Slightly Confused re Herpes Testing

[jw180]

I have read numerous posts and have decided that perhaps testing for Herpes may be jumping the gun at this point.  Quick background:  17 days ago I had a sexual encounter with a woman who I know and who indicated that she was clean.  The encounter consisted of unprotected oral (receptive and giving) followed by approx 7-10 minutes of protected sex with her on top - not sure if any of her fluids came in contact with the base of my penis or the area surrounding, but assume yes.  I have no symptoms whatsoever but today she informed me that she was currently being tested by her doctor for both oral and genital herpes and the she thinks she may have it.  She had one brief encounter prior to ours  (partner status unknown) and one after (approx 7-10 days before her symptoms appeared).  The threads I have read seem to suggest that is unlikely that I have contracted herpes from this encounter.  Obviously if she contracted it after me - no question, but if she had it from her encounter 3 months or so ago she did not know and it could be possible.  What are the chances and should I get a test? I don't want to possibly infect anyone else.  Thanks for your invaluable service to the many folks who benefit from this site!!

[H. Hunter Handsfield, M.D.]

Thanks for the thanks about the forum.  I hope I can help.

I agree it is unlikely you acquired herpes or any other STD from this encounter.  As you understand already, whether or not you were at risk from this exposure depends on whether she is infected and, if so, when she caught it. But even if she turns out to have herpes and had it before your exposure, the statistical odds you were infected are low, especially since you haven't had any symptoms.  The average risk of herpes transmission, if a partner is infected without symptoms, probably is no more than one chance in several hundred.

You are fortunate that your partner cares about your welfare and told you she is concerned and is being tested.  Your attitude in return should be one of gratitude and sympathetic understanding of her own fears.  Keep in touch about her test results.  If there is a positive result for any STD, you should see a health care provider for evaluation.

In the meantime, don't worry too much.  And regardless of the outcome, send your partner some flowers or treat her to dinner and a nice bottle of wine.  You'll both enjoy and appreciate it.

Best wishes--  HHH, MD

[jw180]

Thanks for the reply.  It has been almost teo weeks since I asked the question above and was awaiting to see the results from the persons test but unfortunately she has not responded to me.  So I have made the assumption that her test was positive and am charting my own course of action.  I still have no symptons of an outbreak (4+ weeks post exposure) however, since I recieved the news I have been obsessing like most about the what-ifs and wanted to run a few final follow up questions by you.  As with most I am anticipating the worst and constantly am checking and re-checking my "p" for any signs of a possible outbreak.  I have experienced almost from the day I got the news a feeling on the left side of the shaft about half way up a patch of skin that I think has always been there but I have been getting a feeling on that side much like a burning or raw feeling - perhaps from checking and rechecking. In any event, I from time to time stretch the skin to see if there any possible bumps or lesions under the skin and from time to time I perhaps see a bump or two.  At this point I am assuming that if the burning was related to a pending outbreak - the outbreak would have occurred by now.  Yes? I am fairly rational and have been trying to rationalize the events that took place so here are my questions:

1.  She told me that she was with someone three days after me and then told that she was being checked for oral and genital herpes the sysmptons of which appeared 9 days after she was with the second person - (a.) is it normal for someone to have both oral and genital outbreaks simultaneously from exposure? and (b.) she also indicated that she was with someone several months before me, but was not sure if she contracted it from him - if so, stands to reason that she would not have shedding two weeks before an outbreak, meaning she was not really contagious when we were together - correct?

2.  The sex was protected.  I have read that outbreaks occur at the site of infection, doesn't that mean that I "most likely" wouldn't have an outbreak on my shaft.

I went to a clinic today and they refused to test me since I have no lesions.  The theory being that test would just tell them that I was exposed but that it is genital herpes.

Thanks for all your help.  

[jw180]

Sorry - noticed a "typo" or two above.  In my final comment - meant to say they wouldn't test since they "would not" know if it is genital without a lesion.  

What would you recommend that I do from here - do not want to see my PCP as it is a family member.  

[H. Hunter Handsfield, M.D.]

First, I would not necessarily assume your partner is infected on the basis of not getting back to you.  Maybe she just doesn't want to deal with it either way.  But you know the relationship so you're the best judge.  Second, your symptoms don't even hint at genital herpes.  They sound like normal body sensations magnified by anxiety.  You are correct that prodomal symptoms like burning precede an outbreak only by a couple of days -- and in any case, such prodromes are associated with recurrent herpes, not the initial outbreak.

1) Too much overthinking.  Many exposed partners don't get HSV even when the infected person is shedding virus.  If your partner had genital herpes, there is no way to predict the probability that she was or was not shedding virus.

2) It is rare to catch herpes during condom-protected sex.

As to the follow-up comment, there is no such thing as a test that detects "exposure". Positive means infected and negative means not infected, whether or not one has been exposed.

All things considered, it seems unlikely you have HSV-2.  If your past partner suspected only that you were exposed, I would not recommend testing at all.  However, since she apparently suspects you might have been the source of her infection, it is reasonable to have a blood test for HSV-2 antibodies.  Perhaps the clinic only tests lesions for the virus, in which case I agree there is no point.  What you need, either from that clinic or another provider, is an HSV antibody test.  Otherwise, it's only speculation.  Feel free to return and report the result if and when you get tested, but there's not much point until then.