Avatar universal

Did I give my boyfriend HSV? I'm symptomless. He's + culture, - blood.

Sorry this is long -- I'm confused and beside myself with guilt.  I've been reading a ton of these to see if anyone had situations similar to mine, and people always ask for more info, so I'm including as much as possible here.

We've been together for 7 months (since the beginning of February) and have been having unprotected sex the whole time.  He's been having sex for 20 years and had never been STD tested, but always asked his partners their status.  I've been having sex for 15, and have always gotten STD tested regularly and sometimes at multiple places in a short span of time "to be safe" (or maybe paranoid).  In our first month together, I told him that I'd been told I had tested positive for HSV once many years ago, probably close to 10 (I don't know what kind of test was used, and I don't know which type of HSV -- I had no idea it was so complicated), but have always had negative results after that.  I dated a doctor for a few years around that time who I told about this, and he assured me things were fine, so I've always assumed that one test was a false positive and I was negative, especially since I've never had outbreaks, and I've never had a situation where any partner has had outbreaks.  

Over the weekend, my (possibly now ex?) boyfriend had what looked at first like an ingrown hair on his pubic bone area right where the shaft starts.  He had no other symptoms other than fighting off a cold we both got when we came back from Burning Man on September 2.  The "ingrown hair" got worse, so Monday (September 10), he went to urgent care and the doctor visually diagnosed him with herpes.  I ordered a blood test from RapidScreenings.com and went to a lab to get blood drawn.  On Wednesday, his swab came back positive for HSV2 (I think they only tested for HSV2), and my blood work came back positive for HSV2 (IGG).  Today, his blood work came back negative.  I don't know what test they used: if it was IGG or IGM, if it was for both HSV1 and 2, or anything else.  

I just know that I feel terrible because I'm worried that a positive culture swab and a negative blood test means that it's recent and that I gave it to him.  
Did I?  
Have I had this for a long time and just never had symptoms?  

Please don't try to make me feel better if I did.  We'd resigned ourselves to believing that we'd both had it, dormant, for years and not known about it.  That was better.  Me giving it to him changes things a lot.  He's very upset and not speaking to me, which I can understand.  I feel incredibly irresponsible and like I've tainted some clean, perfect creature.  While I love him and want to stay together, I honestly don't know if that will be possible.

Aside: We're also a bit baffled by the nonchalance of the medical world about this, and how no one seems to advise testing for it.  In fact, I'm wondering how many of the dozens of times that I've been tested for STDs have they actually included testing for HSV, even when I asked for it, or if they did, what kind of test they did and how accurate it was.  Were all those things I thought were subsequent "negative results" just the absence of HSV testing or bad testing?!  A lot of times, I go to free clinics -- places that only call you if you have something, and where you never see your paperwork, so I don't even know if I can track down those records, but I'm trying.
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Avatar universal
It does seem to me that they exclude HSV testing from the usual std checks and physicals, which also baffles me. How would we ever know otherwise?! I agree with you.

In another sense though, there is no point in beating yourself up about it, because it’s true. They don’t test for it unless it’s reauested or visible. At least not here!
Helpful - 0
Thanks for your reply and commiseration!  I get that in the medical world, it's probably not a "big deal" because it's not life-threatening, but for those of us who get the diagnosis, it's definitely a big deal and is life-altering (in a bad way).
Avatar universal
If his swab came back positive and blood test negative, then it is highly likely that this is a new infection. The IgG does miss up to 8% of infections so there is a possibility the test simply missed it for him. If he hasn’t had sex with anyone but you, and seeing that you are positive for HSV2, then you would be the source.
It is definitely possible that you have had this for a long time and never had symptoms. It is not rare for someone to find out their status after a partner becomes infected because the carrier simply never had symptoms or had symptoms they mistook for something else all together (yeast infections, allergic reactions, razor burn).
Your past testing could’ve been an IGM test, which is garbage. It’s amazing because many doctors/clinics still use it. It could be that past tests didn’t include hsv testing at all. I’ve learned that asking for “the works” when it comes to std testing rarely includes Hsv testing. And sometimes when requesting Hsv testing, they don’t do a type specific test, so people won’t know if it’s HSV1 or HSV2. Since HSV1 is so common, many doctors/clinics brush it off and without typing the test, the assumption is made that it’s HSV1.
It’s all chaos and doctors are incredibly ill-informed and don’t give a darn to learn more. They figure no sores, no problem.
I’m not going to wax on about how you should or shouldn’t feel but I will say that this exact scenario is incredibly common.
Helpful - 0
Thanks for your reply!  Not that I feel "better" per se, but I guess there's some slight comfort in knowing that this exact scenario is common and that I'm not reckless but that the whole system around HSV testing is maddening.  I'd somehow have felt better if we were both positive and his wasn't recent so that neither of us could blame the other or feel guilty.  This is probably the worst scenario for both of us mentally.  Do you think there's any benefit to doing a Western Blot?  I ordered two kits this week that should arrive next week.
A positive swab is conclusive. He wouldn’t need a Western Blot because there is no doubts that he has HSV2. He may not have antibodies yet, on top of that if the infection was recent. It can take up to 12 weeks to form antibodies.
As for yourself, if you had an index value below 3.5 on the IgG, a Western Blot could let you know for sure if you are infected. While it looks like yes, you transmitted, if you are negative by Blot, this could open more questions about fidelity.
I know this is maddening. You weren’t reckless. Testing is strange and specific. There are rules of what tests to run even by doctors. One positive test followed by negative tests, assuming the doctors are running the correct tests, it’s easy to get confused about all this ****.
Not sure if this is helpful at all, but his swab results said:

Herpes Simplex Virus Culture with RFL to typing -- see note
Test status: final
Specimen source: not given
Specimen quality: adequate
HSV culture: Isolated
HSV type 2: Isolated
HSV type 1: The incidence of HSV1 infection in the presence of HSV2 (dual infection) is extremely rare. Therefore, testing for HSV1 was not performed.

I don't know anything about his blood tests other than that he said that it was negative so "it looks like we know the culprit." :(

There's no chance he had it before, or maybe has HSV1 and not 2?  How is it that he JUST caught it from me after us having sex for 7 months?  Is there a difference between outbreak right after exposure and outbreak after years/months of dormancy?  Why do some people get flu-like symptoms and he just got the sore?  Why is it that he had a pretty severe outbreak, but I never have if we have the same virus from me (does that even make sense as a question?  Why does the same virus passed between two people manifest differently for each of them?)?  Are there different strains or variations of it within 1 and 2 -- like is there a way to track the path of one virus that gets passed between people?  Do the numbers in the blood tests mean anything in terms of how long someone has ben infected?  It's hard to find information on that online -- I saw numbers as high as 17 (for HSV2 -- in the 50s for HSV1) in some forums.  How high can that number be, and what does it mean -- infected longer ago/more recently, more "severe" of an infection, more likelihood of having outbreaks?  Which is "worse:" HSV1 or 2 and orally or genitally?  I've done a ton of hair removal -- waxing, laser, electrolysis -- for the past 15 years.  I've read that these can all trigger outbreaks, and a friend told me she gets an outbreak EVERY time she waxes.  How have I not passed it on (or at least in a way that anyone has had an outbreak) to anyone else?  (I was married for 4 years before him, had two 2-year relationships, and a few shorter ones interspersed.)  Did it "get in" through the "ingrown hair" (or maybe a cut from shaving), or was that already the start of an outbreak?  How long from exposure to outbreak -- I saw the "ingrown hair" on Friday night when we had sex and didn't think anything of it, but by Saturday morning, it was bad and worse by Saturday evening.  Was it from sex the night before or the weekend before?  Have I had it for 10 years and not known?  Or could I have gotten it from the guy I briefly dated before him?  Not knowing what tests have been used at places I've been tested at doesn't help me unravel this.  Sorry for so many questions.  While it won't help with my guilt or his anger, I'm trying to make sense of it all for my own mental health, I guess.  (My therapist says I'm focusing too much on him and am not processing my own diagnosis, but I can't help it.  She also asked if his blood result could be wrong...?)

Also, if he can forgive me and not see me as some gross infector, and we stay together and have sex (I'm worried that sex is now ruined for him -- he says it is), can we pass it to other places?  Will his outbreaks always be on his pubic bone or wherever his "point of entry" of the virus was?  Will I start getting outbreaks?  Can we pass it to our mouths or other areas?  Is it possible to catch HSV1 if we have HSV2?  Should I take Valtrex or similar prophylactically?

Hopefully these questions help others, too.  I've had a hard time finding answers to these.  (My internet history is pretty wild right now.)

Thank you!!!
Avatar universal
OK I’m gonna have to jump back-and-forth and trying to answer when I can. How one person’s body responds to the virus is completely independent.  Everybody is different and everybody responds differently to a virus. There’s really no rhyme or reason, even when we train search for one. Some people have no symptoms at all. Some people get very active outbreak’s. It’s totally individual and it’s frustrating as it is, there’s really nothing that can pinpoint why one person gets severe outbreak‘s and someone else doesn’t. Some may think it’s an immune issue. Like if you’re immune system is slightly compromised, you’re more prone outbreaks. Or if your stress is higher Then someone else’s, you might be more prone outbreaks. Unfortunately, there’s no answer to that.
People can go years where one partner is infected and the other isn’t and not pass the virus. Just like someone could have a one time in counter, and catch the virus. That’s just how it happens. The virus sheds at various times. And when it sheds, most people are completely unaware that it is.
His culture is conclusive. HSV-2 was isolated, so that’s the strain he has. Barring a mixup at the lab, I think it’s safe to say that it is an HSv2 infection. Well his blood test is negative, that points to it being the new of infection. Of course, the IgG testing isn’t perfect. It can miss a small portion of infections.
Numbers on the blood test really mean nothing unless you fall within the equivocal range. That’s 1.1 to 3.5. That’s a gray area and can represent someone newly infected who hasn’t Built enough antibodies for a conclusive positive score or someone who has possibly as a false positive score (which can happen). Unfortunately, again, the numbers can not Tell you how long you’ve had the infection or how infectious you are. They’re basically a confidence number. The higher the number goes, the more accurate the isolation of antibodies is.
For primary infection, most people experience symptoms 2 to 10 days after exposure. But not everybody has a primary infection. Some people can get the virus, and not have symptoms for years and years. Or there’s a delay in the primary infection and they noticed something a month later.
The only risk of infecting other body parts for him, is in the first 3 to 6 months after infection. Once the body builds up enough antibodies, it protects you from spreading it to other places. As for where he will experience symptoms, if he does experience symptoms are outbreaks after the initial one, it varies. Sometimes it’ll be in the same spot or it could move around. Hsv outbreaks can happen anywhere in the “box shorts”region. The butt, thighs, penis/vagina, lower stomach. It all depends on what nerve path the virus he uses to get to the skin. What do you know, the virus doesn’t shed from these areas. The virus will shed from the soft mucous membranes of the vagina the anus and the penis.
This doesn’t mean that you will experience outbreaks. And you could’ve had this for years a not been fully aware. I think with all the testing you had done, either the wrong test was performed or wasn’t performed at all. Many clinics either use outdated tests or, when we ask for the works and a full STD panel, it doesn’t include HSV at all. That’s so frustrating.
HSV-2 pretty much protection from catching HSV one. As for taking antiviral medication, such as Valtrex, if you’re both infected it won’t make a difference. Valtrex for you would only be needed if you start experiencing any symptoms. Many people who are infected and have a partner that does not have it, take Valtrex or another antiviral to reduce shedding, which helps reduce the chance of passing the virus. Valtrex and condom use greatly reduce the chance of transfer from asymptomatic shedding.
I hope this answers some your questions. If you have a chance, if you have an already and it sounds like you’re doing your homework, visit Terry Warren‘s website at Westover heights. She has free downloads to help explain a lot of those and might be helpful for your boyfriend. You can also ask her questions and she might be able to shed some light on things. To tell you the truth, my knowledge comes mostly from her and other sources that seem to specialize in the HSP virus.
I know you’re both angry right now. But arming yourself with information will be so good for both of you.
Helpful - 0
Sorry for any errors. I am using phone dictation
Thank you for all of your answers. They’ve been incredibly helpful. I’m still trying to make sense of this and so I’m going back over years of sexual history, which is an emotional rollercoaster of self-judgement...

I slept with a man starting in late November 2017 and ending late December/early January. He also hadn’t been STD tested recently (or maybe ever). I got tested during or recently after him at one of those places where they only call you if anything is positive. I didn’t get a call.

A few days prior in November 2017, I spent a night at a friend’s house during a particularly emotional time, and woke up to him having unprotected sex with me.  

Before this, I had been with the same man for 4 years and married for 3.  In June/July 2017, he left me in a super strange way and had stoped having sex with me for a year prior. I figured maybe he was cheating, so I got tested three times at three different places because I was paranoid. Nothing.

Anyway, I began dating my boyfriend on February 2nd 2018.  When I told him about my possible false positive from around a decade ago, he (understandably) freaked out. I went to get STD tested in late February or early March. (He didn’t.) It came back negative.

-Is it possible that the test in February/March was a false negative and I’ve actually had it for close to a decade and never had outbreaks or had any partner contract it in the catastrophic way that he has?  He’s in massive pain and has been for over a week.
-Is it possible that I got it from the guy in November or the guy from November to January?  I’d totally forgotten, but after the guy in November, I had what I thought was a mild yeast infection that cleared up in less than a week. As he’s a friend, I know he gets them because he’s mentioned it before (I didn’t realize guys got them), so I figured that’s what it was. But maybe it wasn’t a yeast infection after all? Can initial herpes and yeast infections manifest similarly at all?
-Would late November guy or late November to January guy have shown up on my February test?
-My test after my boyfriend had his outbreak (this September) was 4.70. Is that high? Does that number matter? Could it have gotten that high between the negative February/March test and the September test?
-Is there anything a Western Blot could tell me or clear up about any of this?

Again, I’ve been trying to recall my past far more than is comfortable. I found an old email from 8-10 years ago in which I was, for purposes of full disclosure, telling a new potential partner about my recent positive test and I also told him that the partner I was with when I had the positive test got tested and was negative. I think that made us both think that my positive may have been a false positive.  The doctor I dated for two years shortly after this reaffirmed this. As I trusted him and his knowledge, I figured with the information he had and my absence of outbreaks, I was negative.

Thank you so much for all of your help.
Avatar universal
Okay. I may have to answer in segments. Your IgG score is not high but a positive score. Nothing can really be told by the IgG score as to how long you have had it or it’s severity. It’s simply a confidence number that the test found antibodies. IgG values can move up and down.
It’s hard to say exactly when based on your history. Since you had a positive years ago, it could be something you have carried for years. The IgG for HSV2 isn’t perfect and can miss upto 8% of infections based on recent studies by the University of Washington when comparing to the Western Blot.
An hsv outbreak break can mimic a yeast infection and this is why it’s hard to diagnose. People will ignore symptoms, thinking they are something else entirely.
If you tested less than 12 weeks between your previous partner in January and your new BF in February, then yes, you may not have built antibodies if the previous partner is the source.
The Blot At this point could confirm your diagnosis and let you know your HSV1 status.
I know it feels like you are chasing a unicorn here. I hope this is helpful.
Helpful - 0
That is very helpful. It’s just so weird that the number doesn’t mean anything. I think to make sense of it, I’ve assumed that it’s does.

Could I have had a negative test in late February/early March that didn’t pick up either or both late November guy, or November to January guy?  Or should late November guy have been picked up by a late February/early March test?  But the guy who went into early January might have been missed?

Thank you. I know it “doesn’t matter” because I’m positive now and so is my (ex) boyfriend, but I’m just trying to find some sanity.

Also, is there any chance that the (ex) boyfriend had a false negative blood test and positive swab?  Basically, is there any chance he had it before and I didn’t give it to him?  This outbreak is really bad, so I’m guessing it’s an initial one and it is definitely from me. I’m distraught over it and he is, too.
I’m sorry for the “ex” part. :(
His outbreak sounds very much like a primary. They are usually the most severe and follow infection by a few days.
Is it possible that he was positive all along and just not showing on his IgG but very unlikely.
The guy who went into January could’ve very well been missed. By about 4 weeks of infection, about 40-50% of infections could be picked up but 12 weeks really is the recommendation and when over 90% seroconvert. The one previous (Nov-Jan) should’ve been picked up but, as we know, the IgG isn’t foolproof.
Are you sure these previous tests included HSV? I assume they have and you’re confident in that but STI panels can be a joke when asking for “the works”. I had never been tested for hsv because I assumed my full panel covered everything.
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