For the past 5 months I have had several encounters with high end escorts with the most recent one about 3 weeks ago.  Encounters involved oral sex as well as sex with condoms (one condom came off - about 4 months ago).

Please ignore the IgM test - it is unreliable and has many false positive (or false equivocals).  So if the condom came off with an encounter 4 months, the "input" from that encounter should be reflected in the IgG test that you had this week - we recommend 12 weeks prior to HSV testing, from any risky encounter, so I don't think you were infected then, at least with HSV 2.  The HSV 1 test is no where near as sensitive.  The thing is, neither of you have had lesions or sores, and if you had new herpes, either of you, I would expect sores in one or the other or both of you  There are many reasons a person might have a headache or mild flu symptoms or even an itchy vagina.  Herpes, with no sores, would not be anywhere near the top of my list.  I know you are anxious but I think with your negative testing and no sores, herpes seems an unlikely cause of her symptoms to me.

Terri
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Thanks.   With regard my more recent exposures (last 1 was 3 weeks ago) which involved oral (no condom) and vaginal (condom) can you tell me what the risk is for these?  

I'm a little confused about what you are saying about the CDC and reputable articles?  Are they saying that transmission in spite of condoms is a risk?  It is, I have most certainly seen people who have new herpes (documented by positive swab, negative serology) who were using condoms and acquired herpes at the base of the penis.  And we know that the surge in people with HSV 1 genitally is largely due to people who have no HSV 1 receiving oral sex from someone who does. 
I don't think the risk of acquiring either HSV 1 or HSV 2 at a single exposure is great, but repeated exposures, as you might expect, pose more risk.

The 12 week mark is standard - it takes some people longer than others to make antibody.  If you test negative for HSV 2 at 6 weeks out from the encounter, there is a 70% chance your result will stay that way at 12 weeks - perhaps that is a place to start for you?  And remember that the IgG test for HSV 1 misses 30% of HSV 1 infections.

Terri
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Ok. I incorrectly inferred from your first response that the only encounter with risk was the one where the condom slipped off.   

Well, when the intercourse became unprotected by the loss of the condom, that was the biggest risk, but not the only risk.  Sorry if I confused you there.
Do you feel a grape like thing at your anus?  That could be a hemorrhoid.   Herpes lesions can be present at the anus yes.  You may wish to have an exam, just to get a bit more clear about this anal discomfort - is it discomfort?

Terri
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I can't find any evidence of anything externally.  It Just itches and very mild pain. 

That would be very unlikely this far out and it is quite common for men to have red and irritation between the thigh and the groin, and it is most often fungal - that's what I would suspect anyway

Terri
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