Circumstances:

My spouse tested positive for HSV2 multiple times, and indicates she has not had an outbreak.  We've been together for over 15 years and last had contact in Nov of 2021.  I was tested in twice in 2022 in Feb and in March and was negative both times (Herpes Simplex Virus Antibody IGG Type 2<0.2 AI).

What is the probability of NOT contracting HSV2 over a period of 15 years with regular sexual activity (at least monthly often weekly) with an infected person?

Can HSV2 be transmitted orally or is it only transmitted from genital contact? Is there any way you could get HSV2 from drinking after someone or from someone performing a Brazilian wax who was also infected?  To state another way, what is the probability it was not contracted from a sexual encounter?

Are women tested for HSV2 as part of prenatal care?  We have three children the oldest being 12 and the youngest being 8.

If you have tested negative multiple times and 3 months after last sexual contact, are you a true negative?  If not after what period of time.

I would encourage your partner to look at the number associated with her positive result and if the result has an index value (the number associated with the test result) of less than 5, she may need a confirmatory test as there are false positives in that range.  this is especially true if she's not had an outbreak in 15 years.  that is, if you are still in touch with one another.

The risk of female to male transmission of HSV 2, having sex about twice a week, not during outbreaks, is about 4% per year, so it is completely reasonable that you would not be infected now.

HSV 2 can be transmitted to the mouth by someone giving oral sex to someone who has genital HSV 2, but it is exceedingly rare.  you would not get HSV 2 from sharing a drink.  HSV 2 is indeed a sexually transmitted disease, and that is how it is transmitted.

Women may or may not be tested during pregnancy, that is an individual provider decision.

The IgG test picks up 92% of HSV 2 infections, compared to the gold standard herpes western blot, if one waits 12 weeks from last concerning encounter to be tested.

Terri

The transmission rate is ~4% per year or ~4% per encounter?  I know you are shedding ~17 days in a year and that number is roughly 4%.  I would expect frequency of encounters to have an effect on the statistic and as such would have expected to contract in our first few years. 

If I put 4%, 15 trials, and 1 success into: https://stattrek.com/online-calculator/binomial.  The result is P(X>=1) 0.45791.  In 15 trials at a 4% chance per trial I would have a 45% chance of having contracted HSV2 at least once after 15 trials.  We were very active in earlier years and I would think this number must be higher given that increased activity.  Side note: 17/365.25 instead of 4% gives a result of about 51% likely over 15 trials.

She has tested at least twice positive in the ~3.0 range.  I have tested three times each time less than 0.9.  The test we took had 99% specificity and 90.7% sensitivity.  Are more tests indicated/needed?

How does one request/obtain a western blot?

When the test describes its sensitivity and specificity, it is comparing the ability of the test to pick up infection in people who are swab test positive for HSV 2.  It turns out that when the population tested is people simply screening for herpes, not necessarily with symptoms, the statistics are very different indeed.  If you would like the reference for that paper, I would be happy to provide it.  

If her test is positive in the range of approximately 3, she might want to confirm with the western blot

She can work with her own provider and the University of Washington where the test is done or if that isn't working for her, she can work with me at westoverheights.com.  it might be useful for both of you just to know her true status, correct?  

Remember that the 4% is an approximation and derived from a variety of clinical trials, and it is an average.  some of those couples have been together for a long time, some a short time.

Terri

Yes, I would be interested in the reference paper.  Thanks.

Do I need to confirm the negative or can I say I am definitively negative?

Here is the paper: