optimist

Do you know if his STD tests include HSV testing? Most often, they do not. If they do not, it's very possibly he already has HSV1 and simply is unaware. It's very common and only 30% of people with oral HSV1 get cold sores, so most don't know they have it. You're correct that genital HSV1 is less active and presumed to be less contagious than genital HSV2 as a result. On average, genital HSV2 sheds about 3x more frequently than genital HSV1. However, genital HSV1 is slightly more contagious than genital HSV2 when symptoms are present, so the "less contagious" aspect would not apply to times when symptoms are present. Still, there's a good chance he already has oral HSV1 (which would largely protect him from contracting it genitally) and isn't testing for it, and as you said, he is less susceptible to genital infection because he is male rather than female.

@Waffle Your case is unusual in that your only skin-skin genital-genital contact was with someone who has recently tested negative for HSV2. It's possible he could be in the 5% who tests false negative for HSV2, but also possible you are testing false positive for HSV2, even though that's uncommon over a level above 3.5. It is not impossible it could be a false positive. Terri Warren who is an expert in the field has mentioned seeing two such cases where people who tested in the 4-5 range tested negative on Western Blot. In your case, I'd look into a Western Blot test which is more sensitive. I'd also push for an answer on your chronic symptoms since that's not how HSV2 presents.

@PresentMoment As for what happened in Japan, here's my understanding... A large increase in vaccinations occurred when the vaccine was given to patients at no cost (previously there was an associated cost) and it was proactively recommended. Following reports of adverse effects, which may or may not have been related to the vaccine, the proactive recommendation was suspended while adverse events were researched and the vaccination rates dropped from >70% to close to zero. Less than a year later, the outcome of research indicated the adverse events could not be proven to be related to the vaccine, but the proactive recommendation was not reinstated. As a result, vaccine rates remain very low in Japan.

@PresentMoment You mentioned in another thread that you are concerned about spreading your HSV2 through receiving oral sex. With that in mind, you may be interested to know that one major benefit of the HPV vaccine is that it can potentially prevent unvaccinated men (and women, though less often) from contracting HPV through performing oral sex. A small number of these HPV throat infections lead to cancer (just like with the cervical infections) which is typically not recognized until it is quite advanced (unlike cervical cancer). Annual paps do not check for evidence of the HPV virus, they check for cervical cell changes that can occur as a result of the HPV virus. This can take months or years after infection to occur. During that time, the virus can be spread to others. As with HSV, HPV is very common and usually not harmful to people. However, again like HSV, a minority of people have more significant symptoms/outcomes, in this case cancer. The HPV vaccine is not mandatory and it's your right and your daughter's right to choose not to get vaccinated. It's recommended for boys and girls 11 and 12 years of age because it is of maximum benefit when given before people become sexually active. Research indicates most women contract at least one strain of HPV within two years of becoming sexually active.

Congratulations!

This is an issue with all vaccines. For every vaccine that exists, there are people who prefer to take the risk of being infected and transmitting the virus rather than risk any side effects from the vaccine. As for the specifics of the HPV vaccine and related side effects, the Snopes site does a pretty good job of assessing the info for those who are interested.

What are the antibody values on the IgG blood test? If lower than 3.5, it could be a false positive. Generally speaking, if someone experiences a noticeable primary outbreak, it can last a few weeks while recurrences generally last a few days. Ten months of chronic symptoms does not reflect how HSV normally presents. Positive cultures are considered definitively positive. Negative cultures mean the virus was not detected at that time which can mean the person is negative or simply not shedding virus (or enough virus to be detected) at that time. I would check to be sure the blood test was an IgG test and also check the value (above or below 3.5), but also look into alternate reasons for 10 months of chronic symptoms since that suggests something other than herpes is going on. I did once read of a woman who thought she was having an outbreak for a few months and it turned out she had a secondary bacterial infection that started at the time of her primary outbreak. She mistakenly assumed the secondary infection that lingered was an extended outbreak.

One of the problematic aspects of throat cancer caused by HPV is that it's very hard to screen for, like if it's in the tonsillar crypts which can't easily be swabbed. For that reason, many with throat cancer aren't identified until the cancer is in later stages. While cervical cancer is the largest issue for women, throat cancer is more common among men than women, so vaccinating boys is not only beneficial in limiting spread of various strains of HPV, it's also meant to protect boys/men against various cancers, including throat cancer caused certain HPV strains.

@Mil21 The scenario @BlueMoon described is definitely possible. Even though it's been known for some time time that HSV can be (and most often is) transmitted in the absence of symptoms, many doctors still tell patients it can only be transmitted when symptoms are present. Even more likely, he simply doesn't know hes infected. For every 8 people with HSV2, only one knows they are infected, seven do not know. So odds are he doesn't know he's infected, got it from someone who didn't know she was infected, etc. That is what's most typical. Assuming he has been your only partner over the last 12 weeks, it makes sense you acquired it from him, given the negative IgG and positive swab. I'd suggest presenting the facts in a non-confrontational way, mentioning you developed symptoms you'd never experienced and got checked out and tested positive for HSV2 with tests indicating it it is an infection acquired within the last few months.

@Thisismyusername Glad you liked the video! Ella Dawson is great. She also has genital HSV1. It is very common among college aged women. This is because there's a fairly even split between those who have oral HSV1 and those who don't have oral HSV1 in that age group. Those who don't yet have HSV1 are vulnerable to contracting it genitally, most often from partners who have it orally. It's unfortunate a stigma applies to genital herpes while oral herpes is mostly normalized. Hopefully that will change with time and education.

@LoveTheMountains It's interesting looking over this post almost two years later. I actually still see Guy #1 and he'll always have a special place in my heart because he was so cool in response to my disclosure and didn't treat me any differently and that helped relieve my fears and give me momentum, even though our thing was super casual and still is. I saw Guy #3 off and on for a year and half and we became good friends in addition to on/off casual...uh...lovers? Playmates? Whatever. I met both of them on Tinder. I decided not to proceed with the other two guys I mentioned (Guy #2 and Guy #4).

@MakingIT2017 @PresentMoment Also, FWIW, I have HSV2 and I have two men in my life who love performing oral on me, as well as two former lovers who offer this regularly and I decline because they are former lovers for a reason. All four know I have HSV2. As @LoveTheMountains speculated, it seems men who love it will likely still love it and men who aren't into will continue to not be into it. I had one lover who wasn't into it and he happened to have HSV2 himself, so that was clearly not the issue. Edit to add: When I performed oral on the partner who knew he had HSV2, his HSV status never crossed my mind.

@PresentMoment Do you think you would feel this way about kissing a man who told you he once had a cold sore, or a man who said he gets colds sores a couple times a year?

@PresentMoment So here's the good news about oral HSV2... - It's uncommon, even though tons of people have HSV2, most don't know it, and most engage in oral sex without barriers - If someone contracts oral HSV2 and has a noticeable initial outbreak, it is visually indistinguishable from oral HSV1 - After the initial outbreak, oral HSV2 is unlikely to cause recurring outbreaks (significantly less likely to recur than oral HSV1) - Average asymptomatic shedding of oral HSV2 is 25 times less than average shedding for oral HSV1 (1% vs. 25%) - Once someone contracts oral HSV2, if they don't contract genital HSV2 during the same encounter (which can happen), and if they do not infect themselves genitally while antibodies are still building (possible but rare), they are then largely immune to ever contracting genital HSV2 or even HSV1 for that matter, if they don't already have HSV1

I'm so sorry you're struggling. You didn't mentioned which type you have. Genital HSV1 is extremely common among college aged women. Genital HSV2 is less common in that age group but quickly becomes common in the 20s and beyond, even among women with fairly conservative sexual histories. It may seem less common than it is because people are reluctant to discuss it and most people who have genital herpes are unaware they have it. You may want to seek out Ella Dawson's TED talk if you haven't already. She contracted genital herpes in college and detailed her experience processing it, dating and disclosing.

@Lifegoesonn The IgG tests misses 30% of HSV1 infections. It's possible that was the case here if there was a history of cold sores.

@aurorawriter I've found this to be very random, regardless of whether I disclose before meeting or after meeting, very early or after really getting to know someone, for casual or more romantic purposes, to someone who is emotionally invested or just looking for fun. I've had the experience of feeling relief that it seemed like nobody cared, to feeling discouraged because a couple people in a row were anxious about it. Younger, older, different professions, hasn't seemed to make a difference. The only factors I've seen so far that I think I might consider predictive are general anxiety and avoidance of condoms. I've only twice encountered sort of unreasonable reactions (by that I mean worried about risk that doesn't even exist, such as kissing) and both people described themselves as anxious in general. Both people were very sexually active and almost definitely having sex with others who are infected, and neither knew his own status, but known risk was too anxiety provoking for them. I now discuss expectations for condom use very early, not only because of my HSV status, but because I'll only consider going condomless when monogamous, and that has weeded out the condom avoiders in advance.

You're correct that the treatment would not be different at all. HSV1 and HSV2 present identically, and it's actually more common for people to have noticeable first outbreaks with HSV1, but I get what you're saying that you already had cold sores which makes you wonder if this could be a new type causing problems. If you do have oral HSV2, the good news is that it rarely recurs and sheds virus about 25x less than oral HSV1. I know that doesn't make what's currently going on less painful. Anther possibility is that you currently have an unrelated throat infection and your weakened immune system is causing you to express symptoms of a genital infection. But again, I get what you're saying that you were previously tested for HSV. When you were tested before, did you come back positive for HSV1?

It could be the doctor feels type differentiation is an insignificant aspect, and maybe it is, depending on your situation and how you two feel about it, but if he specifically diagnosed you with genital HSV1 without testing you, I don't see how he could make that assumption based on what you told him. If you feel a need to be typed and it's too late to be swabbed, an IgG blood test will reach greatest accuracy 12 months following infection, though possibly longer if you're taking antivirals. I'd also recommend looking back at the STI tests from last year to see if they included HSV testing. Most doctors don't include HSV testing in STI panels, even when patients ask to be tested for "everything."

I see. Is this a case where you and your boyfriend have only engaged in oral sex and never intercourse? One thing to be aware of it that most people who have HSV (and this applies to oral HSV1, oral HSV2, genital HSV1 and genital HSV2) do not know they have it yet are capable of transmitting it, even in the absence of symptoms. So I'm trying to understand why the doctor is assuming your oral and genital infections are both caused by HSV1. If you have never had intercourse before and have only engaged in oral sex, and he knows your boyfriend has oral herpes, this may be why he's assuming both of your infections are due to HSV1. Oral HSV2 is uncommon and also the least contagious of the various type/location combinations, so he is likely excluding that as a possibility.

Did the doctor swab your oral and genital sores and those swabs came back positive for HSV1?

@MakingIT2017 Your daughter can discuss the vaccine with her doctor. A new one that covers 9 strains came out a few years ago. It could protect against any of the nine strains she has not yet contracted. As for oral sex, I haven't encountered an issue with this. Most people with oral HSV1 kiss their partners. This is really no different.

@Sunset I think awareness of the pervasiveness of HPV grew when the vaccine needed to be aggressively marketed. The vaccine is recommended for 11-12 year old boys and girls and lots of parents were resistant, thinking they would essentially be green lighting promiscuity. In marketing the vaccine, all strains were lumped under the umbrella term HPV, whether they potentially caused cancer or not, and it was emphasized that most people contract "HPV" within a couple years of becoming sexually active. They didn't break it down into different strains and locations as they do with HSV which likely would have been less effective, IMHO. The same could potentially be done with HSV, explaining that 80% of the adult population has it without getting into the types and locations, but there has yet to be a reason to do that. In fact, there has only been a reason to do the opposite in that there has been an effort to normalize oral herpes but make people fearful of genital herpes.

I'm sorry you're feeling this way. HSV is very common, most people who have it just don't know it. For every one person who knows they have HSV2, seven others have it and don't know it. I wonder if that could have been the case with the guy you were with that one time. Also, 80-90% of people don't notice upon contracting HSV2 but some find symptoms triggered by sex, so sometimes people mistakenly believe they were infected from a single encounter when in fact the sex triggered symptoms of an existing infection. Not that it is impossible to contract it from a one night stand, it is, though it is rare. Most people never get tested for HSV and it's rarely included in STI panels, so it can be impossible to know when it was contracted and from whom unless one is testing regularly specifically for HSV. Perhaps you were doing this. Most people only assume they have been tested or would have symptoms if they had it. I'm glad to hear you've encountered people who were accepting. I wonder if it might help you to realize they might have it unknowingly, and the same is true of their past and future partners. It's a risk that is taken every time someone has sex with another person who is not either a virgin or testing with monogamous partners (which again is rare). In disclosing to people, we aren't providing a choice for them to either be safe from HSV or put themselves in danger of contracting it, we are simply sharing we know we are infected. When you think back to the 8 year relationship, as a thought experiment, let's say he had HSV2. Would you have wanted the choice to pursue things with him, or would you have wanted him to protect you by refusing to become intimate? If you truly would have preferred for him to protect you, then I'd say maybe you will be more comfortable, at least for now, being intimate with others who already know they have it, but if you would've wanted the freedom to choose to pursue him, maybe you can allow others the same choice to be intimate with you.

@Sunset The studies I've seen indicate very high rates of genital herpes infection but extremely low rates of diagnosis. In the U.S., 40% of autopsies indicate infection with HSV2, but only 2-3% of those people had been diagnosed with genital herpes. And this excludes genital HSV1. There are demographics in which HSV2 rates reach 70-80% with a slim minority aware they are infected. OTOH, some who know they are infected do have symptoms bad enough to affect their quality of life and/or psychological turmoil related to the stigma. So I agree it isn't nothing, yet it is extremely common and usually nothing, especially when people are unaware they are infected and therefore not subject to the stigma. There are many other lifetime viruses like this that cause major problems for a minority of people yet are very common and usually no problem at all. What seems to be different with genital herpes (even when it is HSV1 which is rarely stigmatized when the infection is oral) is the stigma associated with known infections. I wonder if this will change if awareness grows about how many people have this unknowingly (exponentially more than those who know they have it). I think that did happen with HPV over time.