optimist

Because he is an adult, it is likely he already has HSV1 as the majority of adults do. In the U.S., about 70-90% of people contract HSV1 and 40% of people contract HSV2 over the course of a lifetime. Many factors go into where someone gets infected, which type(s) they get infected with, and whether they ever have symptoms. A very significant number of people contract oral herpes as children through non-sexual contact. Those who do not already have it upon becoming sexually active are vulnerable to contracting it either orally or genitally (sometimes both at the same time) after becoming sexually active. It's my impression that the standard for people with oral herpes is to abstain from contact during outbreaks and not worry about it otherwise as doing so would compromise quality of life. Some people choose to take antivirals either because they get frequent outbreaks or they know certain unavoidable things trigger outbreaks for them, or they want to reduce transmission risk. Some people use barriers for oral sex if they know they have oral herpes but I would guess that's uncommon. It is recommended in general for STI prevention yet I suspect it is uncommon. I have never encountered it myself. If you are concerned about this latest interaction with your ex, perhaps you could ask him if he has ever had a cold sore before. If he has, you can stop worrying. If he hasn't, you can tell him you are occasionally getting cold sores and that you will abstain from contact when you have outbreaks. If you are particularly concerned about his immune system, you could consider taking daily antivirals if he has no history of cold sores.

Have you been tested to ensure you don't yet have it yourself? In most cases, I think the drawbacks of testing outweigh the benefits, but this seems like a case where you might want to consider it. Also, bear in mind about 1/3 of single women her age in the U.S. have HSV2, most just don't know it, so she may actually present less risk of transmitting HSV2 than another partner of unknown status if she takes any precautions such as daily antivirals. Having said all that, if you find anxiety continues to get in the way of intimacy, it's okay to consider it a simple incompatibility worthy of moving on. As she said, she needs to be with someone who feels free and uninhibited in their intimacy with her. Likewise, you need to be with someone you can feel free to be intimate with.

IMHO, I think it's more likely legal penalties would act as a deterrent to people getting tested and/or seeking treatment. This is why some HIV disclosure laws were changed in California recently. When testing is voluntary but knowledge of positive status carries a significantly greater penalty than not knowing one's status, some people who might otherwise get tested or seek treatment opt out of testing which creates negative health outcomes for those individuals and the community. Also, considering 80% of adults (and a fair number of children) have HSV and it's being passed around all the time, routinely suing people for this would be a tremendous legal burden.

Yes, as @HikingGirl said, the IgG test is less sensitive for HSV1, returning 30% false negatives. It's more sensitive for HSV2, returning only 5% false negatives. And for an unknown reason, people who test false negative tend to do so repeatedly.

@HikingGirl Haha. It's an area of interest for me. Terri Warren started quoting new shedding stats a while back that differed from how they were presented in the Handbook and I wanted to understand why. I think it was in some cases related to newer research and in other cases just about how the numbers were presented (like an average versus a range). The current average shedding rates she quotes are as follows: - HSV1 oral, 25% - HSV1 genital, 5 % - HSV2 oral, 1% - HSV2 genital, 14% (10% asymptomatic, 20% symptomatic)

@Neb2006 @HikingGirl Also, on average, oral HSV1 sheds 25% of the time while oral HSV2 sheds 1% of the time, so likelihood of exposure is 25x greater on average with oral HSV1 than oral HSV2.

Has she been tested to determine whether she may already have HSV2?

@outbreak_surfers Regarding your dermatologist's comments, I live in the U.S. where studies indicate roughly 40% of autopsies reveal HSV2 infection, and as your doctor said, only a small percentage of these people were aware they were infected. The stigma is so unfortunate.

If you truly feel a need to know, one option to narrow things down is to wait until you have more of those shaving bumps and get those swabbed to see if you've indeed been symptomatic for some time. For some people, symptoms are triggered by shaving. For others, symptoms can be triggered by having sex (especially rough sex) after not having sex for a while, so that could be another possibility if you two had been apart and then came back together. Edit to add: Fluctuating hormones can also be a trigger for people. This would include starting/ending new birth control, pregnancy, menstruation, perimenopause, menopause. Any abrupt changes in hormones.

Nope. It's my understanding that once the value is in the positive range, there is no further meaning to the number as it can fluctuate. I don't know why it fluctuates, but I have read numerous times that the level no longer matters when it is a long established infection. It isn't like tree rings that continually increase with age, it just indicates an infection that was established more than several weeks back.

Nope, it does not mean that. My understanding is that anything > 3.5 is considered almost definitely a true positive (though there are exceptions) and it takes time for antibodies to build to that level which is why it is suggested to wait 12 weeks to test for highest accuracy. After those few months have passed, values can fluctuate within the positive range and do not indicate how long one has been infected. Levels don't just keep building in a straight line forever, apparently.

You can go to Westover Heights Q&A forum. I believe she charges $20 for a certain number of questions. I am not affiliated with her or the site in any way. I just respect her expertise. You can also search her forum to see if your question has already been asked. But keep in mind that even if you think you were infected recently, it doesn't mean your husband cheated. If he had any partners prior to you, he could have been carrying this virus since before you married.

I can't answer that. I don't know. I've seen someone ask this question about a month after last exposure and the herpes expert said antibodies would not build that quickly. Don't know if it's possible after 2 months.

I'm so sorry to hear of all your losses. That sounds absolutely devastating to a degree I can't even imagine. Yes, it's possible you've had it all along (if you had any partners prior to your husband). Also possible you acquired it more recently, but not within the last several weeks or you would not have had a 3.9 IgG test result. Possible the bumps were HSV related, possible they were not. This is one reason most people with HSV2 have no idea they have it. For most people, symptoms are so mild they are mistaken for things like razorburn, or they have no symptoms at all. Only 1 in 8 people with HSV2 are aware they have it. 7/8 who have it do not know. Your husband could be one of those who is unaware, or he may be uninfected. Women are more vulnerable to infection than men. As for future pregnancy, the greatest concern (by far) is contracting genital herpes (of either type) during late pregnancy when there isn't enough time to build antibodies prior to labor. If you do the math on neonatal herpes, you will see that it is actually more likely (though still uncommon) for a HSV- woman to become infected with genital HSV1 or HSV2 in late pregnancy and pass on neonatal herpes than it is for someone who is HSV2+ at the time of conception to pass on neonatal herpes during childbirth. There is a tiny risk, but it is even tinier than the risk to women who are HSV- upon becoming pregnant. Additionally, knowledge of your status allows you to take precautions such as antivirals in late pregnancy to decrease risk even further. I'm so sorry you're going through all this.

I'm glad you're feeling optimistic! I discovered my status in a similar fashion. I was being thorough in search of peace of mind and instead got a surprise HSV2 diagnosis. At the time I tested, I must have been carrying it for somewhere between 1.5 and 32 years. Just never realized it. I'm sorry about how your stepmother is treating you. Assuming she is middle aged, this is a virus carried by a large percentage of her friends. She may even have it herself. Rates are high among both single and married middle aged women. And as Username said, there is no need for precautions in this case anyway since you are not in a sexual relationship.

@butterfly2018 I see your question but I think you are referring to @hikinggirl's comment about her husband's negative status after a long marriage, so hopefully she'll chime in. But yes, it is very common to not have symptoms or to have symptoms so mild they go unnoticed (in fact, that is what is most common). And many couples manage not to pass HSV2 from one partner to another, though odds are better when HSV status is known and precautions are taken.

I know sun exposure is a known trigger for oral herpes outbreaks.

I think it was more like a series of breakthroughs. And sometimes it's like several steps forward, a couple steps back, then more steps forward, so I try to be easy on myself. I think my breakthroughs were as follows: - I found that whenever I mentally substituted the words "cold sores" for herpes, it was easy for me to identify how much of my thoughts were related to the stigma vs. the actual condition. I discovered that virtually all of my distressing thoughts were about the stigma, not the condition itself. - I spent a lot of time reviewing studies and gaining an understanding of prevalence, transmission risk, etc. This opened my eyes to the fact that 80% of adults are capable of transmitting HSV to an uninfected partner's genitals, yet the vast majority don't expend any energy thinking about this and don't know their own status or the status of their partners. So when someone would say something like "you should use a dating site for people with herpes" I would think "isn't that all dating sites?" - This is more specific to me personally, but I discovered 50% of women in my specific demographic (age, race, marital status) have HSV2 and most don't know it. I had no idea it was this common, nor did I realize most people are unaware they are infected. I realized that by taking all steps known to reduce transmission risk (disclosing, taking antivirals, using condoms), I pose less risk of transmitting HSV2 than nearly half my peers who are unknowingly infected. This helped me understand I am not a unique risk but actually very ordinary in terms of the risk I present. - I asked myself if I would do things differently if I could go back to when I first started kissing and having sex. Would I have done partner testing and limited to long-term monogamy with people who tested HSV negative? Or would I have used dental dams to receive oral sex, knowing that most of my partners likely had oral HSV1? If testing was the norm and everyone knew their status, would I have avoided the roughly 80% of past partners with HSV? My honest answer is that I would have done almost nothing differently. Maybe in rare cases in which I was very much already on the fence and ended up regretting the encounter anyway, it could have been a factor in falling onto the other side of the fence instead of proceeding. But those instances in my life were rare. In all other cases, I would've enthusiastically done exactly what I did and taken those risks I didn't even realize I was taking at the time. This reflection on my own choices helped me understand that it's okay to allow other people to manage their own risk. I would not have wanted 80% of my past partners to opt out in order to protect me from HSV. Why should I make that choice for someone else? - I had a great disclosure experience. The guy was totally accepting, said he had oral HSV1 so he understood how HSV works in general and wasn't afraid. We quickly moved on from that discussion and it was clear he was still very attracted to me. Getting physical with him felt euphoric, not hesitant or clinical. Even though we didn't see each other for long, his reaction gave me some forward momentum and proved to me that sex did not have to feel any different and HSV2 did not have to be a big deal in a physical relationship. It also made me realize I did not have to settle for clinical and hesitant sex, so when disclosing to prospective partners, I don't just feel like I'm awaiting acceptance or rejection, I'm also gauging whether their mindset will allow for mutually satisfying sex. If not, I swiftly move on.

It's my understanding the IgG picks up 95% of HSV2 infections at/after 12 weeks from infection and misses 5%. Also my understanding the same people tend to get false negatives upon repeat testing. And as you said, a positive swab is considered definitive. But if you're concerned about the possibility of a lab mix-up or miscommunication of swab results, perhaps you could try a Western Blot which is more sensitive.

@Sandraa, it's funny reading this old post (almost two years old now) because I started disclosing the following month and had many positive disclosure experiences. Not that every single experience worked out, but most did. Hang in there!

Agree 100% with @Dumfounded. HSV is very, very common. He may have HSV himself. His daughter may have HSV. It is likely the known risk combined with the location of the infection and related stigma have triggered this panicked response. Agree that if education does not ease his mind, you are better off walking away as this will be unhealthy for you. Considering the prevalence of genital herpes, particularly among adult women, combined with your antiviral use, you are not presenting a unique risk worthy of this type of response. However, some people are simply anxious about known risk and anxiety isn't always logical. Sucks for him and for you. I'm sorry you experienced this.

@powerhouse3248 I can't provide a specific anecdote, but I can tell you that I somehow managed to never contract HSV1, even though statistics would indicate it is likely at least 2/3 of my partners over the course of my life have had it, and it's unlikely many (if any) of them were taking antivirals. Having said that, almost everyone will contract HSV1 at some point, either orally or genitally, mostly with the exception of those who first contract HSV2 which largely protects against HSV1. You may want to take a look at this chart to understand how very common HSV is (93% of people in their 40s infected; 95% in their 50s): http://projectaccept.org/who-gets-hsv/ The fact that your girlfriend is taking antivirals and has very infrequent outbreaks would place her in a lower risk category for transmitting oral herpes than most people you will encounter. However, if her known HSV status is causing you anxiety that is interfering with intimacy and you expect that will not change, you may be better off either abstaining, finding a partner who has recently tested HSV-, or simply being with a partner who does not know her status if you are more comfortable with that. For some people, it is the awareness of risk that triggers anxiety rather than the risk itself.

I've disclosed to many people because I tend to disclose very early, often before even meeting and knowing whether a sexual or romantic relationship will develop. I really haven't noticed much of a pattern at all in who will and will not be okay with it. I guess the closest I've seen to a pattern is that people who generally are very anxious may be anxious about this as well. I've encountered that a couple times where their anxiety was greater than is typical, both related to HSV and life in general. And both of these people were fine having many casual partners, as long as they didn't know their HSV status. It was known risk that provoked anxiety, not risk itself. But obviously that's a small sample size. Those who have not had an issue with it have expressed a variety of reasons for that. One had a good grasp of relative risk in the dating pool and felt safer with someone aware of her status and taking precautions, one was attracted to my honesty in disclosing and that outweighed concerns about HSV, one thought the risk was small enough to not worry about, one had a history of cold sores so understood how HSV works and did not buy into the stigma that says genital herpes is scary while oral herpes is nbd, one said it would never be a factor for him in relationship choices, one had a primary partner (open relationship) who also had it, a couple knew they had it themselves, one thought it was ridiculous to consider this a deal breaker because it is so prevalent.

I believe you mean POTS and Ehlers-Danlos. I'm sorry to hear that. Has he been tested for HSV? Personally, my approach is to allow others to manage their own risk. Thinking back on my life and intimate partners, I would not have wanted any of them to opt out of intimacy for what they might have considered my own good. Considering roughly 80% of adults have HSV, I would've missed out on a lot of great experiences. If he does not yet have whichever type of HSV you have and you decide to move forward, options to reduce risk of transmission include taking daily antivirals and avoiding sex during outbreaks.

In your specific case, it might be worthwhile to get yourself tested (IgG type specific blood test) for HSV1 and HSV2. It is not something I would normally recommend, but given your anxiety level about contracting HSV1, it could be worthwhile for you to know if you are even vulnerable to doing so. If you already carry HSV1 in any location *or* HSV2, you would be largely protected from contracting oral HSV1. Bear in mind most people contract HSV1 during the course of a lifetime, many during childhood. Before people become sexual, it is typically contracted orally. After becoming sexual, it is typically contracted orally or genitally. Some people who contract it genitally as adults wish they had contracted it orally instead as there is lesser stigma associated with cold sores. On the other hand, an oral HSV1 infection sheds much more frequently than a genital HSV1 infection. And it does not protect against genital HSV2, so contracting genital herpes would still be possible, though they would be largely protected from contracting genital HSV1. Outside of initial outbreaks which can range from unnoticeable to very painful, most people tolerate oral HSV1 well and either have no symptoms or mild symptoms. For those with more bothersome or frequent symptoms, and for those with painful primary outbreaks, antivirals are usually helpful. After further education and perhaps testing, if you find you continue to have this level of anxiety or avoid intimacy with this woman, I would suggest moving on and considering this a simple incompatibility issue. Each of you deserves to be with someone who is comfortable being intimate and affectionate with you.