[Question #4157] HSV and HPV

31 months ago
Hi Drs, 
Iam 27 year old male circumcised.
So between 2015 to 2017 I was sexually active with numerous girls most were 1night stands and I used condoms for all vaginal intercouse never did anal. With 2 girls the condoms broke and I had unsafe sex for 20sec.  From May 2017 I got tested (all negative except for herpes i didn't get tested)  and then abstained from sex till the end of March 2018. In March I had unprotected sex with girl who asked about my status. She asked about herpes since a mutal friend that I slept with in 2015 had it. To my knowledge, I thought the test I did in 2017 included herpes.
In June 2018 (9 to 10 weeks after last sexual interaction) I did full panel of std test including igg test for hsv1 & hsv2. All the test came back negative including hsv1 & hsv2 which came back negative without any numbers.
My questions are:
1) 

I know the recommended time frame for herpes is 12-16 weeks. Since at 10 I was negative. That means if I test again at 16 weeks and it came positive that means it's from the girl in March 2018? Or are my results conclusive and no need for testing for any Std?
2) 
I'm probably getting married at the beginning of 2020. Until that time I'll be abstaining from sex. The girl im marrying is a virgin. My concerns are about HPV.  I never had any warts and always used a condom. Since there will be a 2 year gap since my last intercouse should I have any concerns?

I have read a lot of your answers respect the things you do. Thank you and hope to hear from you soon.



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
31 months ago
Welcome to the forum. Thanks for your confidence in our services. Directly to your questions.

1) There is in fact no recommended protocol for blood testing for herpes. In general, testing isn't recommended at all in people without symptoms, only in those with symptoms suggestive of herpes or those with known high risk exposure, i.e. sex with a known infected person. And even then, the main recommendation is for testing only of people with ongoing exposure, e.g. regular partners of people with genital herpes.

That said, when testing is done, it can take up to 12 weeks for positive results. However, most newly infected people have positive results by 6 weeks; a fairly small percentage take longer. So your negative result at 10 weeks is quite reliable, if not conclusive. However, you also give no evidence your partner has herpes; and you also apparently have had no symptoms to suggest you were infected. So even without testing, I would put the chance you acquired herpes at under one chance in many thousand. With the negative test result, even at "only" 10 weeks, I would put your chance of having HSV2 at one in a million. In other words, zero for all practical purposes.

2) You can be quite certain you have had genital HPV, perhaps more than once. Almost all sexually active persons become infected within their first 3-5 lifetime sexual relationships. Condoms only modestly reduce the risk of HPV, because of skin contact above the condom, and the overall risk of eventually getting HIV is no lower in consistent condom users than nonusers.

Still, it is unlikely you have a currently active HPV infection, since most HPV infections are cleared by the immune system within 2 years. However, there is no way to be certain. In addition, it isn't all that rare for HPV to make an appearance in virgins -- either because there were un-admitted sexual exposures,  because of non-intercourse events (e.g oral sex, genital apposition without penetration), or perhaps even a few non-sexually acquired cases. So although it is unlikely HPV will ever appear in your future wife, it could happen. That's why all women should follow standard guidelines for cervical cancer prevention (pap smears at recommended intervals) and why both you and your partner should consider vaccination, which would protect both of you from the 9 most troublesome types of HPV.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD


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31 months ago
Hi Dr,
Thank you for replying so fast. 
1)
Regarding my sexual exposure (2015-May 2017), and since I abstained from sex for a year,  is my herpes test in June 2018 conclusive for the exposures in 2015-2017? Therefore my only concern would the girl in March 2018? 
2)
Regarding HPV, I'm afraid to ask for the vaccination since I'm middle eastern and this is an arranged marriage. I'm scared that this would break the marriage. I'm pretty sure that the girl had never even touched a man due to our culture. I was just hoping that abstaining 2 years from sex be good enough. I feel really guilty about those 2 years (2015-2017) therefore probably never would have sex outside of marriage.  So, can I be confidant at 2020 all my HPV infections would clear up and would be no risk to her? She is 21 right now.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
31 months ago
1) Your test result is conclusive for any and all exposure more than 12 weeks before testing.

2) Sorry, but I have no answer to your dilemma. I have a hard time believing that getting vaccinated against HPV would threaten the marriage. But I'm not part o that culture. In any case, I cannot guarantee that any past HPV infections would be gone forever. Although most infections are cleared by the immune system within 2 years, sometimes the infection reactivates 5, 10, 20, or 40 years in the future. I cannot change that biological fact. 
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