After an ambiguous PCR test, my girlfriend had a type specific blood test done which came back positive for HSV 2 with a very high antibody count.

I am faced with the decision of whether or not to get tested. I have never shown typical symptoms for either HSV 1 or 2. My girlfriend and I have had sex probably 50-75 times and I would guess that roughly 15 of these instances have been unprotected. I understand the low likelihood of transmission from a female to a male during any one instance of exposure, that 1 out of 5 people have HSV 2 and 80-90% don’t know it, and that routine screening is not protocol because it is not clear if the benefits of knowing one’s HSV 2 positive status outweigh the mental health costs associated.

I do not want to act unethically, but at the same time I am worried about the psychological/emotional cost of finding out I am HSV 2 positive - knowing myself they would be considerable. I have obviously been exposed via my girlfriend numerous times, but the likelihood is I have also been exposed via past partners who were unaware of their status. If I get tested and test positive for HSV 2 it could very well have been transmitted to me from one of these past partners (and I had no reason to test after them in the past!). I realize HSV 2 not a serious condition and that it is overly stigmatized, but I want to make sure I’m responsible while also practical about if there is a realistic need for testing in my scenario. 

I have seen you guys recommend not getting tested after a single exposure, whereas I have had numerous exposures. I am planning on continuing this relationship, but I may have other partners later in life if it doesn’t work out. 

Thank you for your time and the invaluable service that you all provide. 

Thanks so much for your reply. As for our background, I was last tested for HSV 2 about 6 years ago when I was in my early 20s, and I tested negative. However, I have had numerous partners since then so those results are not relevant anymore. I don't believe my girlfriend had ever been tested before her recent test, and she too has had multiple partners in the past. Consequently, if I do test positive it is impossible to know if I infected her or vice versa. 

I have read through as many official, empirical sources about HSV 2 as possible, including the CDC information you quote in your response. I definitely do fall into category 3, but I just wasn't entirely sure if my exposure to my girlfriend  merited testing any more so than the exposure I almost certainly - though unknowingly - experienced in the past via partners who were unaware of their status. Since most people are indeed unaware of their HSV 2 status and 1/5 people are HSV 2 positive, the odds are that I have been exposed before. Yet despite the likelihood of exposure people don't normally get tested due to concerns that knowledge of one's HSV 2 positive status may in fact have detrimental value due to the mental health costs associated, and the real question is what do you do with the knowledge when it is a benign, incurable, lifelong disease. My girlfriend was not even intentionally testing for HSV 2 - she had a PCR packaged in with another health procedure she was undertaking and the results indicated cell abnormalities associated with HSV 2. She then had a type specific IGG blood test done which showed she was positive; however, had the PCR not been packaged in with an unrelated medical procedure, she would never have been tested for HSV 2 and would never have found out (as she is asymptomatic). We would therefore, like most people, not be dealing with this situation since we simply would not know our HSV 2 status since it is not part of typical testing protocol.

That said, I was leaning towards testing for the reasons you outline in terms of my relationship with my girlfriend. You seem concretely sure that I should get tested if indeed I do have future partners, and I understand that. 

I am planning on getting tested in the next couple of weeks. If I test negative, how often should I retest while I am with my current HSV 2 positive partner? 

I really appreciate your flexibility in allowing me additional questions given the circumstances -  thank you for being so considerate and thoughtful in your response. 

I really appreciate the information, feedback and perspective. I value and respect your expertise on this matter, and thank you for laying out clear answers to my questions. I am getting tested for HSV 2 and will proceed accordingly once the results are in. If negative, we will pursue all possible avenues to reduce transmission going forward. My girlfriend and I have not had sex for nearly 3 months so the results should be quite accurate. Keep up the great work and I know I am not alone in saying that the services and information you guys provide here are critical for many.

All the best!

Thanks for keeping this thread open. I got my results back:

HSVI Type Specific IgG: < 0.2

HSVII Type Specific IgG: < 0.2

The attached interpretation chart indicates that "< or = to 0.9" should be interpreted as negative. As I have consistently read from expert sources, including yourself, that retesting is only necessary if one were to receive something from around 0.9 to 1.9, I am not planning on retesting at this point and I am interpreting my results as negative. Would you agree?

Many thanks again for your advice and help over the past month, and happy holidays to you and yours!

Thanks a lot for the quick reply! I am aware that over 50% of people have HSV 1, most without being aware of it, and since that wasn't the focus of my testing I won't be pursuing a Western Blot or a retest at this time. 

I had not had sex with my girlfriend (nor anyone else) for about three months prior to my being tested, which fits exactly with the recommended window post-exposure for receiving accurate test results. I have received oral sex from her within the three months prior to my testing, but to my knowledge this would not have any impact on the validity of my test results since HSV 2 is not transmitted in this manner, and the likelihood of HSV 1 being transmitted orally to genitally is extremely low. Since I did not perform oral sex on her and we did not have sexual intercourse of any type for the three months prior to my testing, I feel confident that my test results are accurate. Would you still agree? 

Thanks!

As I've said before, I appreciate your thoughtful assistance immensely! All the best for the new year.