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Ambiguity regarding Herpes / What to inform future partners?
Dear Doctor,
I had an encounter with a CSW (protected intercourse, unprotected oral) in summer 2012. Lots of anxiety and guilt after that. All tests negative. Finally dealt with anxiety & guilt issues with counseling, not a problem anymore. You can find my old posts to Dr Handsfield and Terri. Short version: multiple IGG tests after encounter up to 5months, all negative. Stopped testing at that point.
Then end of Feb 2013 had two red patches of skin, slightly swollen on my penis shaft. Had masturbated the night before they appeared. Went to show them to a doctor and told of my herpes scare of the past. Doctor's opinion was "that definitely looks suspicious". I told him about my multiple negative IGG tests, he said could still be herpes as the tests are not accurate. I asked him to order a PCR. He said we can do a PCR but because your lesions are dry, it is unlikely we will get a good sample. From what I've read is that for PCR there doesn't need to be fluids. Anyway, went to the lab and the lab nurse's comment was "this is not herpes" but we did the swab tests anyway. Vigorous swabbing and the skin on my penis broke and I had slight bleeding. Came up negative. Doctor says on the phone that I have 50/50 chance of having herpes, based on visual. He was surprised though as I never had pain and the lesions (which were maybe few mm in diameter) disappeared in a matter of 2-3 days.
I told my wife at this point and she did not believe I had herpes or if I did, was willing to accept the risks. We continued to have unprotected sex after that. She has had no symptoms. We recently agreed to allow each other extra-marital sexual experiences and I've been having sex with a single partner outside of my marriage, using condom. Now my extra partner wants to start using other form of contraceptive but I am puzzled what I should tell her about my herpes status. I do not want to infect her with herpes.
I had an encounter with a CSW (protected intercourse, unprotected oral) in summer 2012. Lots of anxiety and guilt after that. All tests negative. Finally dealt with anxiety & guilt issues with counseling, not a problem anymore. You can find my old posts to Dr Handsfield and Terri. Short version: multiple IGG tests after encounter up to 5months, all negative. Stopped testing at that point.
Then end of Feb 2013 had two red patches of skin, slightly swollen on my penis shaft. Had masturbated the night before they appeared. Went to show them to a doctor and told of my herpes scare of the past. Doctor's opinion was "that definitely looks suspicious". I told him about my multiple negative IGG tests, he said could still be herpes as the tests are not accurate. I asked him to order a PCR. He said we can do a PCR but because your lesions are dry, it is unlikely we will get a good sample. From what I've read is that for PCR there doesn't need to be fluids. Anyway, went to the lab and the lab nurse's comment was "this is not herpes" but we did the swab tests anyway. Vigorous swabbing and the skin on my penis broke and I had slight bleeding. Came up negative. Doctor says on the phone that I have 50/50 chance of having herpes, based on visual. He was surprised though as I never had pain and the lesions (which were maybe few mm in diameter) disappeared in a matter of 2-3 days.
I told my wife at this point and she did not believe I had herpes or if I did, was willing to accept the risks. We continued to have unprotected sex after that. She has had no symptoms. We recently agreed to allow each other extra-marital sexual experiences and I've been having sex with a single partner outside of my marriage, using condom. Now my extra partner wants to start using other form of contraceptive but I am puzzled what I should tell her about my herpes status. I do not want to infect her with herpes.
I will go forward with my original plan which is to let her know I had a herpes scare last year but after extensive testing there is no proof that I'm infected. I will tell her that there is a minuscule chance that I am infected with HSV-1 genitally and let her act based on the information I've given her.
I want to make it clear that the reason I didn't tell her yet is because I simply forgot about the whole ordeal. My counselor told me to move on and I did not even think about the matter anymore. It was only when my new partner started discussing the condoms that it came back to me.
One important thing also is to check her HSV-1 status, many people have it orally. If she has it orally it even further reduces any risk of potential transmission.
Regarding further testing: I see little point because when I had the PCR done the lesions were very fresh, so in my opinion the test should have picked up HSV-1 if it was the cause of them. I will only seek further tests if I ever get a "classic" symptom or severe symptoms.
Thanks for your helpful answers doc!
I want to make it clear that the reason I didn't tell her yet is because I simply forgot about the whole ordeal. My counselor told me to move on and I did not even think about the matter anymore. It was only when my new partner started discussing the condoms that it came back to me.
One important thing also is to check her HSV-1 status, many people have it orally. If she has it orally it even further reduces any risk of potential transmission.
Regarding further testing: I see little point because when I had the PCR done the lesions were very fresh, so in my opinion the test should have picked up HSV-1 if it was the cause of them. I will only seek further tests if I ever get a "classic" symptom or severe symptoms.
Thanks for your helpful answers doc!
MEDICAL PROFESSIONAL
Thanks for the clarification; I missed the details of the exposure you were concerned about.
Genital herpes due to HSV-1 rarely recurs and is infrequently transmitted by intercourse, so even if you are infected -- which I continue to strongly doubt -- there is little risk to either partner.
Genital herpes due to HSV-1 rarely recurs and is infrequently transmitted by intercourse, so even if you are infected -- which I continue to strongly doubt -- there is little risk to either partner.
Thanks Doc,
One correction. I was worried of HSV-1, never HSV-2. Due to the nature of my exposure.
One correction. I was worried of HSV-1, never HSV-2. Due to the nature of my exposure.
MEDICAL PROFESSIONAL
Welcome back to the forum.
I respectfully disagree with your doctor. As of your most recent activity on MedHelp (last September), the evidence was definite that you did not have genital herpes and were not infected with HSV-2. Visual inspection of genital rashes or lesions is highly unreliable; research has shown that even the world's best herpes experts are often wrong. The lab tests are more reliable. And despite your doctor's statement that your new penile rash looked "suspicious" and his "50:50" estimation of herpes, I still consider the lab results as much more reliable. I would also point out that the large majority of genital skin rashes, even recurrent ones, are not herpes.
So I agree with your wife's judgment. She is obviously willing to take the small risk that you actually have herpes and of catching it herself if you do.
As for your extramarital partner, from a medical standpoint, it can be argued you need not mention your possible HSV-2, since it is unlikely you have it. However, from an ethical perspective, since you are concerned you may be infected, in my opinion you are obligated to tell her about it. If you have it, even consistent condom use cannot guarantee that you will not infect her -- and you need to tell her that too. (In other words, the form of contraception you use makes no difference in what you should say to your partner.) Then let her make a decision about what your sexual practices together should be.
In summary, I remain confident you don't have genital herpes, but of course cannot guarantee it. If you ever develop a new, more typical genital lesion, you might immediately (within 28 hours) have another PCR test. In the meantime, you'll have to make a judgment about informing your extramarital partner -- whether to 'fess up your fear and your doctor's "50:50" judgment, or to accept the strong scientific evidence you dont' have HSV-2 and go forward on that assumption.
Good luck with it-- HHH, MD
I respectfully disagree with your doctor. As of your most recent activity on MedHelp (last September), the evidence was definite that you did not have genital herpes and were not infected with HSV-2. Visual inspection of genital rashes or lesions is highly unreliable; research has shown that even the world's best herpes experts are often wrong. The lab tests are more reliable. And despite your doctor's statement that your new penile rash looked "suspicious" and his "50:50" estimation of herpes, I still consider the lab results as much more reliable. I would also point out that the large majority of genital skin rashes, even recurrent ones, are not herpes.
So I agree with your wife's judgment. She is obviously willing to take the small risk that you actually have herpes and of catching it herself if you do.
As for your extramarital partner, from a medical standpoint, it can be argued you need not mention your possible HSV-2, since it is unlikely you have it. However, from an ethical perspective, since you are concerned you may be infected, in my opinion you are obligated to tell her about it. If you have it, even consistent condom use cannot guarantee that you will not infect her -- and you need to tell her that too. (In other words, the form of contraception you use makes no difference in what you should say to your partner.) Then let her make a decision about what your sexual practices together should be.
In summary, I remain confident you don't have genital herpes, but of course cannot guarantee it. If you ever develop a new, more typical genital lesion, you might immediately (within 28 hours) have another PCR test. In the meantime, you'll have to make a judgment about informing your extramarital partner -- whether to 'fess up your fear and your doctor's "50:50" judgment, or to accept the strong scientific evidence you dont' have HSV-2 and go forward on that assumption.
Good luck with it-- HHH, MD
You are reading content posted in the STDs Forum
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.
