[Question #8035] HSV2 Concern

49 months ago

Good afternoon,

I had a brief (5 minutes or less) episode of intercourse with a girl (I’m a 48-year-old male) I have been dating 14 days ago. We have mutually masturbated each other and performed oral on each other over the last few months as well.

She says she had one event with another guy back several months ago prior to me. During that event they had intercourse twice and performed oral on each other.

She had a full STD panel test done right before the first guy. I saw the results and all was negative. So was the most recent STD panel test of mine.

I wasn’t too concerned about her status with the one event with the other guy thinking one time even though multiple types of sex probably equated to very low risk. Plus, the guy before me was asking her for the test so I assumed he was clean.

Now we have decided to both get tested and my test as of last week 1 day after we had brief intercourse was negative except for HSV1 which I had never been tested for before but kind of assumed I had. I believe I have had since a teenager.

Her test has come back negative for all except HSV2. I was kind of shocked at hers given the one event with the one guy infected her.

I believe you say that I should wait 12-16 weeks to be tested for HSV2 but there is a Quest Labs test claiming to be conclusive in 4-6 weeks. Obviously less time is good. Not overly concerned with the HSV2 even if I am infected but would like to simply know. Seems my HSV1 status may lower the chances of it ever being symptomatic anyway.

So questions:

What are the odds she was infected with HSV2 during her one event from the one guy before me?

What are the odds I may have been infected by my girlfriend with the brief intercourse episode and the mutual masturbation and oral?

When can I get tested to give me some idea of my status of HSV2? The test appears to be fairly cheap so I don’t mind getting tested a few times until I can get a conclusive answer.

Thanks for your help.

Terri Warren, RN, Nurse Practitioner

49 months ago

So you looked at her first full panel of tests and HSV testing was included and she was negative, is that correct? And then you both recently tested and she was positive, is that correct? At what index value? It is essential that I understand this number to give the best advice possible.

At 6 weeks out from a concerning sexual encounter, the test picks up 70% of infections, waiting longer is more accurate.

I think the odds of her contracting HSV 2 from a single episode of intercourse, and with no symptoms, is incredibly unlikely but not impossible. And then that you would get it from her with only masturbation and oral sex? Even more unlikely.

Do you know if her contact with the other partner was protected or unprotected?

You can test at 6 weeks and see what you get and then repeat if you wish. Remember that if you test and get an index value of 1.1 to 3.5, you need a confirmatory test.

I'm eager to hear her index value and whether she needs a confirmatory test to be done. And are you sure it was an IgG test, not IgM?

Terri

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49 months ago

Thanks for your reply. To answer your questions for clarity:

So you looked at her first full panel of tests and HSV testing was included and she was negative, is that correct? Yes that is correct. Actually saw the lab report.

And then you both recently tested and she was positive, is that correct? Yes that is correct. Saw that lab report as well.

At what index value? It is essential that I understand this number to give the best advice possible. 19.6 - a high index I believe. She spoke to her Ob/Gyn and he believed she is no doubt positive. I'm hearing his comments second hand of course through her.

At 6 weeks out from a concerning sexual encounter, the test picks up 70% of infections, waiting longer is more accurate. Ok thanks. The website claims 99% at 6 weeks post exposure. I can send the link if you wish. Actually two different websites claimed this. Can't always trust the web though.

I think the odds of her contracting HSV 2 from a single episode of intercourse, and with no symptoms, is incredibly unlikely but not impossible. They actually had one meeting with two episodes of intercourse and oral sex performed on him. But still, to me seems pretty unlikely.

And then that you would get it from her with only masturbation and oral sex? Even more unlikely. We did a have a 5 minute session of unprotected intercourse recently after several episodes of masturbation and and oral sex over the past few months. But again I tested negative 2 weeks ago which timing wise would have picked up many of the episodes of masturbation and oral sex. Not the intercourse as it only occurred a little over 2 weeks ago.

Do you know if her contact with the other partner was protected or unprotected? She stated it was all unprotected.

You can test at 6 weeks and see what you get and then repeat if you wish.

Remember that if you test and get an index value of 1.1 to 3.5, you need a confirmatory test. Understood - thanks.

I'm eager to hear her index value and whether she needs a confirmatory test to be done. And are you sure it was an IgG test, not IgM? Both lab reports were IgG test. I checked that as well.

So you see my confusion over her lab results. Could they be incorrect? Of course I have to consider that maybe she is not being fully truthful as well about other partners recently. I'm not in panic mode or anything. At my age, if I'm infected it might potentially be a nuisance to me at times and perhaps to others if I have other sexual partners. But I believe I know enough about STDs that MOST times it is more likely that you are infected over time through a pattern of activity simply as a matter of probability.

Thanks in advance for your advice and anything you can provide to help clear up what I considered a surprising lab result from her.

Terri Warren, RN, Nurse Practitioner

49 months ago

If her index value for HSV 2 was 19.6, I don't think there is any real question about whether she is infected or not. But it does seem so unlikely that she would contract HSV through two unprotected encounters but certainly possible.

The data on the test product website looks at people who are known to be swab test positive for HSV 2, comparing them with people who are positive on the IgG test. But when you look at people who have newly acquired infection that has been documented by a negative IgG test at baseline (and are swab test positive) those numbers are different. Do you see the difference there?

Terri

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49 months ago

Thank you again for your responses.

So what are the chances I may have been infected from 5 minutes of unprotected intercourse? We did have a couple of brief episodes of protected intercourse over the last couple of months which I recalled after I wrote to you yesterday. I would think my recent test had a chance of picking up those antibodies had I been infected. Should I get tested again now or at some point in the future?

Of course I need to dig a little deeper with her on other recent potential partners. Something seems amiss. Seems very unlikely that the one guy infected her after one time basically.

As far as the claim I found on the internet about the accuracy of the test at 6 weeks: You can post the below links into a web browser to find the stated claim.

https://privatetestingcenter.com/accurate-herpes-blood-test-6-weeks/

and this one:

https://www.stdcheck.com/herpes-i-ii-test.php

These appear to be very misleading based on what you are telling me as an expert.

Again, this isn't a panic situation for me. I obviously don't won't to be infected as it could be nuisance, will impact this relationship, and impact any future relationships if they occur. Of those, more immediately, is how I proceed with the current girlfriend. Gonna tread lightly with unprotected sex until I can figure out my status and perhaps her recent sexual history.

Thanks again.

Terri Warren, RN, Nurse Practitioner

49 months ago

Yes, I'm aware of what is said about the IgG test sensitivity and timing, but thank you.

I think if you want to test, you should do it about 3 months from your last unprotected intercourse. I'm not as worried about the protected intercourse though condoms don't perfectly protect men from becoming infected by a female with HSV 2.

Terri

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