AboutMark Behar Expertise Almost any question or concern about sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), gay men's health issues.
There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything.
Rather than trying to “prescreen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and conseqences of possibly “catching” something from someone who’s hotter than expected (pun intended!).
There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!
Experience Family Practice PA since 1981;
Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answer STD questions submitted to their web site.
Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.
Organizations Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.;
Wisconsin Academy of Physician Assistants;
American Society of Colposcopy and Cervical Pathology (ASCCP); Board of Directors, National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)
Publications Journal of the American Academy of Physician Assistants (JAPA)
Education/Credentials Physician Assistant Certified, since 1982;
Masters in Physician Assistant Studies;
Colposcopy Recognition Award, American Society of Colposcopy and Cervical Pathology (ASCCP);
Awards and Honors Colposcopy Recognition Award (CRA), from the American Association of Colposcopy and Cervical Pathology;
Distinguished Fellow, American Academy of Physician Assistants;
Fellow, Wisconsin Academy of Physician Assistants
Past/Present Clients Brady East STD Clinic, Milwaukee, WI
Question Hello, my name is Shena, I am a 26 year old female living in New York City. I am single and I have approximately 2-4 new partners a year with whom I used condoms. I also have an IUD as an added birth control measure. Every 3-4 months, to be safe, I get a panel of STD tests. I come out negative for all seven major STDs (HIV, Herpes 1 and 2, Syphilis, Hepatitis B (immune to A and C), Genorrhea and Chlymedia). However, in June 2008 and April 2009, my tests results for Herpes 1 and 2 was 0.06 and 0.07 (respectively), which was negative. Then in June 2009, I decided to take the test again and I got 0.16 and 0.17, respectively, for the Herpes tests. Still negative, but why the increase? I know that it measures antibodies to the virus. Could it be because I exposed myself to someone with Herpes but did not get it? Or got it but it does not show on exams yet? What are your thoughts? I am a bit worried.
Answer Hi Shena,
Although it seems like you increased your antibody level 2-3x (0.06 to 0.17), it is not thought to be "positive" reflecting antibody (your body's reaction to a viral infection) to the virus until the numbers exceed (1.09) depending on the test technology. Other things can cause variations in these antibody tests. That is why low levels of antibody are not significant indicators of anything. Most of these tests are enzyme-linked immunosorbent assays (ELISA), whereby a chemical luminescence is measured by a light emitting and recording piece of equipment. An instrument measures and assigns an artibrary numerical value to the "strength" of the chemical reaction. If the number exceeds a certain number (1.09 by my clinic's lab), then it is positive. What if the test is close but not quite up to that number, 1.09? Then it is called an "equivocal" result. Normally, acute antibody (known as "IgM"), very rapidly increases with an acute infection with herpes, and then drops off fairly quickly after an acute outbreak. IgG is the antibody that persists and lets us know that a person may have had an infection before.
Nothing to worry about. If you had been successfully exposed to and infected with herpes, within a few days you will develop signs and symptoms of infection, and your antibodies will go up immediately.
