Aa
Unreasonable fear of Herpes?
Hi Drs:
Mon "rash" - small red bumps on buttock (btwn buttcheeks- closest were at least an inch, most more than that, away from anus- outward towards -buttock/thighs)
both sides
areas on each side covered 3+ in on skin
not "clustered" some closer together than others, spread out over area
hair bearing area, had shaved there that morning
most red bumps had hair in center, might have been all
Tues am some gone, most getting lighter in color
few got slightly larger, a few got what looked like could be a head on them, all still very small
Wed am- most gone, all on lft side gone. rt side a few persisted- 1/2 have turned into a little larger lumps, closest to "head" on them could be small amt of pus, or just skin trying to grow over?
no fever, sickness, etc.
have had folliculitus before- in bikini area, sometimes even on legs- looks similar for the most part
bkgrnd:
Jan 09 strange white spot on inside of vaginal opening, dr said scar tissue, but swabbed anyway, came back positive for HSV- Jan 09 bloodtest- HSV 1 + HSV 2 - (1.5 mnths post exposure)
did not test again until Jan 2010- (never had another symptom, then freaked out that I could have atypical symptoms so at my annual requested another test) HerpeSelect test 1 yr after culture: HSV 1 + HSV 2 -
Jan 2010 HSV test done 1 yr after culture, also 14 wks after last exposure to anyone other than my current bf.
Previous relationship (last exposure was 14 wks previous to HSV test) was protected/unprotected vaginal sex.
Partner did not disclose any STDS, never saw any outward signs.
1. I’ve read about the 12 wk-16 wk outline for HSV blood testing. Can I count on a 14 wk blood test, HSV1 Positive, HSV2 Negative (at that point, no symptoms at all of Herpes, and never seeing my partner with symptoms) to be definitive that I did not carry an HSV2 infection out of my previous relationship?
2. Does current rash seem Herpes related? I guess I’m looking for reassurance that I’m drawing logical conclusions.
Mon "rash" - small red bumps on buttock (btwn buttcheeks- closest were at least an inch, most more than that, away from anus- outward towards -buttock/thighs)
both sides
areas on each side covered 3+ in on skin
not "clustered" some closer together than others, spread out over area
hair bearing area, had shaved there that morning
most red bumps had hair in center, might have been all
Tues am some gone, most getting lighter in color
few got slightly larger, a few got what looked like could be a head on them, all still very small
Wed am- most gone, all on lft side gone. rt side a few persisted- 1/2 have turned into a little larger lumps, closest to "head" on them could be small amt of pus, or just skin trying to grow over?
no fever, sickness, etc.
have had folliculitus before- in bikini area, sometimes even on legs- looks similar for the most part
bkgrnd:
Jan 09 strange white spot on inside of vaginal opening, dr said scar tissue, but swabbed anyway, came back positive for HSV- Jan 09 bloodtest- HSV 1 + HSV 2 - (1.5 mnths post exposure)
did not test again until Jan 2010- (never had another symptom, then freaked out that I could have atypical symptoms so at my annual requested another test) HerpeSelect test 1 yr after culture: HSV 1 + HSV 2 -
Jan 2010 HSV test done 1 yr after culture, also 14 wks after last exposure to anyone other than my current bf.
Previous relationship (last exposure was 14 wks previous to HSV test) was protected/unprotected vaginal sex.
Partner did not disclose any STDS, never saw any outward signs.
1. I’ve read about the 12 wk-16 wk outline for HSV blood testing. Can I count on a 14 wk blood test, HSV1 Positive, HSV2 Negative (at that point, no symptoms at all of Herpes, and never seeing my partner with symptoms) to be definitive that I did not carry an HSV2 infection out of my previous relationship?
2. Does current rash seem Herpes related? I guess I’m looking for reassurance that I’m drawing logical conclusions.
MEDICAL PROFESSIONAL
Glad to have helped. Didn't mean to sound like I was lecturing you about your HSV-1 infection; it just wasn't clear to me that you had a handle on it. Clearly you do.
In people with genital HSV-1, the initial infection with HSV-2 tends to be mild. Your main protection against it, I suggest, is twofold: 1) For new or casual sexual exposures, use condoms consistently. They are highly protective against HSV, if not quite perfect; and you have a built in rationale for condom use anyway, i.e. your desire to protect your partners (of unknown HSV-1 status) from your current infection. 2) For promising relationships, ask your partner to be tested for HSV-1, when an HSV-2 test normally would be done as well. So you'll know whether or not there is a risk in that scenario. If you follow both these strategies, you can be confident that HSV-2 isn't in your future.
In people with genital HSV-1, the initial infection with HSV-2 tends to be mild. Your main protection against it, I suggest, is twofold: 1) For new or casual sexual exposures, use condoms consistently. They are highly protective against HSV, if not quite perfect; and you have a built in rationale for condom use anyway, i.e. your desire to protect your partners (of unknown HSV-1 status) from your current infection. 2) For promising relationships, ask your partner to be tested for HSV-1, when an HSV-2 test normally would be done as well. So you'll know whether or not there is a risk in that scenario. If you follow both these strategies, you can be confident that HSV-2 isn't in your future.
That helps a great deal, thank you very much. I understand the fear is anxiety driven, and less than logical. I (had) continued to get hung up on a fear that my 14 wk mark was not good enough proof that I had not managed to acquire HSV 2 from my previous relationship. Your response to my question makes it entirely clear. (And as I've seen you mention in other posts, I do actually seek counseling for anxiety related tendencies, so I'm working to chill out a bit :) )
The HSV 1 Genital disclosure is also understood, and discussed in my current relationship. Thank you also for the information in regards to pregnancy and future children.
These clarifications are quite enough to quiet my fears.
Thanks also to you (Dr. Hook, and others supplying their services) to constantly quiet the fears of those of us anxiety ridden folks and offering logical, scientific based information about STDs.
The HSV 1 Genital disclosure is also understood, and discussed in my current relationship. Thank you also for the information in regards to pregnancy and future children.
These clarifications are quite enough to quiet my fears.
Thanks also to you (Dr. Hook, and others supplying their services) to constantly quiet the fears of those of us anxiety ridden folks and offering logical, scientific based information about STDs.
MEDICAL PROFESSIONAL
Welcome to the STD forum.
To be honest, even after scanning prior discussions you had on the herpes community forum and carefully reading this question, I don't really understand what isn't clear to you. You had a positive test for HSV from a genital lesion a year ago. From what I can tell, that specimen was not tested to determine the virus type. However, you had a positive blood test for HSV-1 and negative for HSV-2. So for sure you have genital herpes, due to HSV-1. (This is a good example of an apparently atypical presentation that turned out to be herpes.)
You can expect your HSV-1 blood test to remain positive forever. If you ever get a new genital herpes infection, it will have to be HSV-2. As long as your HSV-2 blood test remains negative, you will know that hasn't happened. To your specific questions:
1) Yes. With a negative HSV-2 blood test 14 weeks after your last sexual exposure, you can be sure you didn't catch HSV-2.
2) Your description sounds much more like folliculitis or other superficial bacterial skin infection than herpes. Combining that description plus the negative blood test adds up to zero chance you have HSV-2.
Going back to your genital herpes due to HSV-1, the odds are good you will have few recurrent outbreaks in the future, maybe none at all. And most lkely you are shedding virus without symptoms fairly infrequently. (In most people, genital HSV-1 recurs much less frequently and asymptomatic shedding is less common than for HSV-2.) So your future sex partner(s) probably are not at high risk. Still, the chance of transmission to a partner or your baby, if and when you have children, isn't zero. The jury is out on whether you have an obligation to discuss it with future sex partners, but most people would say yes -- your partners should know about it before you have sex with them the first time. When you form longterm relationships, your partner(s) can be tested to see if they already have positive blood tests for HSV-1, in which case no problem -- those people are immune to catching it again. Finally, if and when you ever are pregnant, make sure your ObG is aware of this history, to assure precautions to prevent neonatal herpes. The risk is low, but not zero and icommon sense precauations are, well, common sense.
I hope this helps. Best wishes-- HHH, MD
To be honest, even after scanning prior discussions you had on the herpes community forum and carefully reading this question, I don't really understand what isn't clear to you. You had a positive test for HSV from a genital lesion a year ago. From what I can tell, that specimen was not tested to determine the virus type. However, you had a positive blood test for HSV-1 and negative for HSV-2. So for sure you have genital herpes, due to HSV-1. (This is a good example of an apparently atypical presentation that turned out to be herpes.)
You can expect your HSV-1 blood test to remain positive forever. If you ever get a new genital herpes infection, it will have to be HSV-2. As long as your HSV-2 blood test remains negative, you will know that hasn't happened. To your specific questions:
1) Yes. With a negative HSV-2 blood test 14 weeks after your last sexual exposure, you can be sure you didn't catch HSV-2.
2) Your description sounds much more like folliculitis or other superficial bacterial skin infection than herpes. Combining that description plus the negative blood test adds up to zero chance you have HSV-2.
Going back to your genital herpes due to HSV-1, the odds are good you will have few recurrent outbreaks in the future, maybe none at all. And most lkely you are shedding virus without symptoms fairly infrequently. (In most people, genital HSV-1 recurs much less frequently and asymptomatic shedding is less common than for HSV-2.) So your future sex partner(s) probably are not at high risk. Still, the chance of transmission to a partner or your baby, if and when you have children, isn't zero. The jury is out on whether you have an obligation to discuss it with future sex partners, but most people would say yes -- your partners should know about it before you have sex with them the first time. When you form longterm relationships, your partner(s) can be tested to see if they already have positive blood tests for HSV-1, in which case no problem -- those people are immune to catching it again. Finally, if and when you ever are pregnant, make sure your ObG is aware of this history, to assure precautions to prevent neonatal herpes. The risk is low, but not zero and icommon sense precauations are, well, common sense.
I hope this helps. Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
