"Test me for EVERYTHING!" I hear this daily in the office from my patients who want to be checked out for STDs. Most of these tests are straightforward...except for herpes testing. Herpes can be elusive--carriers of the virus may never have another outbreak of bumps after their initial course. A few folks never even have an initial outbreak--they just pick up the virus with no symptoms at all. But the best test for herpes is a swab of a bump on your vulva or vagina, when the lesion is fresh (only a day or two old).

"What about blood tests?" patients then ask me. Well, blood testing for herpes can be ambiguous. There are two types of herpes, herpes simplex I and II. Back in our parents' day, cold sores were all herpes I, and genital herpes were all herpes II. The breakdown these days, though, is not that simple--it's about 80/20 now. That is, 80 percent of genital herpes is type I, and 20 percent is type II--and roughly the same split goes for oral herpes. We believe that it's scads more oral sex that has led the viruses to "jump" from their usual habitats...the one downside of more open attitudes toward oral sex, I guess.

So what do these numbers mean for you?

When your gyno does a blood test for herpes, the lab tests for both types. If they both come back negative, you're in the clear. If you're positive for both, it most likely means you've got both types of herpes. But if you're positive for just one type, that's where interpretation gets complicated. Your doctor won't know if that means you've got cold sores and oral herpes (like most people), or genital herpes. Blood testing for herpes, then, needs to be carefully considered, and the results cautiously interpreted.

Have you or anyone you know had testing for herpes? Was it explained well enough to you?



2 Comments

Sarah said:

I had a herpes testing nightmare! In February 2007 I went and got tested for everything. I came back positive for herpes, but they told me that they tested wrong and didn't test for either type I or type II. So, I went back a few weeks later and got tested again. Now I was told that it wasn't the test, it was the fact that I never had an outbreak and I should get tested another time. I had been calling my doctor and only speaking to nurses who had been looking in my file. They told me to come back and get tested, finally these results were read by a nurse over the phone to me who told me that because the virus is new in me, I would have to come back in 3 months to get tested to see which one it became. I didn't go back in three months. I was extremely frustrated after being tested 3 times with no answers as to which herpes I had. When I went back to see my doctor this past February, she looked at all my results and explained that because I didn't have an outbreak, there was no way to tell. She told me to get tested on more time. She called me herself with the results and told me that because I had such a low positive the first time, and now I was in high negative. This showed that I was probably exposed, but didn't get it. It is still confusing. I still have never had an outbreak of any type.

said:

i am absolutly nervous about geting tested...i feel positive that i ahave the std...but that would just ruin my life...my sex life how do you tell some one that you have herpes?????

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Em & Lo, more formally known as Emma Taylor and Lorelei Sharkey, are the self-proclaimed Emily Posts of the modern bedroom.

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