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Confused about what my OBGYN said about my genital HSV 1?

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Yesterday my boyfriend and I went to my OBGYN to discuss my herpes condition and what kind of precautions we should take when we have sex or should I take an antiviral to reduce transmission.

So long story short she kind of made it out to be really nothing at all. I mean herpes no matter the type is just an annoying skin condition after all, but the way she made it sound was kind of concerning... well at least to my boyfriend and somewhat me.


I told her about my test results that came back as a positive culture for genital HSV 1 and neg. for type 2. I did also have a positive igM that was 1.0. My igG results came back negative (type 1 was 0.3, type 2 was 0.1) indicating it was a recent infection.


She told me that the labs don't really differentiate what type you have or that the tests aren't sensitive enough. I felt what she basically saying was that genital herpes is genital herpes regardless of what type you have. I know in a sense they share a lot of similarities but the way they both behave down below are two different stories such as reoccurrence, shedding and transmission.


My boyfriend also asked her how likely I have it orally (I've never had a cold sore in my life and based on my results its unlikely I ever had HSV 1 until 2 years ago) and she told us that we can't really tell and it doesn't discern its location. Doesn't having in one area of your body make it very unlikely to acquire it anywhere else?


Now, my boyfriend tested negative for HSV 1 & HSV 2 (I assume it was an igG not an igM but his doctor didn't specify). I think his result was .01 for type 1. Though I know the igG can miss 1 out of 10 cases of HSV 1 and the WB is really the only accurate test for it. He's convinced he doesn't have it because he never got a cold sore and tested negative for the blood test. He previously dated a girl who had recurrent outbreaks of oral HSV 1 for 2 years and majority of his family members get cold sores. So either the blood test missed his antibodies or he has a lot of luck lol.


Getting back to my doctor, she was saying that 99% not contagious and I'm really only contagious is when I'll get an outbreak and we don't have to take any precautions during sex (but obviously avoid sex during an OB).


My boyfriend walked out of her office very skeptical, he looks at statistics and only reliable sources. He also has OCD about his health and anything medical, he basically thinks he's dying everytime he gets sick. He's really scared about catching it too. We've only known each other about 3 months but we want to be prepared when we do get to that point and have sex.


We plan on going to an Infectious Disease doctor in 3 weeks to get a second opinion (my boyfriend rather hear it from a doctor than the internet) but hopefully its something positive he has to say. I've done a lot of research about genital HSV 1 and it seems theres not much to worry about is that true?

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Hello, I would advise he get a Western Blot test for HSV-1. The common ELISA test misses up to 30% of HSV-1 infections (far to unreliable for decision purposes). You will not need to use protection if he is already infected.


Hi Jack,

Thanks for responding. Do you know of a way to obtain the Western Blot? Apparently Westover Heights is not doing it through Quest labs but you can still get it through AnyLabTestNow. My problem is is that the nearest one of the labs are 100 miles away from where I live.

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Honestly you don’t have to go to a infectious disease doctor about this , the risk is only 2% he just has to deal w the risk when it come to you


I wish my boyfriend could deal with it, he's a germaphobe in a way. He started freaking out when he saw tiny red bumps from irritation on his penis. He's been supportive but really afraid of catching herpes from me.

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