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Long-winded question about testing and antivirals
I'm a gay dude who probably has herpes. The diagnosis is still new (got the results back earlier this month), so I'm vacillating between anger, shame, acceptance, and cautious optimism.
They initially did a culture swab and the test came back negative. Lessions (I'm assuming that's what they were, kind of sucked because I couldn't see them myself, let's call it taint herpes) were relatively new. They put me on the 5x5 trial for Acacylovir and the lessons eventually cleared up. I got an IgM blood test a few weeks later because my paranoid *** just had to know. Results came back 2.85, but as you guys know, could not distinguish between HSV-1/2.
Now, that sucked, but I had done so much research I didn't trip off it too badly. They put me on Valtrex which I took for about 2.5 weeks. Currently off it because I want to see how my body reacts to the virus. Nothing yet but again, the diagnosis is still new.
So I have some questions:
1. Is there any possibility the IgM could've been a false positive? I think between 1 and 3.5 is worth a retest, or at least wait for an IgG, but I might just be in denial. Also, doesn't a positive IgM indicate you're a carrier for one of the herpes viruses? The diction confuses me, "exposed" vs. "infected," I figure if the results come back with a number you have it regardless, but then human error and lesser strains of herpes might be a factor.
2. What is ya'll opinions on an IgM blood test? I understand it's not held in too high regard. I think they can be useful for determining if you HAVE herpes at all, but the lack of distinction can be troubling, especially if, say, you have HSV-1 on your genitals, which I think presents a lower transmission rate than HSV-2. I do understand the lack of distinction can cause people to loose sleep and undue stress, but I don't think they're useless in the sense they don't tell you something relevant.
3. Is there ANY data for transmission rates among gay men with herpes? I guess what I'm really asking is, is anal sex somehow less transmittable then vaginal sex? Given that it's skin to skin contact I'm assuming no, but I figure I'd ask. To my knowledge there isn't any data for this coupling, same with lesbians, which would make for very interesting research and would probably help to further educate communities.
4. Should I continue the Valtrex? The long term effects likely ruin your liver from what I've read, but would taking it every day now have an effect on the virus for the course of my life time? Like, would suppressing it in the acute stage of infection help suppress it for life. Or should I let my body strengthen itself against herpes? So many people have such variegated reactions that I wonder if there's a "wrong" way to handle this.
5. As far as shedding reduction go (everyone's favorite aspect), does every day matter vs. times you feel you're about to have sex/oncoming outbreak? Like if I made plans to have sex, I'd begin taking Valtrex prior to the date. Is that an effective (as effective as one can be against herpes) strategy?
6. And of course: Is there even a remote chance I don't have herpes? The experience has opened my eyes to a very misunderstood infection and for that I'm grateful but still would prefer to be herpes free.
After reading all this, what would you do in my shoes?
Herpes is like HIV's punk little sibling, not fatal overall (I understand herpes can result in some scary complications but these seem few and far between), but so damn transmittable. On one hand, I wish I never got the blood test to confirm, on the other, at least now I can't transmit it.
They initially did a culture swab and the test came back negative. Lessions (I'm assuming that's what they were, kind of sucked because I couldn't see them myself, let's call it taint herpes) were relatively new. They put me on the 5x5 trial for Acacylovir and the lessons eventually cleared up. I got an IgM blood test a few weeks later because my paranoid *** just had to know. Results came back 2.85, but as you guys know, could not distinguish between HSV-1/2.
Now, that sucked, but I had done so much research I didn't trip off it too badly. They put me on Valtrex which I took for about 2.5 weeks. Currently off it because I want to see how my body reacts to the virus. Nothing yet but again, the diagnosis is still new.
So I have some questions:
1. Is there any possibility the IgM could've been a false positive? I think between 1 and 3.5 is worth a retest, or at least wait for an IgG, but I might just be in denial. Also, doesn't a positive IgM indicate you're a carrier for one of the herpes viruses? The diction confuses me, "exposed" vs. "infected," I figure if the results come back with a number you have it regardless, but then human error and lesser strains of herpes might be a factor.
2. What is ya'll opinions on an IgM blood test? I understand it's not held in too high regard. I think they can be useful for determining if you HAVE herpes at all, but the lack of distinction can be troubling, especially if, say, you have HSV-1 on your genitals, which I think presents a lower transmission rate than HSV-2. I do understand the lack of distinction can cause people to loose sleep and undue stress, but I don't think they're useless in the sense they don't tell you something relevant.
3. Is there ANY data for transmission rates among gay men with herpes? I guess what I'm really asking is, is anal sex somehow less transmittable then vaginal sex? Given that it's skin to skin contact I'm assuming no, but I figure I'd ask. To my knowledge there isn't any data for this coupling, same with lesbians, which would make for very interesting research and would probably help to further educate communities.
4. Should I continue the Valtrex? The long term effects likely ruin your liver from what I've read, but would taking it every day now have an effect on the virus for the course of my life time? Like, would suppressing it in the acute stage of infection help suppress it for life. Or should I let my body strengthen itself against herpes? So many people have such variegated reactions that I wonder if there's a "wrong" way to handle this.
5. As far as shedding reduction go (everyone's favorite aspect), does every day matter vs. times you feel you're about to have sex/oncoming outbreak? Like if I made plans to have sex, I'd begin taking Valtrex prior to the date. Is that an effective (as effective as one can be against herpes) strategy?
6. And of course: Is there even a remote chance I don't have herpes? The experience has opened my eyes to a very misunderstood infection and for that I'm grateful but still would prefer to be herpes free.
After reading all this, what would you do in my shoes?
Herpes is like HIV's punk little sibling, not fatal overall (I understand herpes can result in some scary complications but these seem few and far between), but so damn transmittable. On one hand, I wish I never got the blood test to confirm, on the other, at least now I can't transmit it.
For some people Herpes is NOT a big deal, a minor skin condition, treatable with medication, and then of course there are people who never get OBs, and those who walk around unaware they even have the virus.
Then there are the unfortunate few (out of an unfortunate few who experience symptoms) for who herpes is a debilitating disease, resulting in neurological complications and conditions such as Meningitis, MS, nerve pain, etc. These are not necessarily isolated incidents, enough posters on here seem to suffer frequently, almost perpetually.
I've been stewing over this a lot. The CDC doesn't recommend herpes as part of routine STD testing due to its prevelancy and stigma. Their very philosophy contributes to the spread of this virus. I wonder if making more noise would ever cause them to change their classification of herpes, if it would contribute to more aggressive research so we may find vaccines or functional cures (which I'd be more than happy with). Educating people without herpes on herpes is massively difficult. Besides the myriad of research on it (some which presents different figures), the symptoms are so variegated from person to person that it seems impossible to assess. Generally, I'd say people with herpes don't experience the symptoms too often, but there are always the extreme cases that I'd tell people to watch out for.
Basically, it's like I want to tell people herpes is no big deal so I can still have intimate relationships, but I don't want to discredit those who truly, truly suffer from it. How do we de-stigmatize this without isolating ourselves? I WANT people to be more educated on herpes, but I don't want to scare them.
What really got me thinking about this was how a user stated they'd rather have HIV. From a purely sexual standpoint, I agree, with medication and PrEP it seems far less transmittable than herpes. Healthwise, though, I'm not so sure.
Then there are the unfortunate few (out of an unfortunate few who experience symptoms) for who herpes is a debilitating disease, resulting in neurological complications and conditions such as Meningitis, MS, nerve pain, etc. These are not necessarily isolated incidents, enough posters on here seem to suffer frequently, almost perpetually.
I've been stewing over this a lot. The CDC doesn't recommend herpes as part of routine STD testing due to its prevelancy and stigma. Their very philosophy contributes to the spread of this virus. I wonder if making more noise would ever cause them to change their classification of herpes, if it would contribute to more aggressive research so we may find vaccines or functional cures (which I'd be more than happy with). Educating people without herpes on herpes is massively difficult. Besides the myriad of research on it (some which presents different figures), the symptoms are so variegated from person to person that it seems impossible to assess. Generally, I'd say people with herpes don't experience the symptoms too often, but there are always the extreme cases that I'd tell people to watch out for.
Basically, it's like I want to tell people herpes is no big deal so I can still have intimate relationships, but I don't want to discredit those who truly, truly suffer from it. How do we de-stigmatize this without isolating ourselves? I WANT people to be more educated on herpes, but I don't want to scare them.
What really got me thinking about this was how a user stated they'd rather have HIV. From a purely sexual standpoint, I agree, with medication and PrEP it seems far less transmittable than herpes. Healthwise, though, I'm not so sure.
It's tougher as a gay dude, you're only as useful to other gay men as your *** is tight. I can't meet anybody now. The anecdote is encouraging though.
Shedding can happen for as little as a few hours. Shedding also differs from person to person. I participated in a shedding study a few years ago and a few of us compared our results and it was really interesting. I was the one with the most recurrences historically and I shed the least. we only swabbed once a day so we didn't capture any short shedding periods like the folks who did the 4x/day shedding studies did but they were still really interesting to look at. Of course we also learned that if your dog eats the transport medium, it's ok...lol ( yes, one of my dogs ate a vial)
I used to have 20 recurrences a year when I wasn't on suppressive therapy. I am now down to 2-3 without it. I have only transmitted the virus twice in the almost 30 years I've had hsv2 - once before I knew I had it and once when I was an idiot. Once I got on daily suppressive therapy it protected my partners as well as enabled me to have a normal sex life. think about it - what are the odds that you'd have sex with a partner when you were shedding a short period of time without an obvious recurrence? Really, really low. How often the virus is shedding is actually different from how likely you are to transmit it. Transmission rates are low if you know you are infected and if you are able to recognize recurrences. The idea of having it, now that's the real issue since unfortunately we aren't taught how common it is and how easy it is to reduce the risk to a partner.
I used to have 20 recurrences a year when I wasn't on suppressive therapy. I am now down to 2-3 without it. I have only transmitted the virus twice in the almost 30 years I've had hsv2 - once before I knew I had it and once when I was an idiot. Once I got on daily suppressive therapy it protected my partners as well as enabled me to have a normal sex life. think about it - what are the odds that you'd have sex with a partner when you were shedding a short period of time without an obvious recurrence? Really, really low. How often the virus is shedding is actually different from how likely you are to transmit it. Transmission rates are low if you know you are infected and if you are able to recognize recurrences. The idea of having it, now that's the real issue since unfortunately we aren't taught how common it is and how easy it is to reduce the risk to a partner.
Thanks for the words grace! Shedding just sucks because it can happen for only a few hours day to day. I wish they included in studies the time frame for shedding, like if it's consistent with the hours it's been shedding from
why would your sex life be ruined? It's just herpes dear!! the idea of living with it is far worse than actually living with it. Daily suppressive therapy reduces recurrences as well as significantly reduces viral shedding to greatly decrease the risk of transmission to a partner. I've actually had more men not want to date me because I work night shift and have big dogs than I have had turn me down for my herpes ( and trust me, I'm no special beauty! )
Ob's do differ from person to person. Over time, it gets easier to know what is likely an ob and what isn't. Usually they are more open areas in the skin than bumps.
Ob's do differ from person to person. Over time, it gets easier to know what is likely an ob and what isn't. Usually they are more open areas in the skin than bumps.
Definitely aware of being more receptive to HIV. I'm on PrEP so with other mitigating practices the chances should be especially low to catch it.
Right now the taking Valtrex only when I'm about to have sex sounds like a good idea. One, aren't I most contagious right now if I do have HSV-2? Two, I'd feel more comfortable organizing my encounters anyway.
As for going off the med, I am interested to see how many ob's I end up getting. Correct me if I'm wrong: ob's can be anything from the actual lesions to a simple elevated bump, right? I ask this because the slightest itch right now makes me think of herpes, and the anus is so sensitive that so many things can affect the skin's texture.
And if I do have HSV-2, it'll mean I messed up, and my sex life, save for a few horndogs or especially considerate people, is essentially ruined.
Right now the taking Valtrex only when I'm about to have sex sounds like a good idea. One, aren't I most contagious right now if I do have HSV-2? Two, I'd feel more comfortable organizing my encounters anyway.
As for going off the med, I am interested to see how many ob's I end up getting. Correct me if I'm wrong: ob's can be anything from the actual lesions to a simple elevated bump, right? I ask this because the slightest itch right now makes me think of herpes, and the anus is so sensitive that so many things can affect the skin's texture.
And if I do have HSV-2, it'll mean I messed up, and my sex life, save for a few horndogs or especially considerate people, is essentially ruined.
you came to the right place :)
At this point, you will certainly need to follow up with more accurate testing to determine your status. Herpes igm testing has a high false positive rate and it's actually considered malpractice to diagnose based on a + igm alone. You should follow up 3 months after you last had sex with a type specific herpes igg blood test to know your full status.
assuming you do test + for hsv2, what does it mean for you? Well we don't have studies at this time on transmission rates between gay males. We assume that the rate of transmission is similar as for straight males but it could differ due to anal sex practices. Having hsv2 also increases your risk for contracting hiv too. In your best interest in the future to always have protected sexual contact with partners whose std status you aren't sure of. Keep in mind that most folks will say that they are std free and that they get tested- odds are they don't get the right testing nor do they get it at the right times so protect yourself! don't be naive.
Can you take daily suppressive therapy long term? You sure can! we have info on over 20 years of non-stop suppressive therapy use with acyclovir that show that there are no long term safety issues. there are not risks to your liver or kidney's from it either if you are otherwise healthy. (valtrex is an acyclovir prodrug and we assume safety is the same and so far it is in 10+ years of follow up with people using it long term suppressively)
Is it worthwhile to only take an antiviral when you know you are going to have sex? no it is not. It takes at least 5 days for it to start being effective so unless you have a regular partner that you know you will only see one weekend out of the month so you can take suppressives for 10 days a month, not a good strategy compared to just taking medication daily.
Is there such a thing as letting your body deal with the virus? Well, no. Studies have shown that folks are shedding the virus about the same amount whether they have 0 ob's a year or 10 ob's a year. the virus sheds regardless and unless you have a hsv2+ partner or only have recurrences that are rather mild infrequently, I always think from personal experience that it's worth suppressive therapy to control the virus. Why have more pain than you need to? why let the virus interrupt your sex life more than it has to? why worry about transmission more than you need to? I know I just don't have time to wait for a recurrence to heal, I'd rather have less of them! ( also I was on suppressive therapy for almost 20 years - still healthy!)
The rates of hsv1&2 are rather high in gay males. Even if you don't end up having hsv2, always good to inform yourself about them so that you can protect yourself in the future as well as be educated about protection to take with a future partner who discloses their status to you :)
keep asking questions!
grace
At this point, you will certainly need to follow up with more accurate testing to determine your status. Herpes igm testing has a high false positive rate and it's actually considered malpractice to diagnose based on a + igm alone. You should follow up 3 months after you last had sex with a type specific herpes igg blood test to know your full status.
assuming you do test + for hsv2, what does it mean for you? Well we don't have studies at this time on transmission rates between gay males. We assume that the rate of transmission is similar as for straight males but it could differ due to anal sex practices. Having hsv2 also increases your risk for contracting hiv too. In your best interest in the future to always have protected sexual contact with partners whose std status you aren't sure of. Keep in mind that most folks will say that they are std free and that they get tested- odds are they don't get the right testing nor do they get it at the right times so protect yourself! don't be naive.
Can you take daily suppressive therapy long term? You sure can! we have info on over 20 years of non-stop suppressive therapy use with acyclovir that show that there are no long term safety issues. there are not risks to your liver or kidney's from it either if you are otherwise healthy. (valtrex is an acyclovir prodrug and we assume safety is the same and so far it is in 10+ years of follow up with people using it long term suppressively)
Is it worthwhile to only take an antiviral when you know you are going to have sex? no it is not. It takes at least 5 days for it to start being effective so unless you have a regular partner that you know you will only see one weekend out of the month so you can take suppressives for 10 days a month, not a good strategy compared to just taking medication daily.
Is there such a thing as letting your body deal with the virus? Well, no. Studies have shown that folks are shedding the virus about the same amount whether they have 0 ob's a year or 10 ob's a year. the virus sheds regardless and unless you have a hsv2+ partner or only have recurrences that are rather mild infrequently, I always think from personal experience that it's worth suppressive therapy to control the virus. Why have more pain than you need to? why let the virus interrupt your sex life more than it has to? why worry about transmission more than you need to? I know I just don't have time to wait for a recurrence to heal, I'd rather have less of them! ( also I was on suppressive therapy for almost 20 years - still healthy!)
The rates of hsv1&2 are rather high in gay males. Even if you don't end up having hsv2, always good to inform yourself about them so that you can protect yourself in the future as well as be educated about protection to take with a future partner who discloses their status to you :)
keep asking questions!
grace
Hi and welcome.Regard to all of your questions, we dont use igM for many reasons including false positive issues. And at the your value also surely false into the false positive range as any number less then 3.5 would be considered.
Low positive like yours indicate a false positive, recent infection or testing to early.
Testing for confirmation would be at the 3 months mark post exposure.
So do retest and come back with your results.
dave
Low positive like yours indicate a false positive, recent infection or testing to early.
Testing for confirmation would be at the 3 months mark post exposure.
So do retest and come back with your results.
dave
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
