Should I test following possible HSV-2 exposure?

[aspen5433]

I had a previous partner tell me they tested positive for genital HSV-2 (lesions swabbed). We last had sex 10 weeks ago and they tested positive around 1 month after we were last together. They may have had other partners. We had unprotected sex once about 4 months ago, otherwise only protected sex.
I have not shown any apparent symptoms or herpes lesions and do not think I have in the past. I have felt fine.

I reached out to my telemed doc and they recommended I get tested. I reached out to Planned Parenthood to set up the test and they told me I should not get tested as I have no symptoms and that the risk of transmission was low if they did not have lesions when we had sex. (I don’t have a primary care doctor, I just moved and they are all booked)

Should I take an IgG HSV-2 test at the 12 week mark or should I follow Planned Parenthood’s advice and not test? I also don’t know if it would be better to just go for a Western Blot test immediately for a more accurate result rather than IgG.

Thank you for your help and resources.

[Terri Warren]

Your call. As you’ve seen, false positives are possible with the IgG test which is why is not recommended routinely. With a single unprotected encounter, transmission is statistically unlikely.

If you really want to know and don’t want to risk a false positive, you could start with the blot, yes. Or you could start with the IgG and if you get a low positive, less than 5, you could do the blot at that time.

Can you live with not doing anything here?

Terri

[aspen5433]

Hi Terri,

Thank you for your thoughts. In terms of herpes epidemiology and social implications would not getting tested be unethical? This is a hard decision to make and I understand the very personal nature, but as a provider do you guide your patients a certain way? (from a personal and public health standpoint)?

There is so much conflicting information out there and I understand it is not a straightforward answer, I would feel bad in a scenario where I didnt test, was positive, and passed it unknowingly to a future partner and they were symptomatic. But of course the main thing weighing on me is potential disclosure of HSV-2 as someone who is asymptomatic and still searching for a monogamous relationship and facing possible rejection for it (not necessarily the health outcomes which is minimal).

Thank you for your time and perspective.

[Terri Warren]

If we had better and easier to access tests, I would say yes, do it. But we don’t.
The best we can do in your situation is for you to do one of a few things:
1) do an IgG test and if in a low positive range, do the western blot.
2) start with the western blot which is probably going to cost you around $400 or a little more.
Because 80% of people with HSV 2 don’t know they are infected, I would of course like to see all sexually active people tested for HSV 2 but our testing situation just isn’t there right now for the majority of people.

Terri

[Author]

Posts