Risk of HSV-2 transmission

[brooklyn1981]

So I'm in a bit of a dilemma. I'll try and be concise:
Met someone I really like and am interested in starting a relationship with. We have not slept together yet. I did mention to her that I have some hypochondria-related issues pertaining to sex. She then told me that she does too, and not to worry, because she'd just been tested in the not so distant past.
The reason she'd been tested is that she had slept with a man who (either before or after they slept together) told her had HSV-2. She says she had protected sex with him about 5 times. Unfortunately, she got her HSV tests only two weeks after those encounters, and wasn't aware that this time frame doesn't do much good for a reliable result.
Now I'm a bit stuck and in a tricky spot. I'd like to suggest that she get tested again after an appropriate amount of time has passed--I think it has already. And in return I would also go get tested again, to be fair. But I also don't want to make her feel like a pariah, especially since this is a new relationship.

So my real question here is: Given the nature of her possible exposure, is there a high risk that she could have contracted HSV2? From what I've read on the forum before it seems that the risk of HSV2 transmission even with frequent UNprotected intercourse is quite low, and she says she used a condom with this partner.

And the second question--let's say we end up have protected sex together before we go about getting tested again. (Not planning on this, but, you know...things happen sometimes.) What is the general transmission rate of HSV2 when condoms are used?

Thank you very much.

[Edward W Hook, MD]

Correct,  the risk for HSV-2 from oral sex is considerably lower than 1 in 10,000.

And yes, I did mean two weeks.  

Time for this thread to end and for you to relax.  EWh

[brooklyn1981]

Dr. Hook, one final follow-up and then certainly no more.

*You did mean that the blood test would be 50% effective two WEEKS after exposure, not 2 months, right?

*If the general risk of transmission of HSV2 genitally is 1 in 10,000 when someone is not symptomatic, I'm assuming the risk of contracting HSV2 orally through unprotected oral sex is considerably lower?

[Edward W Hook, MD]

I am presuming her test was an IgG.  Igm tests for HSV are not recommended as theyt are plagued with false positve results.  

My advice is to stop worrying and move forward.  EWH

[brooklyn1981]

Thank you Dr. Hook! This is very very helpful.
I had no idea the accuracy of the blood test after 2 weeks was as high as 50%, that's further reassurance. Perhaps I should gently ask her though whether she had the IgG or IgM test? I know from this forum that the latter is basically worthless, though maybe if it was a negative IgM test that would still be an 'accurate' result?

[Edward W Hook, MD]

Welcome to our Forum.  I'll be pleased to comment and want to gently suggest that your self-acknowledged hypochondria may be getting the best of you.  Your question can be distilled to whether or not your potential partner MIGHT have gotten HSV who told her that he had HSV. the answer is probably not.  Several reason lead me to say this:

1.  Scientific studies show that person who know that they have herpes are at least 25% less likely to transmit infection to sex partners that the large proportion of persons who have HSV but do not know it.  This is because those who know and disclose their infection typically know what to look for in terms of recurrences and can/do take precautions to prevent transmission.

2.  Most exposures to infected partners do not lead to infection.  Less than 1 in 10,000 exposures lead to infection when the partner is asymptomatic.

3.  If your partner had gotten HSV, having known that her partner had the infection, she would have most likely noted signs/symptoms of infections within 14 days of acquiring the infection.

4.  Her negative blood test, two weeks after her last encounters, would have detected over 50% of recent infection.  

While none of these statements is definitive, when you put them together there is really very little chance that your partner was infected and no reason for her to seek further testing.  I hope that you will not let her honesty about her past relationships impede your relationship with her.  (and remember, given that well over 1 in 5 Americans has genital herpes but does not know it, any time you have sex with a new partner, your risk of having sex with someone who has HSV but does not know it is considerably higher than any risk associated with this person as you describe her).

I hope my comments are helpful.  EWH

[brooklyn1981]

And a small addendum I forgot to mention--while we have NOT slept together yet, we did have close contact while naked, with potential genital to genital contact (unprotected, since we were not having sex.) I gather that HSV generally requires prolonged contact, friction, etc--i.e. actual intercourse--and there wouldn't be much of a risk of transmission from this sort of contact?