[Question #8145] Herpes risk and testing

48 months ago

Hi,

I am a 30 yo man living in the US. I had an 8-month relationship with a 33 yo woman, the only person I have had sex with. We only had protected sex and a few (less than 5 or 10) unprotected oral experiences (both ways). Only had unprotected genital contact very few times for a short time in the shower (no penetration). Both STI free and no symptoms as far as I know.

My ex had been with a few high-risk partners (a bisexual man and a drug addict). She also had an IUD for 10 years and had regular unprotected sex with long-term partners, except for a few times that sadly she had no control. She also was very into alcohol.

We ended last Oct. and I am starting a serious relationship. I talked about this relationship with my new partner, but not STIs. My main concern is HSVs. I have never had symptoms, but my OCD and the feeling that I might give it to my new partner makes me agitated. I am trying to solve this problem by myself without involving her, which I am not sure how she will react because of our cultural. If my risks are reasonably very low, I don't want to miss this chance because of my OCD. Your opinion will help me to put this to rest.

How do you assess my risk of catching genital HSV? How about risks from the few genital contacts in the shower?
Does the sexual background of my ex change my odds?
As a healthcare professional, do you recommend an IGG test? I know even gold standard tests can be inconclusive and are not recommend for everyone.

Thanks!

Terri Warren, RN, Nurse Practitioner

48 months ago

I think your risk is low - not zero. I take it that you've had no symptoms suggestive of genital herpes - sores in the genital area?

Are you at all able to contact your previous partner and ask for her (and pay) to be tested?

Condoms reduce transmission of HSV 2 from infected females to uninfected males by about 60-65% so the fact that you used condoms is a big plus

The shower experiences are very limited risk because there was no penetration and I assume soap was involved at some point?

The sexual background of your ex definitely makes a difference in your risk, certainly.

In this situation, and I think from you post that your cultural background makes this very important to know for certain, is that correct?

In your case, I would recommend herpes antibody testing. The best test is the herpes western blot from the University of Washington. But you could start with the IgG test. The IgG test misses 8% of HSV 2 compared to the western blot, but a reasonable place to start, and end, if you are comfortable with those odds. While a few people can get an indeterminate on the western blot, it is not common and if there are two indeterminates within a 3 months period, UW recommends that you consider yourself negative. So eventually, I don't think they are inconclusive. I think in your case, I would recommend testing. If you test positive without symptoms on the IgG test, I want you to do the blot, especially if you are 1st or 2nd generation here in the US. Or skip the IgG and go right to the blot. Your call.

Terri

---