[Question #1144] Should I be worried?

48 months ago
I am a returning customer and want to briefly go over my situation. Almost 2 months ago, I was sexually assaulted. About 5 & a half weeks later I was tested, and everything came out negative. Hsv 2 was negative with a value less than .2. During the assault, a condom was used. But now i am experiencing symptoms, and I don't know If i'm just overthinking things now. I was also told to provide my test results after I got them. 

All day, its been burning while I pee and my vagina is a little sore. I'm getting off of my period, so today was the last day i put in a tampon. I did not get any symptoms after the assault, but now i'm worried. I even looked at my vagina today with a mirror, and saw nothing. 

Questions:
1. Since I tested negative for hsv 2 at 5 & a half weeks, can I be some what confident that the genital symptoms I am experiencing is not due to herpes? I know 3 months is conclusive, but I want to know how confident I can be in my test results.

2. Should I be worried that I contracted hsv 2?
Edward W. Hook M.D.
Edward W. Hook M.D.
48 months ago
Thanks for your question.  I will be happy to comment. Your symptoms are not suggestive of genital herpes.  Let me provide more of an explanation.

The test you has for herpes immediately after your assault was a test for HSV antibodies and the value you report indicates that you did not have herpes at the time of the assault.  Because it can take weeks or even months for antibodies to develop, it did not give you information about whether you were infected at the time of the assault.  Despite that, the evidence now is that your current symptoms are not due to herpes.  Most people who acquire herpes develop readily noticed lesions within a week or, at the outside, two after contact.  The fact that despite your symptoms (which are not suggestive of herpes) have occurred so far out make them likely to be unrelated to the assault that you suffered.  Further, I would add that as your assailant used a condom makes it unlikely that you would acquire herpes from the assault.  

At this time, based on what you have told me, I would not suggest further herpes tests.  Without symptoms your risk of a falsely positive antibody test is just as likely as discovering that you acquired herpes.

I hope these comments are helpful to you at this difficult time.  EWH
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48 months ago
Oh no, while your reply does not put me at ease, I really appreciate the information you have provided me and your condolences. 

I read somewhere that at 5 weeks, an hsv antibody test is 60% or so accurate, which sort of quieted my worries. Yes, my attacker did use a condom but I am still worried. For 2 weeks after the assault, I was constantly being checked by my gyno for herpes symptoms and she did not discover any for the entire two weeks. I recently just got a wax because I felt pretty confident that I did not have genital herpes. Now, I am completely worried that I may get ingrown hairs or bumps from the wax and confuse them for genital herpes. Is there any other information you could provide me to potentially put my worries at ease?

Questions:
1. How accurate is my 5 and a half week negative hsv test?
2. Should I be worried that I contracted genital herpes?
3. Should i be worried about getting genital herpes symptoms 2 months out?
4. How likely is it that i did not contract genital herpes from this incident, given that I have not had any genital symptoms yet?
Edward W. Hook M.D.
Edward W. Hook M.D.
48 months ago

I understand that there is nothing I can say which will help how you feel.  I hope however that my information can help you get by this excessive worry about herpes.  I have provided responses to your questions below.  By way of context however, please remember that most people do not have genital herpes, that most unprotected exposures to a person with active herpes lesions do not lead to infection, that condoms reduce the risk for getting herpes if your partner had infection by 35-50%, and that most people who acquire herpes develop outbreaks within 10-14 days after exposure.  Putting all of this together, your continuing fears is far out of proportion to the likelihood that you were infected.  As for your specific questions:

1. How accurate is my 5 and a half week negative hsv test?
We do not recommend blood tests to evaluate for acquisition of herpes.  Even with a prior negative test, in most situations, a falsely positive test is a more likely outcome than diagnosis of otherwise inapparent infection.  That said, at 6 weeks about 60-75% of persons who acquire HSV would have a positive IgG blood test.  IgM tests are so unreliable that they are never recommended.

2. Should I be worried that I contracted genital herpes?
For all of the reasons mentioned above, plus your negative blood tests, there is almost no chance that you acquired HSV at the time of your assault.

3. Should i be worried about getting genital herpes symptoms 2 months out?
I would not be worried and would urge you to ease off of your search for sighns of infection.

4. How likely is it that i did not contract genital herpes from this incident, given that I have not had any genital symptoms yet?
Please see my comments before,

I hope this information is helpful to you.  EWH
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