February 19, 2015 at 10:15 pm #5090
Hello Terri! My husband and I had been monogamous for 19 years before deciding last summer to open up our marriage. (We also have become active members of our local kink community.)
After about 6 months of openness, we decided to have full STI panels performed. While my HSV-2 test was negative, his came back positive with a 2.91 index. He has never to his knowledge experienced symptoms of an outbreak. We have not used condoms for intercourse for the majority of our marriage.
We are now trying to find a doctor who will order a Western Blot test for him to be performed at Quest Diagnostics.
While we work on this, we have questions about the accuracy of information we are passing on to our other sexual partners.
Based on our own research, we have concluded his HSV-2 test result was most likely either 1. A false positive or 2. An infection he has had since before we were married. Our reason for suspecting an old infection is he has not yet had intercourse with any partners outside of our marriage, and it’s our understanding oral transmission of HSV-2 is rare. He has has performed oral sex on one outside partner and received it from about four others (not including myself).
I HAVE had intercourse with other partners, always with a condom. We assessed risks and made a decision not to use barriers for oral sex. (We do communicate with our outside partners about when they were last tested.)
Is it accurate for us to say viral shedding would be uncommon to rare for an asymptomatic HSV-2 infection? Or have I just been extremely lucky not to contract the virus? Should we assume it is likely his positive result will be confirmed, since the index is close to 3? And should we consider suppressive therapy despite his lack of symptoms? Will a doctor even prescribe it for an asymptomatic person?
We are basically trying to figure out what risk we have exposed our outside partners to at this point, whether we should advise them to get tested, and whether we are giving them accurate information about how likely it is for this test to be a false positive.
February 19, 2015 at 10:21 pm #5091
I forgot to mention we both tested negative for HSV-1.
February 20, 2015 at 12:06 am #5094
He definitely needs a western blot. There is no other clarification that is going to help you at this point. Until the western blot is done and he knows his herpes status for certain, I would hesitate to address this issue with outside partners or have sex with them. At his value, there is a 60% chance he is positive and a 40% chance it is a false positive.
I don’t think it is correct that asymptomatic shedding is rare in a asymptomatic person. It is possible to be a couple of years and not transmit virus, but I’m also thinking, because you are negative, that this may well be a false positive.
The risks of acquiring HSV 2 from the oral sex encounters that you describe is quite low.
Our clinic can order the western blot for you at a Quest lab near where you live, if that is what you need.
February 20, 2015 at 12:15 am #5095
Thank you for your quick response. Can he call your clinic directly to get the Western Blot ordered?
Also, what about future suppressive therapy should he need it? I would guess the best protocol for us going forward would be to continue using condoms with outside partners & for him to take antivirals? If I continue to have unprotected intercourse with him, should I also go on antivirals?
February 20, 2015 at 12:22 am #5096
If he turns out to be truly positive, then he is the one that should be on antiviral therapy. He needs to know that is not a perfect solution to viral shedding – he will still shed some. You would not take the medicine, that doesn’t help.
Yes, he can just call the clinic and set up an appointment for a consultation and we will get the test ordered. The cost is $250 for the consultation and test fee and that can be paid with a credit card at the time of the consultation.
February 20, 2015 at 12:29 am #5097
My last question: Are there percentages on how often HSV-2 is shed? I read in one article it was up to 10% of days for a year post infection, and less frequently after that.
Your answers have been so helpful. Thank you!
February 20, 2015 at 12:36 am #5098
The average indicates 13% of days – so 13 days out of 100. With daily therapy, that is cut in half.
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