Good morning, my wife and I have an open relationship and also swing from time to time. We always practice safer sex with condoms. About a month ago, on Oct 23, we swapped partners with another couple. We used condoms for everything but oral sex. A few days later my wife was noticing some odd odor. She went to get tested on 11/9 and everything was neg, except for hsv1, which was equivocal .94 on an IGG test. She then went to the Dr. and was diagnosed with BV. 

Welcome to our Forum and thanks for your thoughtful questions.  I'll be glad to comment. 

BV first.  At the risk of providing more information than you want and even confusing the situation, BV is now referred to as a "sexually associated" STI in which the concentrations of bacteria normally present become unbalanced (the scientific term for this unbalanced situation is called a "dysbiosis").  BV is associated with having new sexual partners but, interestingly, treatment of partners has not been shown to change the response to the therapy or recurrence rate.  Treatment of BV rebalances the bacteria and resolves symptoms in about 80% of persons and over the next 3-6 months, about 1/3 of women with BV will experience a recurrence.  Condoms do reduce the occurrence of BV.  Whether or not BV is associated with oral sex is unclear.  If it is, it is less common than unprotected genital-genital contact.  If I had to guess, your wife's BV is more likely to have resulted from a poorly cleaned sex toy than from oral sex. 

BV bacteria are no known to cause sore throats.  I doubt that your sore throat is related to BV.

As far as the HSV-1 blood test, these tests are notoriously unreliable.  Falsely positive results are common (and can come and go), as are falsely negative tests.  In general, when blood tests for HSV-1 are clearly positive, the higher the numerical value to the result, the more likely it is to reflect a true positive infection.  For HSV-2 which we have better data, attests typically take weeks or even as long as six months to become positive.    I would be skeptical that your wife's positive test was due to your recent encounters - too soon, too low. 

I hope my detailed reply is helpful.  The data to answer these questions is modest at best.  EWH

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Thanks Dr. Hook - just a few follow up questions. 

BV is an area of active research but the emerging sense is that it is caused by sex acts. 

There are no data so suggest the probiotics help BV but there are no data that they hurt either.  I would not count on them helping.

When persons acquire herpes of any sort, they are most often symptomatic.  I favor her test result as being falsely positive.   Equivocal certainly does not mean her test is positive.  You may be able to get more clarity if you repeat her test in 3-4 weeks.  If this is truly a new infection, her test would be expected to be clearly positive at that time. 

Hope this helps.  EWH

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