[Question #13154] Genital Herpes Testing Accuracy
2 months ago
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Hi,
I live in Melb, Aus. My last exposure was approximately 5 months ago with a woman who is a sex worker (legal brothel). I have had 3 other encounters before this 6, 7 and 8 months ago with different sex workers. Each encounter I have used condoms. Sex has always been oral on me and vaginal intercourse. Around 2 months ago, I noticed a single small lesion or ulcer (1mm) under the tip of my penis head. When my penis is limp, it just appears red, however when I take a closer look at it by stretching the skin, it looks round and ulcer like (when stretched 2mm). It disappeared completely after about 4-5 days I noticed it. I haven't had any other lesions or ulcers since (2months have passed). There was no pain, when I touched it or stretched it or any other symptoms i.e. sickness. Only thing I felt was maybe a tingling sensation. I asked a doctor to look at it after the 5th day, doctor didn't do anything as he wasn't able to see a clear ulcer or lesion. I have done full STD check for HIV, Syphillis, Gonorrhea, Chlamydia and Hepatitis at 6, 9, 12 and 15 weeks post exposure and all negative, however no test for genital herpes. Due to ongoing anxiety I asked doctor for IgG blood test for genital herpes. Doctor ordered both IgG and IgM blood test and all came back negative at 16 weeks post exposure. I am wondering what next steps are? I am worried I have genital herpes and stressed that test is incorrect/unreliable. I don't have access to WB test. What if I can't do swab test if no ulcer or lesions ever appear. Also, I am worried as I have a wife and 3 kids. I also had sex with my wife after the ulcer disappeared.
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Terri Warren, RN, Nurse Practitioner
1 months ago
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It just isn't possible to know what they was without a swab test. Did you use a condom for receiving oral sex?
It's very good that your IgG test was negative, but it does miss about 30% of HSV 1 infections compared to the gold standard western blot
Have you ever in your life had a cold sore on your lip or in your nose? If yes, then you already have HSV 1 infection, as does about half the US population.
It is also good that the lesion itself was not tender or painful.
If you get it again, but sure to have it swab tested right away, but for now, I don't know what else you can do about this for greater clarity.
I'm sorry, I know this must be worriesome for you.
Terri
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1 months ago
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Yes, I always use condom with oral sex and condom with vaginal with sex workers. I’ve also never had a cold sore in my life.
1 months ago
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More worried about HSV-2.
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Terri Warren, RN, Nurse Practitioner
1 months ago
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Condoms reduce transmission of HSV 2 from women to men by 65% so good, but not perfect. But the IgG test is far better for HSV 2 than HSV 1, missing only about 8% of infections.
Terri
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