Help! Confused about herpes test results and relationship impact

[Geemmach]

I apologize but this is long….

I recently received a positive result of HSV-1 via PCR. I went in 5/31 because I was really sore after sex with my partner. The soreness didn’t seem normal or like any other pain or discomfort I had experienced before. The soreness was 2 or 3 days after sex and mostly by my butt. We had sex 2 weekends in a row after not having sex for a month or so (we live almost an hour apart, both have kids, full-time jobs, etc). Both weekends involved everything (vaginal, oral and anal sex). 
 

I was fortunate to snag a last-minute cancellation with my PCP. She examined and swabbed my vagina but said everything looked normal (and was negative for gonorrhea and chlamydia but WBC Wet Prep showed Few. I showed her the spot by my butt that was sore and she said that looks like herpes and swabbed it (negative for HSV-2, positive for HSV-1). All other urine and blood tests were negative. 
 

Obviously this was a shock because I have been with my partner since 2019. I was angry! I was married for 10 years prior to him and he was my first and only partner after my divorce. Of course I accused him of giving it to me and questioned whether he was faithful to me. He went in a week after me (a different clinic) and got tested. All his tests were urine and blood because he had no outbreak so there was nothing to swab. They called with his results and said everything was negative, including herpes. Second shock I received! How could I be positive and the person I was having sex with for the last 4 years be negative?! It has been an emotional drain, on both of us. We essentially broke up, but question if we should, but both are confused about our results and scared to even consider having sex. 
 

I reached out to my doctor to try to get some answers or clarity on the situation. She said my test has a lesser chance of being a false positive than his does of being a false negative, because of the testing methods that each of us had. Over the weekend, he got a paper copy of his results in the mail and he sent me screenshots. English is not his first language and it was a lot of medical jargon and confusing so he didn’t understand it all. That’s when I noticed that his herpes test said: 

HSV 2 IGG, W/REFL AS 2 INHIBITION (17170)

HSV 2 IGG, TYPE SPECIFIC AB

 

I tested positive for HSV-1 but it doesn’t look like that is what he was tested for. Is a HSV-1 IGG and a HSV-2 IGG 2 separate tests? Can that be determined from his results? Did the doctor just assume that he had HSV-2 because of my sores and positive result? Or am I just driving myself crazy trying to explain how we could have different results? 
 

I am including the screenshots. All identifying information has been removed. First screenshot is my positive result from my online patient account and the screenshot of the paper copy he received. All this is already difficult to understand, much less trying to explain all these things to someone else in a different language

[mr_hopp]

Hi @Geemmach, this is so common to have confusion and frustrations around how these tests are performed. By its very nature, it's confusing stuff! Let's try to unravel this together.

HSV-1 and HSV-2 are indeed separate tests, and they specifically look for antibodies related to each type of herpes virus. From what you described, it seems that your partner's test results focused on HSV-2 specifically, which might explain why HSV-1 wasn't mentioned.

And since you were swabbed and it came back positive for HSV-1, then he should have been tested for both. It could have been interpreted by his healthcare peeps that he was wanting to be tested for genital herpes, and most healthcare professionals (incorrectly) assume HSV-2 only (while over 50% of all new genital herpes cases are HSV-1). There's also the fact that most people in the world (70-90%) carry HSV-1, so clinics don't tend to test for it absent an outbreak since most people's blood tests would be coming back positive for HSV-1; this complicates things because you can't tell *where* HSV-1 shows up without an actual outbreak to locate the possible zone of transmission. Our western culture is also particularly odd because it calls genital HSV-1 or HSV-2 "genital herpes" (oooh, scary STD!) but if HSV-1 is in the oral region, it's only called harmless "cold sores" (when in reality, it's all the same, just in different regions). This is thanks to our culture's sexual shame in general, but that's a whole other conversation ... 

The best thing to do in this kind of situation is for both of you to get a Western Blot test for both HSV-1 and HSV-2. It's way more accurate than IgG without the potential of false positives/negatives. Here are details about how to get that set up: https://depts.washington.edu/herpes/pages/hsv_resources

I hope this clarifies the situation for you both. Remember, you're not alone in this journey, and we're here to support you every step of the way. If you have any further questions or concerns, feel free to reach out. Wishing you clarity, peace of mind, and continued strength!