Just diagnosed

[desperatelyseeking]

My new partner has developed a bumpy like rash on the base of the head of his penis(he is not circumsized);He developed this condition about a week ago after us having been very very sexually active(with each other)during a weekend get away.He does not have any pain, discharge, or swelling and he had ruled it out as a simple rash but he did ask me if I had ever had any type of STD's. Of course, I responded by saying no but fearing the worse I decided to get tested.

Today, my Dr.confirmed that I have been exposed to herpes 1 & 2 and that I have heavy yeast growth.(all other tests came back negative)At this point I do not know what to do. The Dr. suggested that my partner get tested and that I go in for a more in depth analysis. In the interim, my Dr. has prescribed diflucan for both of us & a tpoical ointment for my BF (lotrimin)He suspects that my BF's condition may be something as simple as yeast/balantis but still wants to do some blood work for herpes. What if it turns out that he really only does have balantis? Is it really necessary that I tell him about my exposure to the herpes?  I have never had any symptoms and I live a very healthy lifestyle so finding out this information today was shocking to say the least.

What exactly does "exposed" mean?  Does this mean that I have it? Is there any cure or anything currently being tested as a possible cure?

I have been involved in this new relationship for about a month and I do not want to jeopordize my future with this individual.  
My Dr.keeps telling me that herpes is very common but somehow I do not think this will offer any sort of consolation to my new partner. My Doctor says that there are treatments to surpress the disease and that it is important that my BF get diagnosed so that we can move forward with a treatment.  Is there a chance that my BF does not have herpes even though I have been exposed to it?  If his testing comes back negative can I still infect him?

I am hysterical & overwhelmed with fear. Prior to my new relationship I was married for 6 years.We got seperated because I found that he had a very active sexual lifestyle with a variety of women across the country. I suspect that this is how I contracted the disease but I also understand that I cannot be 100% certain because testing does not reflect the amount of time or when the disease was contracted.  

Any suggestions and/or advice would be greatly appreciated.

[H. Hunter Handsfield, M.D.]

It would be helpful to know exactly what tests were done.  But you need to assume you are infected with both viruses, most likely HSV-2 in the genital area and HSV-1 oral.  The latter probably dates to childhood, although if you haven't had recurrent oral symptoms (cold sores), there is no way to know for sure.

There is no such thing as "exposed" but not infected.  A postive blood test indicates infection, period.  Your doctor either doesn't understand the tests very well (which is common); but more likely s/he was trying to soften the blow but using a less dramatic term. (But all this depends on having the right kind of test--which is why it would be helpful to know more details.)

As to whether your partner has herpes, I cannot tell from your description.  But it sounds like the doc is on top of things and will figure it out.  Whether or not he has it, you need to tell him about your infection.  Think about what your own feelings would be, right now, if you knew for sure your former husband knew he had herpes and didn't tell you.  Then put those thoughts into your new partner's head.  Common sense and a basic sense of compassion will tell you what to do.

As far as "hysterical and overwhelmed", that's a common reaction to a new diagnosis of genital herpes, but it's really not appropriate.  Most cases can be controlled, and transmission--if it hasn't yet happened--can be prevented pretty effectively.  Learn more about the disease.  Start with the article on herpes in the link STD Quick Facts and Articles on this forum's home page; also try CDC (www.cdc.gov/std), the American Social Health Association (www.ashastd.org), and the Westover Heights Clinic information (www.westoverheights.com).  You will be mostly reassured.

Herpes is a complex infection; both this brief reply and the initial reading you will do will probably only scratch the surface.  But it's a start.  Good luck--

HHH, MD

[yoy]

Slowdown.  First, if the test detected HSV-1 that is the virus the vast majority of us have becasue of cold sores.  It is not surprising that you have it.

HSV-2 is in about 25% of the population.  Many do not know they have it.  Some have such midl symptoms that never know it.  This may be you.

Your B/F may have HSV-1 already and HSV-2 as well, prior to you meeting him.  Who knows.  There are fancy test that may be able to show an accute infection- to show that he got it recently, but first he has to have it.  So let him get tested.

You and he should meet with someone knowledgeable about HSV so they can explain that you may have had no idea that you had HSV and that this is reasonable.  

So lets say he is neg.  Then you can continue to have a relationship that is open and work to not have him infected.  If he is positive, then you can work that out with open discussions about HSV.

Relax take this one step at a time.  Get the information you need to answer his questions and yours.  You will be fine.  For you HSV did not seem to cause great distress-you did not even know you had it.  HSV, if he has it, could be that mild for him as well.  

[nsns]

First of all, if you want to have a long term relationship with this guy and continue having unprotected sex with him, YOU MUST disclose the fact that you have herpes and let him make the decision of if he wants to take the risk or not. Just because you have it, and had sex with him does not mean he has caught it yet. I am going on 9 years with my girlfriend and I have HSV2 and she has yet to catch it from me and I get Ob's all the time if I am not taking Valtrex. Telling someone you have herpes is NOT EASY! But I can tell you from experience that once you get it off your chest it's not as bad as you are thinking. I have told my last two girlfriends and I thought for sure I would be dumped, they both looked at me and said is that all! After that they both incated unprotected sex with me. So you never know. It's not the end of the world you will go on and live a normal life. Good luck...

[desperatelyseeking]

Thank you. As you can imagine I feel like it is the end of the world & fear that he won't understand that I had absolutely no idea I was exposed to herpes. So does "exposed' mean that I am positive?

[who_is_this]

You need to find out what kind of herpes test you had.  See the various posts on this site for the types to get.  You don't want one that gives the answer in IgM, which some doctors may explain to you as being "exposed" in the past.  This result is meaningless, and many doctors don't understand it.  

One type of test is the HerpeSelect test.  Look in the archives here for more info while waiting for the doc to answer.

[monkeyflower]

I agree with whoisthis. You keep saying "exposed", which I think might signify an IgM test - which means this is NOT a conclusive or accurate diagnosis by any means. Read back a bit for more great info from Dr. Handsfield on this subject. In the meantime, I definitely think you should NOT tell your bf you have herpes until you clarify just what your doctor meant by "exposed". I personally think that your yeast infection could certainly explain both of your symptoms.

[desperatelyseeking]

Apparently "exposed" means that I have been sexually active with someone who has genital herpes however, somewhere along the line my body naturally created antibodies which have not allowed the virus to surface which would explain why I have never experienced any outbreaks or symptoms. Doc says that the chances of me transmitting HSV2 to my partner are slim to none. I'm still not sure if I should tell my BF or if I should wait until one or both of us has symptons. In the interim, we are both on diflucan for yeast.

[t1234]

FOr what it's worth, I'm 59, male, and seronegative for HSV2.
However in the last 10 years (since testing was available for
HSV2) most (90 per cent) of my sexual partners have tested positive for HSV2 although they, like you, were unaware they were infected. I know this sounds high, but remember at my age
most of the women I meet have been married and divorced at least
once and both they and their sexual partners (former husbands) have had multiple sexual partners.

So far, I've never got HSV2 from them, so the good news is if you're truly without symptoms I doubt you will transmitt it; and
your Doctor is probably right about the risk being low.

The F-M transmission rate is approximately 4 per cent with
unprotected sex when the infected partner has outbreaks.
The transmission rates for persons with no symptoms (like you) is unknown, but it has been established that the "shedding rate" is less.

Remember, if your BF did become Seropositive there is an 80
per cent change he wouldn't be aware of it as 80 per cent of the
persons who are infected have no symptoms.

The bad news is that you need to tell your partner.

It's too bad, since the vast majority of persons with HSV2 have no symptoms, the highest priority is not given to documenting
the transmission rates in such cases so we can make better informed decisions without having to just assume the "worst case."

[monkeyflower]

I'm curious about the obligation to tell her partner, since she doesn't even know if she had an accurate test. Doesn't saying she's been "exposed" sound vague enough to warrant a call to her gyn's office to ask for clarification first? Or does the fact that her gyn referred to both HSV1 and 2 imply that it was a HerpeSelect test? And apparently both she and her partner have yeast infections, which would explain their symptoms...

[H. Hunter Handsfield, M.D.]

Thanks.  I should have clarified that the "must tell" advice applies if/when the diagnosis of HSV-2 infection is confirmed.  Indeed, my entire reply applies if/when the diagnosis of herpes is confirmed. It seems highly likely, but desperatelyseeking should discuss the test and its interpretation with her doctor.

Desperately, let me confirm what I said before:  There is no such thing as exposed without being infected.  Your doctor is just plain wrong:  everybody with a positive test for HSV-2 has active infection that can be transmitted.  That risk declines with time, because both symptomatic outbreaks (in those with symptoms) and asymptomatic shedding of the virus become less and less frequent as the years pass.  But assuming you have been infected for less than 10 years, you need to assume you are capable of infecting any and all persons with whom you have sex.  (Again, this assumes your diagnosis is with a proper test with reliable results.)

HHH, MD

[desperatelyseeking]

Thank you to everyone for your support. The doc says that there is not much more he can do until I have an outbreak. Apparently when I was exposed to the virus my immune system created antibodies which have surpressed the virus and in turn have surpressed any outbreaks. Unless I have an active outbreak, the doc does not feel that it is necessary to do more testing. Again, I have never had an outbreak so again I ask myself, should I tell my new BF? What if I tell him I have been "exposed", he gets tested and his results are negative??? why should I risk the chance of him walking out??? Should I just wait for his results to come back? The possibility still exists that I could have contracted the virus from him, right? Neither of us has had any symptoms. The first time we were intimate was April 12th.  He claims he was tested for STD's in March and that everything came back negative. Is there a common STD test? Does it include a herpes test or is this a specific request?

It seems like the more I read about HSV-2 the more confused I become. Apparently more frequent than not, the virus is transmitted male to female. I also read that the chances of a female transmitting the disease is about 4%. I find it difficult to believe that a cure does not exist. Does anyone know of any drug that is in the process of being approved by the FDA? Is there any hope fo us?

[H. Hunter Handsfield, M.D.]

You still don't get it.  There are key facts about herpes you don't yet understand.  As I said in my initial response, this is typical--it's a complex disease.  But the things you are "learning" imply a lot of denial, that is, that the more unpleasant facts about herpes aren't sinking in.

For example, you write "Apparently when I was exposed to the virus my immune system created antibodies which have surpressed the virus and in turn have surpressed any outbreaks."  EVERYBODY develops antibodies when infected with herpes; that is not the reason you aren't noticing symptoms.  Most people with genital herpes don't notice symptoms; and all those people still can transmit the infection.  YOU ARE INFECTED. THE VIRUS IS PRESENT IN, ON OR AROUND YOUR GENITALS FROM TO TIME, AND WHEN IT IS THERE, YOU CAN INFECT A SEX PARTNER.  You must not tell him you were (only) "exposed", which is misleading.  Your obligation is to tell him you are infected and that there is a chance he could catch it from you, if he hasn't already.

Most routine STD testing doesn't include tests for herpes.  But apparently he has been tested recently and is awaiting his test result.  It is a good idea to wait for that result before you discuss your infection with him.  If he also is positive for HSV-2, then he cannot catch it again from you or anyone else, so it won't be an issue for you.  But if he is negative, you could infect him.

Continue your reading.  Even better, go to the ASHA website (www.ashastd.org) and find the herpes help phone line.  Call and talk to a counselor; it is an excellent service.  A single 30 minute conversation will save you 10 hours of learning about herpes on the web or in forums like this one.

And as suggested above by monkeyflower, all this assumes you had a proper test with reliable result.  You don't say whether or not you have checked that out with your provider.  If not, do it.

HHH, MD

[t1234]

If you had a reliable test such as Herpes Select and the IgG antibody for HSV2 is positive you have the virus. To paraphase, "the rest is silence."

The only constructive thing we can do is lobby for more funding
for research, and hopefully we can eventually find a vaccine that works.

Dr. Handsfield,  Sorry I mistyped your name in a previous post. My bad!

[monkeyflower]

"YOU ARE INFECTED. THE VIRUS IS PRESENT IN, ON OR AROUND YOUR GENITALS FROM TO TIME, AND WHEN IT IS THERE, YOU CAN INFECT A SEX PARTNER. You must not tell him you were (only) "exposed", which is misleading. Your obligation is to tell him you are infected and that there is a chance he could catch it from you, if he hasn't already."

Dr. Handsfield offers excellent info and advice as always. I have to say that your subsequent posts make me think that you probably do have herpes... but you need to know for sure. Then, you MUST tell your partner if you find out you do have herpes. If nothing else, do you really want a relationship built on lies and deception? And I hate to say this, but if your partner would leave you over a herpes infection, is this someone you really want to be with anyway? Even short term? Personally, I'm all about character and integrity, and I think if someone would leave you over something this small, even this early in a relationship, it speaks volumes about the kind of person you're dealing with. No one wants herpes, but at the same time I think of it as kind of the head cold of STDs - sometimes annoying and contagious, but it's not gonna kill you ;-) Besides, you can take reasonable precautions.

So, if it turns out you have herpes and he doesn't, I'd talk to your doctor about suppressive therapy. The Valtrex study showed that the transmission rate from female to male, only avoiding sex during outbreaks, was about 4%/year. With suppressive therapy, the rate dropped by about half - and combined with condoms, dropped down even further. I guess those figures aren't totally reflective of real life, since those in the study knew they were infected and were likely vigilant for any possible symptoms. But there's no reason YOU can't have similar results - you know you have herpes, and can pay closer attention to anything that might seem like a possible outbreak. That's a good start. And definitely learn as much as you can from reputable sources (Dr. Handsfield's FAQ/archives, plus the sites he listed in his reply), and accept the bad with the good. It's really not the end of the world by any means.

[desperatelyseeking]

Can you contract herpes from anal sex? Does anyone know where this virus originated from ?

[t1234]

Why don't you and your boyfriend go to your doctor together.

That way your Doctor can discuss herpes with both of you present.  That might be better in your case.

Of course the bad news is you must see that your BF is informed
as I'm sure if it were the other way around you would appreciate
him telling you.

The good news is the risk of him getting it (if he cares)
may be low or he may be already infected from a prior relationship in which case you're home free.

I think there are accounts from Roman times of Herpes.  It's just one of a family of virus's (Chicken Pox, CMV, Epstein Barr,
etc.)  They've been with us forever.