[Question #10827] STI Concern
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19 months ago
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dec 14 had protected sex with csw. lasted about 5 minutes. no symptoms until about dec 25 noticed very small white spots on my shaft about 2 or 3 them. looked like dried scabs not blisters. on the lower part of the shaft, not sure if condom covered this part. they didn't have a red base & couldn't feel a bump & were NOT itchy, painful or tender. dec 30 noticed the scab had turned red & looked shiny under light. went to urgent care that day & doc said it looked like a scab. did blood test for stds. test was negative for everything including hsv1 & hsv2. redness of the spot decreased over 24 hours then it has just stayed a little pink. is hard to see when erect. when flaccid it looks different color of skin then the surrounding. showed PCP on Jan 2 & he thought maybe hpv & said herpes is painful. did a swab test for it. waiting for result. spot has been healing but still there. One of them might be on top of hair follicle. scared because spot has lasted so long. Do you think this is atypical/ mild hsv2 outbreak? if swab is negative should i get another blood test done at 12 wks?
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Terri Warren, RN, Nurse Practitioner
19 months ago
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I think a swab test done over one week after symptoms started may not be fully accurate - difficult to say. Herpes isn't always painful but often at least tender.
Condoms reduce transmission from women to men by 65%, so it may be really helpful but not 100% protective.
Your symptoms don't really sound like herpes to me, quite honestly. But whenever people have dried scabs on the shaft of the penis, I get a little worried. Do you know what kind of blood test you had for herpes, IgG, IgM? That's an important question that I hope you will answer for me.
Do you have any history of cold sores on your lip or in your nose?
Terri Warren
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19 months ago
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got swab test result back today but it says "test not performed. no serum gel received". So it basically says nothing for both hsv1 and hsv2. Think my doctor ordered wrong test since it says Hsv IGG for the swab test too. the blood test i had on dec 30 was IGG test and was negative. Never had a cold sore before. I had Western blot done in 2017 and was negative for both hsv 1 and 2. My pcp recommended me to a dermatologist last week but there is nothing really left to swab since it's healing. I want to add context. I have had protected sex with 7-8 csw's in the last 3-4 years. Never received unprotected oral from a csw. I also received protected oral on Dec 22, few days before I saw the scabs. Not sure if something from that day caused the scabs/spots. What do you suggest I do? What do you think the spots on my shaft were? Any ideas? its about to be 4 weeks since the exposure, if i test negative at 6 weeks on igg how reliable is that? I have seen you say 70% of people have antibodies by 6 weeks, is that still accurate? Would you recommend further testing for me at 6 weeks or 12 weeks? If negative at 6 weeks do you think I can move on and believe I am negative given the atypical/mild symptoms and negative tests? or should i wait for 12 wks? please advise. thanks
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Terri Warren, RN, Nurse Practitioner
19 months ago
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I'm sorry, I don't know what they were. If you are negative at 6 weeks out, you are correct; 70% of people who will be positive for HSV 2 will be positive by then. However, since the concern is HSV 1, the IgG test misses 30% of true HSV 1 infections, so we don't have a statistic for a 6-week period. I think since the contact was protected, infection is unlikely. If you can't relax about this, you can repeat the blot as an option.
Terri
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19 months ago
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Honestly my main concern is HSV2. If I see a negative on the IGG blood test that will reassure me enough. I have just never seen anything like this on my genital area which is why it's worrying me. I'm worried if I saw the white spots/scabs and didn't recognize them to be blisters but think I would recognize blisters if I saw them. Some symptoms match hsv while others don't. Main thing was that there was absolutely 0 sensation on the spot and there wasn't a bump and that's why it didn't concern me when I first noticed it. But the spot is still there now almost 18 days after I first noticed it. It's fading away and almost gone but still.
1. Given the mild symptoms do you think I should be concerned about hsv1 instead of hsv2?
2. Given the symptoms do you think I should be tested at all or should I just move on?
3. the psychological impact of a positive result on blood test will be more impactful than the physical impact for me. Do you think it's still worth testing. Kind of scared of testing positive.
4. Based on everything if i test negative at 6 weeks do you think i can move on or should i wait till 12 weeks?
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Terri Warren, RN, Nurse Practitioner
19 months ago
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I think if there was no discomfort or sensation from the spots, then herpes is less likely.
1. Given the mild symptoms do you think I should be concerned about hsv1 instead of hsv2?
HSV 1 and HSV 2 have the same symptoms - HSV 1 genitally just recurs less often
2. Given the symptoms do you think I should be tested at all or should I just move on?
Move on if you can, y es
3.
the psychological impact of a positive result on blood test will be
more impactful than the physical impact for me. Do you think it's still
worth testing. Kind of scared of testing positive.
I think your fear is reasonable, given the high rate of false positives.
4. Based on everything if i test negative at 6 weeks do you think i can move on or should i wait till 12 weeks?
I think you can move on now because the contact was condom protected.
Terri