Hi Dr. Handsfield,
I got tested at 7.5 week mark since last contact. I got the IgG done and I just got the results. I was negative for hsv-2 (<0.9) and positive for hsv-1 (4.3).
I just spoke to my ex-partner. She said that she never had a formal test done to determine which hsv she has; it was just a visual diagnosis because tests were expensive back then. She seems sure that it was hsv-2 because of the fact that it was pretty severe initially and she had multiple outbreaks per year for the first few years.
I don't quite remember having oral hsv symptoms. I'm pretty sure I don't have genital hsv-1 but I wanted to be fairly sure. What are transmission rates for genital-genital hsv-1? Is there any additional advice you can give me regarding testing or protecting my future partners?
IgG is the only test to have. Do not have an IgM test, which websites (and many unaware doctors) often recommend as an indicator of recent versus older infection -- but gives many false positive results and doesn't accurate distinguish between old and new infection anyway.
Thanks so much for your response Dr. Handsfield.
I do not anticipate many new sexual partners before 3 months but this new relationship is an open one so I might have more than one sexual partner in this time period.
I will get tested soon for additional reassurance like you mentioned. Is the IgG blood test the most reliable one? Thanks again.
Welcome back. I'll go directly to your questions.
1) In the other thread, we discussed your very low risk of infection. That hasn't changed. I agree it's a god idea for you to be tested, but in the absence do symptoms, it's very unlikely. And you can be tested before 3 months for additional reassurance. Although it can take that long for a new infection to be detected, around 80% have positive results by 6-8 weeks, so a negative result now should be helpful.
2) You obviously have absolutely no obligation to inform future partners of STD exposures that did not result in infection. Any "obligation" when the issue is slightly uncertain is up to you. All things considered, I would judge the chance you caught HSV-2 for your previous partner to be under one chance in tens of thousands, maybe less than 1 in 100,000. If I were in that situation, I doubt I would say anything to new partners. But since you're obviously nervous about it, and have already made such a disclosure once, to be ethically consistent, you probably should continue to do so. OTOH, maybe this won't come up again. How many new partnerships do you anticipate until 3 months have passed and you have a definitive blood test?
Best regards-- HHH, MD