This is a follow up to question #13050 now focusing more on herpes, and possibly HIV RNA test (for peace of mind). Summary of my exposure is protected intercourse with 2 female CSW at 2 different locations on the same night.  I forgot to add that I also kissed the provider (a one time kiss) and again nothing present outside the mouth. Today is day 5 post exposure and per Dr HHH recommendation I opted to test for both Chlamydia/Gon for conclusive pending results. 

I have read a couple of threads responded by Dr. Terri and have came to the conclusion that an initial outbreak typically happens 2-10 days after exposure and on average (5.5 days). I just want to ask the following questions. 

1. Per my risk and the incubation period of 2-10 days can I safely assume that an outbreak wont happen beyond the 10 days? I understand the virus can remain dormant but I am more interested in this and anxious to understand this time period. 

2. Can someone with HSV1 also have HSV2? Can outbreaks both happen oral and in the genitals? Would they occur at the same time? 

3. After the incubation period of 2-10 days, are there any tests I can do to confirm conclusively that I was not infected by Herpes. 

4. If I were to have initial symptoms of Herpes, what would I feel. 

5. Lastly, I am planning to do a HIV RNA test, which states that it is conclusive results 9-11 days after exposure. What are your thoughts on this test and can I consider the findings conclusive. 

1.  If people are going to get symptoms with a first episode of herpes, then yes, symptoms normally show up within 2-10 days, with 5.5 days being the average.  However, not everyone gets an outbreak when they are infected.  We know that because 86% of people with HSV 2 don't know they have it, so not everyone can have had a major outbreak with a new infection.  This is particularly true for people who have HSV 1 already.

2.  Yes, someone with HSV 1 can get HSV 2 and yes, outbreaks can happen at the same time or different times.

3.  There are antibody tests for herpes but they often have false positives, although the new Roche test done at LabCorp is better about that.  The best test is the herpes western blot done only at the Univ of Washington.  However, anyone can have their blood sent there for testing through their clinician.

4.  Herpes symptoms would typically be sores in the genital area

5.  I'm not up to date on HIV testing, but I will let the other experts to respond to that question for you.

Terri

1. Per my previous STD panel I can safely assume that I don’t have both HSV1 and HSV2 before my exposure. I have done IGG blood work at good time windows that came out negative for both.  if this is the case and me not having any symptoms like sores in the genital area or flu like symptoms by day 10 can I assume that the likelihood of me getting infected per my exposure is virtually zero beyond the 10 days? 

2. What is the time window for the western blot test and the roche herpes test? Do you know, as I am very anxious I would like to be tested right away. Also what is the process to order the western blot test? 

3. What is your professional opinion of the likelihood that I acquired an infection given my exposure, it being day 6. Dr. HHH has mentioned that he believes my odds are near zero. I also read that with a condom there is 65% protection of acquiring herpes from female to male. Is this percentage assuming that the female is in there most contagious? 

2.  You should wait 8-10 weeks for the Roche test and 12 for the western blot, from the date of the encounter, to test

3.  I agree with Dr. HHH

Terri

I understand you have a 48 hour time window to respond but a quick response would be greatly appreciative. 

Terri