[Question #11949] HSV-1 and HSV-2 transmission risk - worth getting tested?
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11 months ago
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Hi Doctors,
I saw two CSWs this month — a month ago and 10 days ago. Full body naked massage, mutual touching. There probably was contact between my penis and their vaginas/anus, but I was not deliberately rubbing genitalia. Engaged in humping and I probably touched their genitalia that way too. Finished by rubbing penis on their buttocks for five minutes and ejaculating on lower back. Have been asymptomatic since.
1. Does such an event warrant an IgG test or Western Blot in 12-16 weeks, or is the risk so low that you would not recommend getting tested because of false positives?
2. Would it be unethical not to get tested and engage in sex with future partners? My biggest fear is that I meet a girl I like in medical school, we start dating and engage in unprotected sex, and I accidentally give her HSV-1 or HSV-2 because I am asymptomatic. It is severely affecting my work and mental health, and I have become incredibly anxious because of it.
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Terri Warren, RN, Nurse Practitioner
11 months ago
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While your experience is not risk free, it is definitely low risk. As you may know the false positives for the HSV 2 IgG is a real and troubling risk. I don't recommend that you test if your only risk is this experience UNLESS you are prepared to do a confirmatory test like the herpes western blot if the IgG is positive.
Reading over your second question now, it appears that this is bothering you enough to test, and in that case, you could do the IgG and if negative, proceed with the western blot. How do you feel about that? At 3 weeks past exposure, about 50% of those who are going to be positive will be positive, and at 6 weeks, 70%. Yes, you would need to wait 12 weeks to do the blot
Terri
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11 months ago
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Hi Terri,
Thanks for the reply.
I know this is difficult to do, but how much of an actual risk am I at? If you could give me a rough percentage or estimate, that would be great. I understand this is probably difficult because it depends on a lot of variables but it would put my mind at ease.
What time would you recommend I get tested — 3 weeks or 6 weeks? And for both HSV-1 and HSV-2? My only other sexual exposure was protected vaginal sex with a girl I met on a dating app during this month.
If I test negative for HSV-1 and/or HSV-2, do you mean that you still want me to proceed with the Western Blot? I thought that was only used to confirm or disprove false positives, not if you test negative on the IgG.
Once again thank you for your knowledge and look forward to hearing your response.
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Terri Warren, RN, Nurse Practitioner
11 months ago
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I would guess that there is less than a 5% chance that you acquired HSV at this encounter. you could test as early as three weeks, but it surely won't be definitive at that point. If you test at 6 weeks, the result is about 70% accurate with IgG. 12 weeks with the western blot. You don't need to do the blot if your IgG results are negative, but the IgG test does miss 5-8% of HSV 2 infections compared to the western blot.
Terri
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