STDs Expert Forum
do I have genital herpes
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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do I have genital herpes

I recently broke up with a girlfriend and am concerned about dating with an std and am looking for some expert advice. I have HPV.  I found out about it after my girlfriends pap smear was postive for changes consistent with HPV.  I then developed a wart about six monthes later which was treated. Then on one of her 6 month pap smears- they took a biopsy of an area and said it was questionable for HSV1. Her blood test was positive for HSV1 only.  I don't know the details on the biopsy because she wont tell me after we broke up. She says her doctor told her that she has genital herpes now.  She has never had a lesion externally so she says.  I have had a large pimple like red spots and when I break them open they only discharge large amounts of blood-only one or two spots at a time--one was in the crease between my scrotum and leg and the other one was above my penis iin the pubic hair. They never were painful like a cold sore and were not ulcerative like. I had those pimples probably six months ago and 1 year ago-guessing. I have never been tested but am going to be.  It is hard for me to determine if I actually have the genital herpes because she has been deceitful. I wonder if that was her crazy attempt to keep me in the relationship. I will have the blood test done and am sure it will be positive for HSV1 since I have had cold sores in the past and so has she.  I am wondering how I know for sure if I have genital herpes because it sounds like the biopsy of her cervix was questionable. She has had cold sores which could be her positive hsv1. Can I have sex with a condom wothout passing this on? My physician told me I could have sex and not disclose information to my partner about the HPV if the warts are now gone which I dont believe.  How do I know for sure if I have genital herpes?? I know the blood test will help but that is not a sure thing given the situation. Can women over 26 get the vacination for HPV because the real problem is cervical cancer.
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Lots of questions, both about HSV and HPV.  I will try to address them.

First HSV.  A biopsy is not a good way to diagnose HSV (either HSV-1 or HSV-2) and while there are ways this can be done, the testing available in many settings is not very precise.  I would not be surprised if you or your ex have HSV-1- over 60% of Americans do and of those, close to 90% of those who are infected do not know they are infected.  If your ex has a blood test positive for HSV-1, that does not tell the location.  Most infections occur at the mouth but a substantial minority also occur at genital sites.  Given your limited communications with your ex, the best way for you to address this is to get a single type-specific blood test for HSV-1 and HSV-2 such as the HerpeSelect (beware, there are many non-specific tests which give misleading results and DO NOT get an IgM test- they are particularly misleading).  If you have HSV-1 it is probably oral but could be genital- the blood test says nothing about location.  If you have genital HSV-1 that is perhaps as close to a good thing as one can get since transmission of genital HSV-1 is quite rare (far less common than for HSV-2) and is realistically not a major concern.  You can search this site or the excellent site provided by the American Social Health Association for more information on all that I've mentioned above (in the interest of full disclosure, both Dr, Handsfield and I are on the AHSA Board)..

As far as HPV is concerned,  If your wart has been treated and gone for 6 months, you can consider yourself cured and do not need to worry about transmission to partners.  Regarding the vaccine, women over 26 certainly can take it and often benefit. The problem is that most insurance companies do not pay for it and it costs over $300.00.  

Finally, the issues of disclosure to partners are difficult and personal.  We encourage persons to share their STD histories with partners.  It is the right thing to do.  I think it is safe to say that we feel less strongly about the need for sharing HPV histories than other STDs since over 85% of adults will have genital HPV at some time and there is no meaningful way to know or to deal with it.  For women the vaccine and regular Paps are the right way to go.  For men, vigilance and, if infection is present (as warts) condoms are advised.

Hope these comments help.  Your questions are quite broad and difficult to address in the short space available.  Please check out the web sites I suggested.  EWH
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If I am negative for 6 months and do not disclose this information to my partner is there still a chance of her having a change on her pap smear consistent with cancer.  I would not want to do that to anyone.  Or maybe is a matter of how the body deals with it and it will go unnoticed. I guess you said it would not be transmitted --just wanted to confirm.
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Last question. I am also wondering if I have hsv1  do I need to take valtrex.  Probably not because I don't think I have ever had an outbreak.  Do you think those blood filled pimples that i explained are herpes. I would like to thank you for your information because it has calmed my nerves a ton.
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HPV.  the HPV that casues gential (genital) warts does nto cause cerivcal cancer.  If you have warts, you can give your partner warts.  After 6 months, if a successfully treated wart has not recurred there is little or no reason to be concerned about transmission.  In science however we never say never- there are always exceptions.

the "bood filled pimples" do not sound like HSV but are more likely to be folliculitis. To be sure, should they recurr, you should have yoru docotr/health care provider take a look.

There is no proven benefit to valacyclovir therapy for persons with gential (genital) HSV-1.

Having said this, I once again urge you to look at the web sites.  these facts are there.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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