[Question #10128] HSV and Safer Sex

25 months ago

38F, I always worried I got anal HSV1 10 yrs ago. The shame SERIOUSLY impacted my mental health. HX: may have had cold sores growing up, mom says I did

> 10 yrs ago , I engaged in unprotected anal sex/analingus with a partner of unknown status

> 1 week following: sores on anus, swollen nodes, etc

> few months later test with (stdcheck.com) IgG pos HSV1 38.9 index value ; HSV2 at <0.91

>mild recurrences since

Many partners since, regular testing (HIV, G/C, RPR only) always neg

Now I want to have the safest info:

1)Likelihood of contracting HSV2 if already have HSV1?

2) Despite multiple partners, I have only had same sxs -- I am conflicted now to test for HSV2 and open up a can of worms . Does this seem necessary?

3) Risk I will transmit ano/gen HSV1 to a male partner with vaginal/anal/oral sex?

4) Is stdcheck.com a reputable site?

25 months ago

Also thank you so SO much for all that you do. I had issues posting a fuller explanation with all my questions because of the text limit. I just want to start a new chapter of my life with the most safety and mental health and honesty as I reasonably can but I don't want to shoot myself in the foot by overthinking this. I am well aware most people are unaware of their HSV status and I would just like to move on with my life and let go of this pain/shame but be responsible. I probably test way more than I need to. I just have held shame and mental conflict regarding HSV in particular for so long and I thought I'd finally speak to the gurus on it :) Thank you again

Terri Warren, RN, Nurse Practitioner

25 months ago

1)Likelihood of contracting HSV2 if already have HSV1?

Someone can certainly contract HSV 2 after having HSV 1 - the opposite is not true. HSV 2 appears to protect against thd acquistion of HSV 1.

2) Despite multiple partners, I have only had same sxs -- I am conflicted now to test for HSV2 and open up a can of worms . Does this seem necessary?

It does not seem necessary - there are many false positives on this test and I would not recommend testing as a method of screening.

3) Risk I will transmit ano/gen HSV1 to a male partner with vaginal/anal/oral sex?

If you did indeed have cold sores growing up, having vaginal/anal sex is not a risk - giving oral sex to someone else does present some risk

4) Is stdcheck.com a reputable site?

In what respect?

Terri

---

25 months ago

Site is having issues, trying to post short as possible & clarify and I'm checking I'm below limit but may need to split post, my apologies!

Hx: I didn't recall having cold sores, & clarified w/ my mom & she wasn't sure. Given presentation & testing, I presumed GHSV1. I had similar sxs in ONLY anal area w/ small sores a few times in 10 yrs, nothing new beyond that. Since then, my partners weren't concerned about HSV ; & I am routinely tested for [HIV, G/C/ RPR]. I saw a pt w/ concurrent (HSV1/2) infections & became anxious bc I hadn't tested for HSV2 since that result. I know 1 of 5 ppl have HSV2 & most are unaware & routine screening is not protocol bc it's not clear if benefits outweigh mental health costs. I want to act ethically & at the same time know the psychological cost of finding a positive result for me would be CONSIDERABLE (over something that may be nothing or a future partner may not care about)

25 months ago

1) Is it possible my initial testing was incorrect & instead of HSV1, I was actually positive for HSV2? ( Is 'stdcheck.com' for testing a trustworthy source?)

2) Reading your handbook: (A) 30% of HSV1 & 8% of HSV2 tests are false neg; & 50% of pos results <3.5 index are false pos

(B) Never seen G to GHSV transmission (C) I've likely since been exposed via past partners unaware of their status. I realize HSV2 is not a serious condition & it's stigmatized, but I want to be responsible if there is a need for testing in my case.

To clarify, based on the above hx & absence of new sxs you do NOT recommend I screen for HSV2?

Words cannot express how much being able to ask someone in an empathetic space means & I want to thank you from the bottom of my heart!

25 months ago

#3 Thoughts on the fact that my recurrences have ONLY been in the anal region [never and painful urination, vaginal sores, etc]. Should I check to see if that could possibly be something else?

I personally think I will be completely honest (about HSV not being routinely screened )with any future partners and educate them as well and it may well be a beautiful litmus test on whether our communication is healthy. As I am trying to be as responsible/safe as possible I generally will have a talk and ask that anyone I'm with also test (HIV/G/C/RPR) before being intimate. I hope this isn't overcautious, but this safety allows me to actually enjoy intimacy. Any other data or information you may have that may reduce my anxiety is very welcome! (Happy to pay for another question but this box has been frustratingly limited!) Thank you again sry for all the posts

Terri Warren, RN, Nurse Practitioner

25 months ago

The thing about testing for HSV 2 antibody is that there are so many false positives. The herpes western blot does not give false positive results and would be an option for you if you continue to be concerned about this. I don't think there is anything else that you should be checking for that may have caused those sores, no. It does sound like those could be herpes, given the timing and sexual experience the week before.

Maybe you can just decide that these sores were indeed HSV 1 and move on from there. Or you could decide to do a herpes western blot to be certain you don't or do have HSV 2 if this worry still bothers you. The blo is done only at the University of Washington, but any clinician can order that test and kit for you or I can help you with it at westoverheights.com.

Terri

---