[Question #9022] Follow up to: The transmission rate of HSV-2

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37 months ago
Hello. I am posting a follow up to a question I posted last week regarding transmission from a one time encounter that I’d like clarification on since I am still riddled with anxiety. 

Terri Warren replied with: At 6 weeks out from a concerning encounter, 70% of those who are going to be positive will test positive on the IgG test. Given that you've had no lesions, given you test negative so far, given that it was a one time encounter, I seriously doubt that you have HSV 2.  If you want to retest at 12 weeks if you are still worried, you could, but the odds are that it will be negative as well. If your partner tests positive, then you will surely want to test again at 12 weeks out

My partner called to tell me everything was negative besides chlamydia, but he does not know if the blood work drawn at the urgent care includes HSV in it’s standard screening. He doesn’t have an online portal, and relies on a copy getting mailed to him, but he still hasn’t received his results in the mail. He has a follow up with his PCP Wednesday, but I am so nervous now. If he is positive for genital herpes and I have to retest in 6 weeks, given I tested negative so far, never had a lesion, and it was a one encounter, how likely is it that it will be positive? I am wrecked with anxiety trying to understand the probability. Is it 50%? Less than? Please shed some light. I am beyond myself.
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Terri Warren, RN, Nurse Practitioner
37 months ago
I would suggest that he call the urgent care clinic and simply ask of HSV testing was done as part of his visit. 
If he is positive, if testing was even done, you should retest in 6 weeks, correct, from the time you last had sex with him.  If he did use condoms, then the risk of infecting you is reduced by 96%. 
I can't tell you how likely it is for any one person to test positive or negative.  He totally depends upon how many sex partners he has had in the past, how often he used condoms in the past, how many partners he has had who have HSV , etc, etc.  Fill me in when you find out about his test results, OK?

Terri
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36 months ago
Hi Terri, following up to let you know that my old partner tested negative for everything including the chlamydia so safe to assume his doxycycline treatment worked. 

One question - I recently had sex with a new guy, it was one time, I did give him oral sex first and I did not notice any lesions or sores on his shaft or head, I carefully observed because now I’m neurotic. It was a bit of rough sex, it didn’t last long either but we used a condom, I did not observe breakage at all. We went to switch positions and he said the condom was coming off and we stopped sex altogether. I notice after that I had a small cut at the opening of my vaginal wall that was painful to touch. Am I at risk for anything here? Should I go get another HSV or STI test? What if he was shedding the virus at the time this was happening? It’s just hard not to worry now based on my history of having chlamydia.
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Terri Warren, RN, Nurse Practitioner
35 months ago
Well, if he tested negative for everything, I'm guessing that includes HSV?  If you used condoms for the majority of the contact and he tests negative for HSV 2, I'm not seeing a risk there.  
With a small cut on the vaginal wall - I assume that you've been tested prior to this person and were negative?
TErri
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35 months ago
Hi, just want to clarify. I was tested on March 23 and July 13, everything was negative including HSV2 except for chlamydia. I had a round of doxycycline treatment. 

My old partner that gave me chlamydia tested for everything at an urgent care and his PCP 2 weeks later, he was positive for chlamydia only at urgent care and at his follow up, negative for everything. That included HSV2.

I had a new partner last week, and we had sex for a few minutes, it was rough and I was sore after. I looked at my vagina before the sex because I’m always looking at it, and then noticed the cut immediately after and it was painful to touch, but now seems to be going away. The condom didn’t break, but it was starting to slide off when we switched positions so we stopped immediately. He is the first man I’ve slept with since I was tested in July. And my old partner was negative for HSV2, as am I. Just wanted to know the risks, if any. 
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Terri Warren, RN, Nurse Practitioner
35 months ago
Got it.  That's all really good news!  Thanks for the clarification, much appreciated.
So the risk of getting HSV 2 from this new partner, because the condom slipped a bit, really isn't a problem because you stopped having sex right away after that.  Just to be sure I have this right, the condom slipped because you were changing positions during sex and when it did, you stopped. 

This new partner - have they been tested for all STIs as well?  Do you know his status?   I'm going to leave this thread open so you can answer my question.  But regardless of the answer, I don't see a risk here because you stopped having sex when you realized the problem with the condom.

Terri
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35 months ago
Thank you, Terri! Correct, we only did missionary, very fast/rough for maybe 2-3  minutes, and it was starting to hurt, so I asked him to slow down and when we went to switch to doggie, he said the condom was starting to slip off, and we stopped altogether. I did not see any sores/lesions when I performed oral sex, on his shaft, tip, or balls, and I did look for a while. 

This new partner, I did not ask about his STI status because he's going to say "we used a condom, everythings fine" but he gets checked regularly. 

I just wanted to know my risk, or percentage of getting HSV2, based on the condom slipping, if he HAS HSV2, for whatever reason. I feel like I'm in this dark place again based on my last partner.

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Terri Warren, RN, Nurse Practitioner
35 months ago
It sounds to me like the condom slipped when he withdrew to change places so I don't see a risk there.

Terri
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