[Question #6998] Afraid for test results

11 months ago
Hi doctors,
Been debating for awhile whether or not to ask a question, but I suffer from anxiety so I felt this could be a good place to find some peace. I was tested yesterday for the first time for HIV, Hep B and C, and the usual STDs that come with a panel testing. I have only had unprotected sex with two partners, over 3 years ago, and everyone else following has been protected. I’ve been with under 10 individuals. I go in regularly for annual appointments and paps. I can’t remember a time when I was terribly ill, but I know I’ve had instances in 2017 where I might have fallen ill, sore throat and fever etc. I had a small instance of impetigo in 2019, but that was following some rock climbing. I am reading a lot about having an abnormal pap with no HPV being related to HIV, or people living with HIV who don’t know it.  I’m coming here to see what the chances are that I am living with HIV are, or if there’s a chance these tests can back positive. 
Thank you very much in like advance. 
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago

Welcome to our Forum and thanks for your implied endorsement of our service.  Our goal is to be helpful to our clients.  I hope that I can provide the sort of reassurance you seek.  We have had numerous clients who sought our advice regarding hesitancy to seek testing.  I congratulate you on having taken what is often the most difficult step- getting tested.  The background information you have provided puts you into a group in whom STIs are relatively uncommon.

When asked about testing by persons who are anxious about receiving their test results, I typically point out that most people do not have STIs, particularly HIV or hepatitis C (which is almost never sexually transmitted anyway).  Even for persons who may follow a somewhat riskier lifestyle, there is benefit to testing.  Testing will not change whether or not infection is present but the test results provide important information.  For most persons such as yourself the test results are negative and serve to validate there safe sex practices, hopefully re-enforcing continued practices.  For persons who find that they are infected, the results are in some ways even more important as they allow persons to seek treatment, thereby preventing potential complications or transmission to others.  Further, virtually all STIs can now be treated (even HIV).  You did a good thing by testing.  We recommend that all of our clients who have multiple partners, new partners, or partners who have other partners to periodically (about once a year in most cases) get "screened" (tested even in the absence of signs or symptoms of infection) for the most common or most worrisome STIs such as gonorrhea, chlamydia or HIV).  FYI, I realize that many of the 10-test panels include blood tests for herpes.  We recommend against this as the tests are not very good, sometimes yielding falsely positive test results.

I'm confident that your tests will be negative for HIV.  This thread will be open for up to 30 days following this response should you want to discuss your test results further or if anything I've said above needs clarification.  EWH

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10 months ago
Thank you Dr. Hook - I very much appreciate this. All of my results came back negative. My panel did not include testing for herpes. I was however, tested in 2016 when I noticed a small bump near my labia. It was swab tested and positive for HSV1. My bloodwork came back negative for HSV1 and HSV2. My doctor explained the reason for the negative HSV1 was because it suggested a new infection. I haven’t had any problems since then, I had what I thought might have been a recurrence 2 years ago, but nothing as notable as the first time, and nothing since. I’m writing here to see what my likelihood of having HSV2 is. I’ve read a lot about HSV1 over the years, but sometimes I worry that this first (and only) outbreak could really have been HSV2. Thank you so much in advance. 
Edward W. Hook M.D.
Edward W. Hook M.D.
10 months ago
Thank you for the follow up. I’m pleased to hear, but not surprised, that your tests were negative.

I am also glad that you did not get a blood test for HSV-2. Blood tests are notoriously unreliable for this disease in situations such as yours, both because of falsely positive test results and because of falsely negative test results. On the other hand, swab tests are highly reliable. If you are swab test was positive for HSV-1, then that was what was causing the bump. The good news is that genital  HSV-1 rarely recurs and is almost never sexually transmitted to sex partners. I would not worry further about your HSV-1.

I hope that this additional information is helpful to you. EWH
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10 months ago
Thank you Dr. Hook! This is immensely helpful, and gives me much relief. My final question for you is, do you recommend being tested for HSV-2? Is it common to have this and not show any symptoms? I’d imagine if my body reacted at first with HSV-1, I’d likely have frequent outbreaks with a type 2 infection.  
Edward W. Hook M.D.
Edward W. Hook M.D.
10 months ago
My advice to you is not to get tested for HSV-2. Persons who already have HSV-1 as you do may have falsely positive blood test results.  Although some persons can have HSV-2 and not experience the currencies, most persons who are looking for them would be aware if recurrences Did occur.  Consistent with the CDC’s recommendations,  I see little benefit do you have any HSX-two blood test and some potential for it to create problems.

As you have indicated, because this is my third reply, this will be the final reply as a result, this thread will be closed shortly. I hope the information I have provided has been useful to you. Take care. Please don’t worry. Stay safe. EWH
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