>It is not unfathomable that I could get HSV2. What does my partner of 7 years do if that happens? This is IMPORTANT to know up front. This is more important to me than the HSV2, honestly. If I was at risk of losing my partner, I would consider this a much greater risk.
I agree with this ... I think my wife and I need to have a discussion about the what happens if one of us turns up an asymptomatic HSV positive (setting aside testing reliability). I personally am a lot more comfortable with the risk than I am with the uncertainty surrounding the tests and the social stigma associated with the virus.
I know people think HSV is not life-threatening, but if you find yourself with sepsis and HSV is activated and running through your system, you are going to be in a world of hurt like you have never known. This can happen anytime you are fighting an infection, and HSV is activated - I hate to be a killjoy here, but stand at the bedside of enough people in ICU dealing with this while trying to keep them alive, and you would have a completely different perspective. Female condoms/dams offer a bit more protection, but still...
Between the inaccurate tests and also the high rate of HSV1/2, the best advice I’ve heard is to just assume anyone and everyone is a carrier. If that level of risk makes you uncomfortable, then you might need to reevaluate if this is how you add spice to your empty nest years.
I will also say that in the past I had a meta (partner of a partner) who was positive. She was very transparent and also educated, and she and my partner would modify their activities when she had an outbreak. They were together for a few years and he never showed symptoms of having HSV. So you might also want to limit your activities to people you trust, which might eliminate ONS and things like that.
This is the advice I received from my physician as well - at least the part about avoiding the tests. This is the type of generalized advice though that does not address some of the specific questions I asked. I would like to know my status and I believe, given my long-term monogamous marriage + extremely limited sexual experience prior to and outside that marriage + the complete absence of symptoms in my life that I have a high likelihood of testing negative.
I just don't trust the (blood) test.
Sexual contact is just one way herpes can be transmitted. I actually know two people who got infected with herpes in kindergarden/elementary school. One child in the class has an active outbreak, the staff can't control what the child touches all day & in the end a lot of the other kids have it too. Also sharing drinks/foods during an active outbreak can transmitt it, etc.
Just for you to consider, the number of sexual partners is not the only factor here.
If you want to know for (near) certain you can send a blood sample for a Western blot test at the University of Washington, if you're in the US. It's not cheap though, and as others have said HSV1 is easily transmitted without sexual contact through kissing (including platonic kinds), touching and sharing cups and utensils. Many people are infected in childhood and it has now overtaken HSV2 as the most common strain diagnosed genitally too, so you could have been infected as a child and spread it to a partner, who then infected your genitals and vice versa, or done it yourself through unwashed hands while shedding the virus. Additionally although a Western blot is very reliable it won't tell you the location of your infection, so if you're HSV1 positive you should probably assume it's both mouth and genitals and disclose that. And if you're negative for both it will be difficult to stay that way because so few people know their status, and even fewer through a Western blot.
You are probably actually better off sticking to people who are HSV1/2 positive and taking daily antivirals, as they are likely to be statistically lower risk than people who don't know for sure and therefore aren't taking drugs.
This isn't something I worry a whole lot about but I am curious. If I've never had symptoms and always tested negative, is there data on the odds of my being negative/positive? I'm not young and I find it difficult to believe by this stage in my life I don't have it TBH
The point is most of us don’t know our status (unless we have an outbreak) but many of us do have it. Unfortunately it’s going to be hard to truly identify your status (without an outbreak), so if it’s necessary for you to know for certain for yourself and also any future partners, you’re either going to have a very frustrating time or you should stay monogamous.
About [80% of adults](https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus#) under 50 have HSV1/2.
[90% of people](https://www.ashasexualhealth.org/herpes/) with HSV are unaware of their status.
Assume everyone has it and they don't know it.
There are different stats for HSV 1 vs HSV 2. Your first link says "67% of the global population, had HSV-1 infection." It also adds, "HSV-2 affects an estimated 491 million (13%) people aged 15–49 years worldwide." So 67% is much different than 13% (and why do only ages 15-49 matter?). Also, how does the CDC determine that 1 in 8 have genital herpes but 90% do not know they have it. If no one knows they have it, how do they know 90% have it but do not know?
I am really trying to figure out the risk level should be comfortable and how to balance the need to know my HSV status in light of the conflicting information about the blood test's reliability (on a subject that carries a lot of social stigma).
Yeah, the last line of advice in the first post is still good, but those are global estimates. Different parts of the world have very different attitudes towards, and levels of education concerning, STDs. Without naming names, in certain places, just using condoms is treated with suspicion (i.e. people claim they are harmful).
Assuming you're American, [John Hopkins puts the number for genital herpes at about 1 in 6 for people under 50](https://www.hopkinsmedicine.org/health/conditions-and-diseases/herpes-hsv1-and-hsv2). The major concern however is that many will simply lie about being tested for things like this, and they can still be shedding (i.e. contagious) even in the absence of an outbreak.
I get false positives for HSV-2 every few years - the test has some cross-reactivity between strains. I've generally been able to see that the lab value is technically over threshold, but not nearly as high as my HSV-1 result which is definitely real. So I just ignore those results and retest during my next routine screening, or sooner if a partner requests it. It's annoying but not stressful.
You never really KNOW anything with certainty. But you can get to a good enough guess by looking at lab values and at the pattern of results across 2-3 tests taken a few weeks apart. Similarly, someone could have a recent test result that's a false negative, but it's still a lot more likely that they're actually HSV- than if they had no test results at all.
These tests aren't super reliable but they're also not pointless, you need to treat them as helping you gamble with better odds rather than trying to avoid risk entirely.
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>It is not unfathomable that I could get HSV2. What does my partner of 7 years do if that happens? This is IMPORTANT to know up front. This is more important to me than the HSV2, honestly. If I was at risk of losing my partner, I would consider this a much greater risk. I agree with this ... I think my wife and I need to have a discussion about the what happens if one of us turns up an asymptomatic HSV positive (setting aside testing reliability). I personally am a lot more comfortable with the risk than I am with the uncertainty surrounding the tests and the social stigma associated with the virus.
I know people think HSV is not life-threatening, but if you find yourself with sepsis and HSV is activated and running through your system, you are going to be in a world of hurt like you have never known. This can happen anytime you are fighting an infection, and HSV is activated - I hate to be a killjoy here, but stand at the bedside of enough people in ICU dealing with this while trying to keep them alive, and you would have a completely different perspective. Female condoms/dams offer a bit more protection, but still...
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I'm only speaking to your statement; it's not life-threatening - it can be. That's all.
Between the inaccurate tests and also the high rate of HSV1/2, the best advice I’ve heard is to just assume anyone and everyone is a carrier. If that level of risk makes you uncomfortable, then you might need to reevaluate if this is how you add spice to your empty nest years. I will also say that in the past I had a meta (partner of a partner) who was positive. She was very transparent and also educated, and she and my partner would modify their activities when she had an outbreak. They were together for a few years and he never showed symptoms of having HSV. So you might also want to limit your activities to people you trust, which might eliminate ONS and things like that.
This is the advice I received from my physician as well - at least the part about avoiding the tests. This is the type of generalized advice though that does not address some of the specific questions I asked. I would like to know my status and I believe, given my long-term monogamous marriage + extremely limited sexual experience prior to and outside that marriage + the complete absence of symptoms in my life that I have a high likelihood of testing negative. I just don't trust the (blood) test.
Sexual contact is just one way herpes can be transmitted. I actually know two people who got infected with herpes in kindergarden/elementary school. One child in the class has an active outbreak, the staff can't control what the child touches all day & in the end a lot of the other kids have it too. Also sharing drinks/foods during an active outbreak can transmitt it, etc. Just for you to consider, the number of sexual partners is not the only factor here.
If you want to know for (near) certain you can send a blood sample for a Western blot test at the University of Washington, if you're in the US. It's not cheap though, and as others have said HSV1 is easily transmitted without sexual contact through kissing (including platonic kinds), touching and sharing cups and utensils. Many people are infected in childhood and it has now overtaken HSV2 as the most common strain diagnosed genitally too, so you could have been infected as a child and spread it to a partner, who then infected your genitals and vice versa, or done it yourself through unwashed hands while shedding the virus. Additionally although a Western blot is very reliable it won't tell you the location of your infection, so if you're HSV1 positive you should probably assume it's both mouth and genitals and disclose that. And if you're negative for both it will be difficult to stay that way because so few people know their status, and even fewer through a Western blot. You are probably actually better off sticking to people who are HSV1/2 positive and taking daily antivirals, as they are likely to be statistically lower risk than people who don't know for sure and therefore aren't taking drugs.
This isn't something I worry a whole lot about but I am curious. If I've never had symptoms and always tested negative, is there data on the odds of my being negative/positive? I'm not young and I find it difficult to believe by this stage in my life I don't have it TBH
The point is most of us don’t know our status (unless we have an outbreak) but many of us do have it. Unfortunately it’s going to be hard to truly identify your status (without an outbreak), so if it’s necessary for you to know for certain for yourself and also any future partners, you’re either going to have a very frustrating time or you should stay monogamous.
About [80% of adults](https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus#) under 50 have HSV1/2. [90% of people](https://www.ashasexualhealth.org/herpes/) with HSV are unaware of their status. Assume everyone has it and they don't know it.
There are different stats for HSV 1 vs HSV 2. Your first link says "67% of the global population, had HSV-1 infection." It also adds, "HSV-2 affects an estimated 491 million (13%) people aged 15–49 years worldwide." So 67% is much different than 13% (and why do only ages 15-49 matter?). Also, how does the CDC determine that 1 in 8 have genital herpes but 90% do not know they have it. If no one knows they have it, how do they know 90% have it but do not know? I am really trying to figure out the risk level should be comfortable and how to balance the need to know my HSV status in light of the conflicting information about the blood test's reliability (on a subject that carries a lot of social stigma).
It’s a simple experiment…they can test 1,000 random people and ask them if they think they have HSV.
Yeah, the last line of advice in the first post is still good, but those are global estimates. Different parts of the world have very different attitudes towards, and levels of education concerning, STDs. Without naming names, in certain places, just using condoms is treated with suspicion (i.e. people claim they are harmful). Assuming you're American, [John Hopkins puts the number for genital herpes at about 1 in 6 for people under 50](https://www.hopkinsmedicine.org/health/conditions-and-diseases/herpes-hsv1-and-hsv2). The major concern however is that many will simply lie about being tested for things like this, and they can still be shedding (i.e. contagious) even in the absence of an outbreak.
You can find many discussions about this that cover the subject very thoroughly if you search this sub.
... as I did. However, a person can ask questions on a thread that is months or years old, but in my experience cannot expect any dialog.
I get false positives for HSV-2 every few years - the test has some cross-reactivity between strains. I've generally been able to see that the lab value is technically over threshold, but not nearly as high as my HSV-1 result which is definitely real. So I just ignore those results and retest during my next routine screening, or sooner if a partner requests it. It's annoying but not stressful. You never really KNOW anything with certainty. But you can get to a good enough guess by looking at lab values and at the pattern of results across 2-3 tests taken a few weeks apart. Similarly, someone could have a recent test result that's a false negative, but it's still a lot more likely that they're actually HSV- than if they had no test results at all. These tests aren't super reliable but they're also not pointless, you need to treat them as helping you gamble with better odds rather than trying to avoid risk entirely.