[Question #6628] Historical hsv-2 exposure

14 months ago
I am a late 30s married male. I dated a girl in college who told me she had gentian herpes. We had sex maybe 10 times, normally using protection, though IIRC condoms failed once or twice. Not having had any obvious symptoms at t he time or since, and having had at least one STD screen , I assumed I was in the clear on this. But I recently learned that HSV can be asymptomatic, and is not part of standard screens. Learning this triggered an excaberation of anxiety/mild OCD around this issue.

It’s been 20 years, and as far as I can tell Ive never had a classic outbreak - no unexplained red bumps or scabbing in the general area. I’ve had occasional itching over twenty years but only in very normal-seeming ways. A couple i of times I’ve had more intense itching, even a little burning, near the base of my penis, but there was never an appearance of bumps, just a little red skin, associated I think with poor hygiene and warm temperatures. I’ve had other rashes on my body in that time but I don’t remember any notable
unexplained ones around my midsection 

So basically, I’m concerned that I’m an asymptomatic carrier. This worries me because I am married, having been with my wife for almost ten years. (I had only a handful of sexual encounters into the intervening period) I didn’t tell her about this pst exposure, thinking I was in the clear. She’s never complained to me of anything that clearly sounds like herpes symptoms, though not living in her body it’s hard to say for sure. I’d feel terrible if I’d given it to her, and the whole thing would be a very hard conversation.

So, to questions 

(1) What are the chances I was infected under the conditions described
(2) Should I have been tested at the time? 
(3) Should I go for a test now? If so, how, and what test should I look for (needless to say, I am not now having symptoms)
(4) If I should be tested , should I stop having sex with my wife in the interim (we use condoms in any case for vaginal sex)?

Thanks

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
14 months ago
I think the chances that you were infected are incredibly low!  First, most encounters were condom protected.  The transmission rate IF the woman had HSV 2 is about 4% per year, having sex 104 times in that year.  so you can see how low that is, with two episodes of broken condoms.  Also, the real chances of someone in college having HSV 2 genital infection is very low indeed.  She could have been diagnosed with an IgM test, which is often falsely positive, she could have been diagnosed with a visual exam, which is often wrong, but the percentage of incoming freshman at UW, for example, with HSV 2 is 3%.  You've had no symptoms, your wife has had no symptoms. I think is highly unlikely that you have genital herpes.  If you want to test, if your anxiety about this is just bothering you too much, you should do the best test, the herpes western blot or you could start with a slightly less good test, type specific IgG for HSV 2.  I think if you test it is for resolution of anxiety, not so much a medical issue.

Terri
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14 months ago
Thanks! That’s reassuring.

She seems quite confident about it; she seemed to have been counseled about it by a doc, including how not to spread, and she had a story about how she got it from a previous older boyfriend that made sense to me. She didn’t say whether it was 1 or 2, though she certainly described it as ‘genital’

Glad to hear the chances of transmission were low. Still not sure what to do though. I gather you think there’s a low enough chance that I have it that I don’t need to test for the sake of my wife or any future partners? I am reluctant to test, for reasons both good and bad - I’m not sure I want to know if I have it, I don’t want to feed my (mild, but real) OCD, and I am concerned about anxiety from false positives.

If I did decide to go ahead, can you recommend a discrete or anonymous provider? Particularly curious what you think of these companies - stdcheck etc. - that allow you to pay online for tests and then go into a lab location for a blood draw. Finally, how long would each option (IGG and blot) take?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
14 months ago
I understand your question about testing.  The online services are fine - they direct you to large labs like Quest and LabCorp for the testing.  Or you can go directly to the western blot through me - more expensive for sure but also more accurate.  If you want to do that, you can set up an evisit at westoverheights.com.  The IgG results will come faster.  with the blot, you need to call UW for the kit - 206-685-6066, while waiting for it, have a consult with me, then the test can take up to a few weeks.  The IgG will be back in days

terri
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