[Question #3880] STD Testing
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86 months ago
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H. Hunter Handsfield, MD
86 months ago
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Welcome to the forum. Thanks for your question and your confidence in our services.
First, your sexual lifestyle probably has not been as risky in regard to STDs and you might assume. While many persons with such partner numbers will have had one or more STDs, many will not.
You can be certain you have or have had HPV, probably several times, but HPV is essentially a normal consequence of being human and sexual, generally remains asymptomatic and harmless, and accurate testing is not routinely available (and positive results generally don't require medical attention except in connection with pap smears), and doesn't require medical attention unless and until specific problems appear (warts, abnormal paps in women, etc).
The tests you have had were accurate at the times you were tested, i.e. this month. All the standard tests used by various physicians, clinics and laboratories are equally accurate and valid. There is no point in online searching and/or obsessing about minor differences in test performance that you can find online. Of course any two tests for a particular conditions (e.g. chlamydia or gonorrhea) will give slightly different numbers when evaluated in different groups of persons at risk. But those variations do not mean actually important differences in real world testing.
Blood testing asymptomatic persons for herpes is controversial. Most experts do not recommend it in persons with histories like yours, but would limit testing to those with symptoms that suggest herpes and some persons who have had regular contact with partners with known herpes (e.g. if you had a regular girlfriend who you know know has genital herpes). If you do seek herpes testing, be aware the tests are not perfect. If tested, for sure have only the IgG and not IgM tests for HSV1 and HSV2; be prepared for a fairly good chance of a positive result for HSV1 (mostly from childhood oral infection); and also for a possible weakly positive but unreliable HSV2 result. But I recommend you not do it.
I strongly urge you not to waste money or emotional energy on yet another rounds of tests. You clearly do not have, and almost certainly have not had, any conditions about which you need fo inform future or past partners. You definitely should not say anything to any past partners, based on what you know now, and there is no need to say anything about STDs to future partners. You'll just create trouble for them and for yourself, without any benefit to either their health or yours.
I hope these comments hare helpful. Let me know if anything isn't clear.
HHH, MD
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86 months ago
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Thank you for the response, Dr. H. That definitely puts my mind at ease. I understand your response about the type of tests (two tests may report different levels of a disease for a person, but it's not statistically significant: correct me if I am wrong) and I will stop worrying about that.
I just have two quick follow up questions. One: I forgot to mention the last time I had unprotected sex was with a stranger (Caucasian female, 22) mid-April 2018. I know you are recommending I stop putting money into tests, but based on this information, should I go in for a 3/6 month follow up to make cover the incubation window for HIV? Or is the test I just did yesterday fine for that window?
Also, is there any way you can explain why experts don't like giving out the tests to people who are asymptomatic/been exposed? I know herpes is essentially an over-stigmatized skin-rash, but shouldn't you just get the IGg test to be sure?
Thank you!!
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86 months ago
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And lastly, if I do get a low positive for HSV-2 on the IGg, should I tell my partners about this information? Or is it not necessary?
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H. Hunter Handsfield, MD
86 months ago
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We almost never recommend testing after any single heterosexual exposure unless there are symptoms or there was known exposure to a particular STD. Without these, the overall risk is low enough that tesitng isn't warranted. A smarter strategy is for people with occasional new partnerships to get tested at regular intervals, e.g. once a year, rather than doing it after individual exposures. But in any case, for sure it isn't necessary to be tested 3-6 months later. If testing is done at all, it should just be a urine test for gonorrhea chlamydia (valid any time more than 4-5 days after exposure) and blood tests for HIV and syphilis at 6+ weeks. So for sure you don't need any additional testing on account of that event. (Tha said, I would urge you to get into the condom habit for new partners or exposures. What were you thinking??)
Your second question apparently is herpes related. But surely you understand that not all rashes suggest herpes. Of course all experts would recommend diagnostic testing for persons with symptoms suggestive of genital herpes. But just any rash doesn't cut it, only particular symptoms or rashes that are consistent with HSV. The large majority of genital area skin problems are not STDs.
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86 months ago
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I wasn't thinking. Also, I understand the skin situation, doctor. It is just annoying that the IGg test gives out so many false positive results. That's why I am wondering if I do end up getting a positive result within a level of 1.1-3.5, should I even tell my partner, or past partners? Extremely confusing
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H. Hunter Handsfield, MD
86 months ago
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It is pointless to worry about what to say in the event of a low-positive test results. You have misinterpreted what you think you have learned about HSV2 testing. Most test results are cleanly positive or negative. Cross this bridge if and when you come to it. My advice remains that you not be tested and that you go ahead with your life on the very high probability you do not have HSV2.
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That finishes the two follow-up comments and replies included with each thread and so ends this one. I hope the discussion has been helpful.