,100+
herpes tests processed at Epicentre in 2025
Across JHB, CPT & DBN labs

Know the difference

What is the difference between HSV-1 and HSV-2?

Most people think of herpes as one thing. In reality, there are two distinct viruses with different behaviours. Knowing which type you carry changes the conversation with your doctor and your partners.

HSV-1HSV-2
Common nameOral herpes / cold soresGenital herpes
Primary locationMouth and lipsGenitals, buttocks, thighs
Can it infect genitals?Yes. Increasingly common through oral sexYes. Primary genital pathogen
How common?3.7 billion people (67% of under-50s)491 million people (13% of 15-49 year olds)
Recurrence rateLow when genital. 1-2 outbreaks/yearHigher. 4-5 outbreaks/year initially
Asymptomatic sheddingLess frequentMore frequent (up to 10% of days)
How to testPCR swab (active) or blood IgGPCR swab (active) or blood IgG
Why type matters: Genital HSV-1 (from oral sex) recurs far less often than genital HSV-2. Knowing your type helps your doctor plan management and helps you communicate accurately with partners. Epicentre's PCR test distinguishes HSV-1 from HSV-2.

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Symptoms

What are the symptoms of genital herpes?

Many people with herpes never develop noticeable symptoms, or have symptoms so mild they go unrecognised. Outbreaks vary widely between individuals.

The first outbreak is usually the most severe and occurs 2-12 days after exposure. It may include:
🔴Clusters of small, painful blisters on genitals, buttocks, or thighs
🔥Blisters break open into shallow, painful ulcers
😖Pain or burning when urinating (if ulcers near urethra)
🤒Flu-like symptoms: fever, body aches, swollen lymph nodes
Tingling, itching, or burning before sores appear (prodrome)
Recurrent outbreaks are typically shorter and milder than the first. Over time, they become less frequent for most people.
Tingling or itching 1-2 days before sores appear (warning sign)
🔴Fewer sores, healing faster (typically 3-7 days)
📉HSV-2: average 4-5 outbreaks in the first year, decreasing over time
📉Genital HSV-1: typically 1-2 outbreaks in the first year, often none after
Many people with herpes never know they carry it. Symptoms can be so mild they are mistaken for razor burn, ingrown hairs, or friction. Some people never have a single noticeable outbreak.
🤫Asymptomatic shedding: virus present on skin with no visible sores
⚠️You can transmit herpes during asymptomatic shedding
🔬Only a blood test can confirm infection when no sores are present
"
"The biggest challenge with herpes is not the virus. It's the stigma. Most of my patients are relieved to learn how manageable it is. A huge proportion of the population carries HSV-1 without even knowing it. Knowing your type through a PCR test changes the conversation completely."
Dr. Samantha Naidoo, MB ChB, FCP (SA), Medical Director, Epicentre

Complications

What happens if herpes is left unmanaged?

Herpes itself is rarely dangerous for healthy adults. But unmanaged herpes has real consequences, especially for HIV risk and pregnancy.

1
First outbreak: most severe
Painful sores, flu-like symptoms, difficulty urinating. Lasts 2-4 weeks without treatment. Treatment from your doctor shortens this significantly.
2
Recurrent outbreaks
Shorter and milder over time. Triggered by stress, illness, or immune suppression. Many people have no recurrences after the first year.
3
HIV risk: 2-3× higher
Active herpes sores create breaks in the skin that make it significantly easier to contract or transmit HIV. Managing herpes is also an HIV prevention strategy.
4
Neonatal herpes
A mother with active genital herpes during delivery can transmit the virus to the baby. Neonatal herpes can be severe. Inform your healthcare provider if you have herpes and are pregnant.
5
Rare complications
Herpes keratitis (eye infection, can cause blindness), meningitis, and encephalitis are rare but serious. HSV-1 has also been linked to increased Alzheimer's risk in research.
Management changes everything. With treatment from your doctor, outbreaks are shorter, less frequent, and transmission risk is reduced. Knowing your status and your type is the first step.

Get tested

How is herpes tested at Epicentre?

Herpes requires different tests depending on whether you have active sores. Epicentre offers both methods and can distinguish HSV-1 from HSV-2.

Active sores present? PCR swab of the sore. Most accurate during an outbreak. Identifies HSV-1 vs HSV-2. Results in 5-7 days.
No sores, just want to know? Blood IgG antibody test. Detects past infection. Needs 2-12 weeks after exposure to be accurate. Ideal window: 3+ months.

Herpes HSV-1 & HSV-2 Typing

R538🎓 R484

Standalone herpes test. Lesion swab (active) or blood IgG (past). Distinguishes type 1 from type 2.

4× R135/mo with Payflex

Medium PCR (9 pathogens) ⭐

R1,508🎓 R1,357

HSV-1 + HSV-2 included alongside chlamydia, gonorrhoea, mycoplasma, ureaplasma, trichomoniasis, E. coli.

4× R377/mo with Payflex

Express STI (blood panel)

R1,076🎓 R968

Herpes IgM (blood) + HIV, syphilis, chlamydia Ab, hepatitis B. Fastest results: 24hr urgent available.

4× R269/mo with Payflex

Herpes (HSV-1 and HSV-2) is included in all Epicentre PCR sexual health packages from R1,235. View all packages →


FAQ

Herpes: Your Questions Answered

Can you have herpes without symptoms?

Yes. Many people carry herpes for years without a noticeable outbreak. Asymptomatic shedding means you can transmit the virus even without visible sores. A blood test can confirm infection when no sores are present.

Is herpes curable?

No, but it is very manageable. Treatment from your doctor controls outbreaks and reduces transmission risk. Most people find outbreaks become less frequent and milder over time.

Can I get genital herpes from oral sex?

Yes. HSV-1 (cold sores) can be transmitted to the genitals through oral sex. This is an increasingly common cause of genital herpes, especially in young adults.

Does herpes increase HIV risk?

Yes, 2-3 times higher. Active herpes sores create entry points for HIV. Managing herpes reduces this risk. Testing for herpes is also an HIV prevention strategy.

When should I test: swab or blood?

Active sores: PCR swab (most accurate during an outbreak). No sores: Blood IgG test (detects past infection, needs 3+ months after exposure). Epicentre offers both.

Can I still have a normal sex life with herpes?

Absolutely. Most people with herpes have fulfilling relationships and sex lives. Treatment from your doctor, condoms, and honest communication with partners are the key tools. Herpes is incredibly common and far more manageable than the stigma suggests.

How much does herpes testing cost?

Standalone herpes typing: R538. Express STI (blood, includes herpes IgM): R1,076. Medium PCR (includes HSV-1 + HSV-2): R1,508. Students 10% off. Payflex 4× interest-free. View all packages →


STI guide

Other infections in this guide

Know Your Type. Know Your Status.

Herpes is far more common and more manageable than the stigma suggests. A simple test gives you clarity.

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