Likelihood of Herpes...

[unknown47321]

Ok, so I went on vacation and I met this guy at a bar.  Of course, I drank too much and we ended up back in his room.  We had oral and vaginal heterosexual intercourse (I'm the female) and I have no idea of this guys STD status.  He claimed to be clean.  I still made him wear a condom for ejaculation, but we had some penetration prior to putting it on.  I was wondering what my chances were for contracting herpes from pre-ejaculation?  The other thing is that I have a boyfriend and I have decided not to tell him about this, but I also don't want to give him any kind of STD that I contracted.  I have heard that the virus will not even appear in the person's blood until about 6 weeks has passed after exposure.  Also, what kinds of signs/symptoms should I be looking for?  I almost don't want to ask this because I may conjure up these symptoms by obsessing about them.  Please let me know my likelihood of contracting herpes, what kind of testing is available and how paranoid I should be about this.
-worried

[Edward W Hook, MD]

I went to this website.  their ad says same day testing which does not mean that you will be the results back the same day but only that you will be tested the same day, a very different thing.  I also note that they offer and IgM test.  On this forum we have repeatedly stated that IgM testing offers little if any benefit to persons wanting to know if they have herpes.   I think you plan to go the the health deprtment is the right thing to do.

I do not know if or how to get your name removed from the site. I'm afraid you will have to contact the site administrators for that.  I believe your name and e-mail address are secure however.

Take care. EWH

[unknown47321]

Ok, the website I got this information from on those tests is:  www.localstdtesting.com   There is a 1-800 number there to call and make appointments.  I think I have decided to visit my health dept and get tested, but I have not had any lesions or weird happenings with my body and it's been a week since the exposure.  Also, A REALLY IMPORTANT QUESTION... I really need to remove my user name and email from this forum (just in case he somehow comes across it), so is there any way to do that?  Or if I could just change my name that would also be ok.  I think there is too much detail in my story.  Thanks for your advice and I think I will not worry too much about it since nothing has happened and my risk for obtaining an STD is pretty low.  

[Edward W Hook, MD]

I hope I can save you some money.  There is NO test available for a person without lesions which can provide a >99%  accurate answer as to whether of not you have herpes within 24 hours of exposure.    What you have otherwise understood from me about the blood test is correct, both as to the use of IgM tests and the time to being able to count on results (see my original comment).  At six weeks the IgG test, if it is type-specific can be helpful

The flu-like symptoms are part of initial herpes and accompany lesions.  Flu-like symptoms without lesions are not herpes.

EWH

p.s.  Can you tell me what test was claimed to be >99% sensitive within 24 hours of exposure.  I need to be aware to alert others.  EWH

[unknown47321]

Well, the testing is suppose to be 99.9% accurate with immediate results and you can be tested just 24 hours after exposure, that's why it's so expensive.  So these tests are a waste of money?  Well, I could get tested at the Health Dept, but my understanding was that a blood test would not show herpes until the virus had time to manifest in the blood stream, which could take up to 6 weeks or more.  This would not give me enough time to get tested before the boyfriend came back.  Also, what about the flu-like symptoms I mentioned?  Any truth to that?  Ok, so I guess what I am taking away from your advice is that the IgM and IgG tests are a waste of money and I should get tested at the health dept ($50).  In the mean time, watch for lesions (any other symptoms to watch for?) but if I have no lesions, let's say, for 30 days or so I'm probably safe considering my exposure was relatively low?  It's really stressing me out and I'm worrying a ridiculous amount.  Thanks for your time.

[Edward W Hook, MD]

$500 - what for?  Seem very high.  High quality testing for most STDs, including HSV is available at low or sometimes even no cost through health deprtments, etc.

As far as the IgG and IgM tests.  We NEVER recommend IgM tests- they are a waste of money and the type-specifc IgG tests may take as long a 6 months to become positvie.

While persons can occasionally acquire HSV without developing symptoms and lesions, it is far more likely that a person would attribute symptoms to something else (i.e. mis-identify) than miss the appearance of lesions, that is the reason I suggested the low threshold for getting a lesion cultured, should it appear.  EWH

[unknown47321]

Ok, thanks so much!  Well, I called about getting tested and it's very expensive ($500).  I was told this is an IgM and an IgG test that will give me immediate results, even though I was only exposed 6 days ago.  I have not noted any lesions or any unusual activity taking place with my body, but I was also told that one could contract herpes and never know it for, sometimes, up to a year.  Is this misinformation?  If I am understanding what you are saying above, I will definitely get lesions within 2-10 days after the sexual encounter?  I also heard that somewhere between 2-10 days one would develope flu-like symptoms if exposed to herpes, but not necessarily any lesions.  Thank you for your advice, it is very helpful.  Testing is not really in my budget, but at the same time, I do not want to pass anything on.

[Edward W Hook, MD]

You had a single, partially protected exposure without ejaculation to a partner of unknown status.  What are your risks for herpes and other STDs?  Low, he said he did not have STD and this is likely to be true.  In addition....

As mentioned in my summary of your question above, your exposure was essentially unprotected.  For typical STDs like gonorrhea, chlamydia, trichomonas, etc transmission can certainly occur without ejaculation (as can pregnancy) although all are probably somewhat more likely with ejaculation.  You can be tested for all of these STDs within a few days of exposure so you have plenty of time to go to a health care provider and get tested.  This testing might not detect syphilis but your odds of being exposed to syphilis in this setting are so low that unless there was something quite unusual about your partner (and it sounds as though there is not) you have very little to worry about.

As far as herpes, herpes lesions tend to occur within 3-7 (or certainly 10) days of exposure.  If any lesions should appear, be sure to get them tested ASAP although again, even if he had herpes, odds are that you did not get it from a single exposure to a partner who did not have lesions.  As far as testing is concerned, at this time a blood test would most likely tell you if you already have it (being an adult American women your average chance is about 1 in 5 even if you have never noticed an outbreak) but not whether you got it though the encounter you describe.  Thus, my advice is to just watch for lesions and if any appear, get them cultured.  Personally however, I think you risk is quite low.

Hope this helps.  EWH