Your follow-up question should have been posted here. I deleted the new thread. The forum can accommodate far fewer questions than the number of attempts each day, so unnecessary ones block people with new questions.
Your test result proves you don't have HSV-2. "Titer" technically does not apply to the HSV ELISA test you had. The lab is incorrectly using "titer" to mean the strength of the test result. That number actually is an ELISA ratio, also known as the optical density ratio, not a titer. Your ELISA ratio ("titer") is below the level that indicates the presence of HSV-2 antibody.
Don't confuse what most forum users versus the medical professionals say about herpes. If you pay attention only to the comments from me or Dr. Hook (also gracefromhpp and monkeyflower, two forum regulars who understand herpes well), you won't find any disagreement on the points you raise.
If you can't find a personal health care provider who seems knowledgeable about herpes, call the American Social Health Association's Herpes Resource Center for expert personalized advice; see www.ashastd.org.
risk of getting herpes (HSV-2) low, risk of false positive results in testing, risk of false-neg results in testing, you can transfer HSV-1 to the genitals, you can't transfer HSV-1 to the genitals
yes I know I need to talk to a doctor to get straight answers and I'm trying
Everytime I read a thread I get more confused! Who is right?
I just wanted to 2nd what HHH already told you - it was fairly low risk being with this gal. Peace of mind can be invaluable though so why not get yourself a herpes blood test for hsv2 ( since you already know you have hsv1 ) just so you can stop worrying about it? You will always be more likely to contract hsv2 from someone who doesn't know that they have it than from someone who is aware of their infection but it's tough convincing your head of that sometimes. Someone who's aware that they are infected will most likely abstain from sex during obvious genital symptoms to help lower your risk - someone who isn't aware that they are infected isn't going to be so careful.
grace
Yes, there is a possibility of a false positive result for HSV-2 in people with HSV-1. But it's not a high risk.
Thanks for your prompt reply; much appreciated. One quick follow-up:
1) Given my HSV-1 status, is there a potential risk for a false-positive result? I'm thinking I won't pursue any testing at this point given the absence of any symptoms and the very low risk of transmision in that relationship. I was just curious. I'm now convinced this is simply a case of anxiety and I need to let it go.
Thanks again, Dr. Handsfeld.
Happy to help. Directly to your questions:
1) I don't think I ever said condoms are 100% protective against herpes; they are not. But still your risk for herpes from that relationship is extremely low. Even when condoms aren't used, when couples in which one person has HSV-2 and the other does not, who have unprotected vaginal sex 2-3 times per week, transmission occurs in only 5% (1 in 20) couples each year. Obviously the risk for any particular event is low.
2) I agree you don't need HSV testing. Since 20-25% of the population has HSV-2, you could be infected regardless of this relationship--and that includes people like you who previously were monogamous. In other words, if you were to have a positive result, you would not know when and where you caught it.
3) Although you don't need testing from a strict risk assessment perspective, most people in your situation probably will remain anxious about the possibility until they have a negative test result. If that applies to you, it's probably worth getting tested so you don't lie awake worrrying about it. Your choice.
Regards-- HHH, MD