Do I have herpes or not?

[veryfrustrated]

Hi.

I dated someone from January-May of this year.  We had a very bad breakup, and I slept with my ex-boyfriend after the breakup.  Then, I started sleeping with the very bad breakup person shortly after, for about a period of a month.  I, then started dating someone new, and came clean to the ex about sleeping with the other ex about a week or two into the new relationship.  He told my new boyfriend that I gave him herpes, and my new boyfriend broke up with me.

Naturally, I just thought my ex was angry about me finding someone new, or sleeping with my other ex-boyfriend, so I got tested, thinking I was negative, since I had shown no symptoms.  My test came back positive both for HSV-1 and HSV-2.  I got tested at Planned Parenthood.

I still haven't had an outbreak, now going into September.  I thought I was having an outbreak, when I noticed a discharge, so I went to Planned Parenthood, and they gave me a check-up.  They told me that I had been exposed to herpes through my ex-boyfriend (he actually had an outbreak, which is why he told my new boyfriend), but did not actually have it.

Now, I've gone through another break-up, because he is scared of getting herpes from me.  He said that even with a condom, he could get it, which is very frustrating for me, because I still haven't had an outbreak, and never have.  I think it's possible for me to have a cold sore on my mouth before, but I have never had one on my genitals!  And, I haven't noticed any cold sores of ANY sort since testing positive for herpes.

Will I ever be able to have sex again?  Why haven't I had any symptoms?  Is it possible to test positive, and then just be exposed, without actually having the disease?  Should I re-test?

I am very confused.  Any advice would help.

[H. Hunter Handsfield, M.D.]

First, you clearly are infected with both HSV-1 (as is most of the population) and HSV-2 (as is about a quarter of the population).  I can't begin to guess when or from whom you got HSV-2; your HSV-1 infection probably dates from childhood.  Once positive, always positive.  No, it is not possible to "just be exposed" but not be infected.

Second, anybody who would break up an otherwise promising relationship because of fear of herpes doesn't understand the disease and is immature, almost by definition.  You're probably better off with him gone.

Third, most people with positive tests for HSV-2 in fact have symptoms, although they may be mild.  Keep on the lookout for mild problems you might previously not have noticed or ignored, such as an itchy spot in the genital area or a minor sore that could have escaped notice.

Fourth, although you should inform potential partners of your infection, you can do a lot to protect them from infection. Use condoms; they are highly effective, if not perfect.  If possible, learn to recognize subtle symptoms and avoid sex if they are present. Finally, consider taking antiviral therapy, e.g. valacyclovir (Valtrex); it will further reduce the risk of transmission to a future partner.

You should seek out a health care provider who knows a lot about herpes.  Ask around; for example, even if you don't want to visit your local health department STD clinic on a regular basis, the providers there probably will be able to tell you which private provider(s) in your community are up to date on STDs in general and herpes in partiuclar.

Best wishes to you--  HHH, MD

[veryfrustrated]

Also, the discharge was a yeast infection.  Planned Parenthood said I would be fine as long as I used condoms, and took Valtrex.

[chrisaf4]

Veryfrustrated

[veryfrustrated]

Thank you so much for your response!

This is probably a silly question, but is there any way to word it so I don't scare people off?  I am using Valtrex, and I do tell my partners to use condoms, as well as I tested positive for HSV-1 and HSV-2.  The most recent break-up occurred because my boyfriend said I could transmit it through my skin, even with him wearing a condom.  Should he have been scared enough to discontinue sex with me completely?  What are the chances of getting it when the infected uses both Valtrex, and the sex partner uses condoms?

[H. Hunter Handsfield, M.D.]

That's a great question and an important one--but I'm an STD expert, not a relationship expert!  It's very individualized, depends a lot on the nature of the relationship, and raises sticky ethical issues.  For a casual partnership, especially only a one-nighter, some would argue you have no obligation to inform your partner at all, as long as you avoid sex with symptoms and take the other precautions you are following, because under those circumstances the risk of transmission during any single exposure is extremely low.  Others will disagree strongly with this.

The best resource to start with is the American Social Health Association (www.ashastd.com).  Among other things, they have a herpes help telephone line where counselors can deal with exactly that sort of issue.

Best wishes--  HHH, MD

[veryfrustrated]

Thanks.

As an STD expert, do you happen to know how high the risk is of transmitting it through the skin, if the sex partner uses condoms, and I use Valtrex?  I told him the risk was low, but I don't actually know that, and I think he might feel better if he knew it was low.

I will check that website out.  Thank you for all your help!

[gracefromHHP]

On average if all you do is avoid sex whenever you have an ob the transmission rate to a male is about 4%.  If you take valtrex suppressively it cuts that in half. All this along with consistant condom useage the risk of transmitting the virus to a male partner would be around 1% each year. Pretty darn reasonable don't you think?

I highly recommend the herpes handbook at www.westoverheights.com. It's a terrific resource to learn more about herpes, treatments, how to reduce the chances of infecting a partner and how to talk about your herpes is a potential partner.  There are also many support groups out there on the web and in person.  www.yoshi2me.com has a list ( and a link to picking up the pieces ) and also www.racoon.com/herpes is a link to the herpes home page ( HHP ).

[veryfrustrated]

Thank you for that comment.  I looked at that Herpes Handbook, and validated that information.  Even if the most recent guy won't get back together with me, I'm sure those facts will help me with future partners.