[Question #8255] Confidential Question
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46 months ago
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Hi I was recently informed by someone I slept with twice unprotected nine months ago, that their boyfriend has tested positive w symptoms for HSV-1 and shes believes she is likely to have it. I was the only partner she had had prior to that experience and the boyfriend has not had unprotected sex outside of her but has with others. And he had no symptoms until a couple weeks ago. She was tested yesterday and is awaiting her results (I believe she showed some symptoms). I have had no symptoms whatsoever for the past nine months and upon the news was tested across the board with the exception of herpes blood test. When I asked if I should be tested the doctor at CITYMD said she wouldn’t if it was her given the risk of false positives and the fact that i hadn’t shown any symptoms. I’d like to know whether you believe I should be blood tested for herpes or whether I can do without it. Really appreciate the help.
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Terri Warren, RN, Nurse Practitioner
46 months ago
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There has been a lot of time in between here. I think this likely has nothing at all to do with you. Have you ever in your life had a cold sore on your lip? If yes, then you already have HSV 1 and it is not a risk to you. Also, if she has genital HSV 1 (is that what she is saying?) that is rarely shed and remains quite quiet for more people and I have yet to see it transmitted via sex. Also, two contacts are very unlikely to transmit HSV to you, regardless of type.
In my clinic experience, about 6% of people who tested with the IgG test, tested in the low positive range (1.1 to 3.5) and half of those were false positives, so I wouldn't agree that false positives are "common". If you are still worried, and want to test and are worried about false positives, you could do the herpes western blot. But if you do test and are positive for HSV 1, no one can tell you if the infection is oral or genital so I'm not sure how helpful that will be for you. What do you think?
Terri
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46 months ago
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To be clear the boyfriend has had protected sex a couple of times prior to their relationship. And She said she sometimes has legions (she used the word cuts inside of her vagina) I am mainly concerned about testing because I don’t want to unknowingly pass it on to others and of course have the Constant anxiety in having to tell each partner prior to being intimate that I have herpes. I don’t want to live by “ignorance is bliss” but if I don’t have any symptoms or any other STDs/STIs - im trying to figure out whether it’s important for me to be tested. I understand a negative test would subdue all fears but I'm terrified of a positive test and am contemplating if it’s worth it to take the chance. Any advice you have would be much appreciated.
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Terri Warren, RN, Nurse Practitioner
46 months ago
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This may have absolutely nothing to do with sex. This boyfriend could have acquired HSV 1 as a child and has oral infection. There are lots of possibilities here. You should not tell people that you have herpes until you know if you do or do not. Half the US population has HSV 1 so you may well have it and not know it. Most of it is oral in the form of cold sores. You are making this about sex and it may not have anything to do with sex at all. Being terrified of a positive HSV 1 result may be a bit over the top since it is so incredibly common in our population. And if you did test positive, you could not know if this was oral or genital.
Terri
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46 months ago
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Hi thank you for taking the time to respond, I really appreciate your insight. She told me today the swab came back negative but she tested positive for Antibodies for HSV-1. I am now wondering 1) if I have have any obligation to be tested 2) should I even if I don’t 3) would I need to tell any future partners prior to sex that I have HSV-1 assuming I test positive. Would it be wrong of me to not get tested and continue to have unprotected sex as I don’t have any symptoms?
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Terri Warren, RN, Nurse Practitioner
46 months ago
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As I said before, given that about half the US population between 14 and 49 already has HSV 1, I'm not at all surprised that she tested positive. And you might also be infected with HSV 1 and not know it.. Have you ever in your life had a cold sore?
I don't think you have an obligation to be tested as I'm certain that you've had contact with other people who have had HSV 1 in your lifetime. And you don't need to disclose that you've had a partner with HSV 1 either, because others certainly have also. Contact doesn't equal infection.
If you told me that a previous partner had HSV 2, then I might encourage you more to get tested to see if you are also infected, but in this case, since HSV 1 is so common and very often acquired in childhood, I don't think you are under any obligation to be tested for HSV 1 at all.
Also, the test for HSV 1 misses 30% of HSV 1 infections so it isnt' a great test anyway.
Terri
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