I always always go back to the contact that is worrying people – what kind of exposure, for how long, with or without condoms, professional sex worker or not, country they live in if possible. So there is nothing in your contact with the escort that worries me even a little bit. Zero. Fast forward to the exam you had cone that resulted in a visual diagnosis of HSV. You’re correct – even among experienced STI clinicians, the diagnosis by exam only is wrong 20% of the time. You had a foreskin and the environment underneath it, and I would be that the number increases because of things like fungi that grow there and can cause skin ulcerations. Also,your symptoms did not appear until 2 months later? That’s way late, way way, late, for a new herpes outbreak due to a specific encounter.
The screening test for HSV 2 (the main concern with intercourse with a sex worker without receiving oral sex, vs. HSV 1) is quite good and I think you can be comfortable with that. But the HSV 1 is not as good, that’s right. Did you receive oral sex from her? If not, then I”m not very concerned about HSV 1. Plus you could definitely have it from your wife and her medical history. So even if the test misses1-2 out of 10, does that really matter in your particular situation?
Terri