Research shows that people diagnosed with herpes are more likely to become depressed, withdraw socially, and experience reduced self-esteem. We also know that due to the stigma, learning that you are positive for herpes can impact your mental health. (You should not do confirmatory testing with the same blood test that gave you the positive result and to be confident in your results, you should wait 16 weeks from the last possible exposure to be tested.)īlood tests given too early after possible exposure can be false negative. I have worked with a number of patients diagnosed within this range who I encouraged to follow up with the Western Blot and they discovered they were negative. In addition, many doctors do not know about the high false positive rate within this range so they incorrectly diagnose their patients without getting confirmation. The Western Blot is more complicated to obtain (though not impossible) and your insurance may not cover it. The most accurate confirmatory blood test is the Western Blot. If you do test positive within this low range, the CDC recommends confirmatory testing (update: CDC now encourages confirmation between a 1.1 and 3.0, but some experts still say below 3.5). There can be false positives above 3.5 as well but they’re less likely. About 50% of positives that fall in this range are in error, with the closer you get to 3.5 the more likely you are positive and the closer to 1.1 the less likely you are positive. If you are positive for type 2 and fall within a positive range of 1.1 - 3.5, there’s a decent chance this is a false positive. (There is about an 8% chance of false negative with HSV 2.) This means if you test negative, you might still have HSV 1. (Type 2 is almost always a genital infection.)Ībout 30% of negative results for HSV 1 are false negatives. The only way we can know which location is infected is by symptoms. If you have never had symptoms (no cold sores or genital symptoms) and obtain an IgG based type-specific blood test (the standard test for herpes simplex), and the test comes back positive for type 1, we have no way of knowing whether you are infected orally, genitally, or both. The blood tests do have a lot of value, but here are the biggest issues:Ībout 50% of the population has type 1 herpes. The biggest contributing factor to the guidelines is that 1) standard herpes blood tests are not totally reliable and 2) receiving a herpes diagnosis can have a significant impact on mental health while being virtually non-threatening to your physical health. Preventive Service Task Force documents where they discuss the reasoning for their decision. In fact, you can learn a ton about the research on genital herpes and transmission by reading the U.S. If you read the documents, you can see that the researchers sensitively consider their decision from many different angles. So why is this test not included? Doesn’t the medical community care about preventing transmission?Īlthough it may not feel this way, the doctors and researchers who established these guidelines have been quite thoughtful about them. This means they may not have contracted it from their current partner. In fact, by the time some people are diagnosed, it can be very difficult to determine how long they've had the infection. Many doctors also don't inform patients that the test is not included, so when people do have symptoms and receive a diagnosis, there can be feelings of confusion and worry about whether a partner was dishonest or cheated, when their partner simply may not have known about the infection. Nonetheless, asymptomatic individuals can still pass herpes on, and you could be one of them, even if you obtain regular STD testing. While some people have classic symptoms easily identified as herpes, most people have no recognizable signs or no indications that concern them enough to head to the doctor. Most people with herpes have no idea they’re infected. When it comes to STD screening, the general consensus and recommendation is to not test individuals for herpes unless they have symptoms. Major medical associations regularly publish guidelines for how doctors should practice. That means all those screens that you so diligently obtained since becoming sexually active and the one you may have asked your partner to get as well, probably did not include herpes. Many people diagnosed with herpes feel betrayed by the medical system when they learn they had never previously been tested for herpes and their partner likely was not either. If you didn't know before now, herpes is generally not included in a standard STD panel.
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