Sexually Transmitted Diseases/Herpes?


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QUESTION: My doctor clinically diagnosed me with genital herpes 6 weeks ago. The swab results came back negative, but he said they are far from accurate. It's been a very hard time, I'm on week 5 of valtrex right now (it got so bad I had be hospitalized and given acyclovir via IV but that because the sores spread to my throat and I couldn't swallow).
The past two weeks it's been healing up quite well. It's gotten more itchy, but the swelling/redness has gone down and the ulcers have closed over. However, in place where I had two ulcers, two little hard lumps have remained. They were bigger at first, and kinda yellowish. Since I started my last and current round of valtrex they have gotten smaller, but aren't going way (haven't changed size in a couple of days). They are really hard to the touch.
Would could they be/ what should I do?
I have also been experienced a lot of discharge, it's white and very goopy. Sometimes I feel like I have to pee and if I "push" a lot of it will come running out. Is this related?
I am not pregnant and have been tested for other sti's except HPV
Thank you so much!

ANSWER: Hello Sophia,
I would get a second opinion. I am unaware of a person with an otherwise normally functioning immune system would have a protracted 5 week course of herpes unresponsive to valtrex and IV acyclovir. I doubt the diagnosis, and I would disagree about the sensitivity of HSV DNA tests, which are exquisitely accurate! Herpes antibody tests are not easy to interpret, but the logical and "gold standard" test is the DNA test (also called a PCR or NAAT test).

My recommendation is that you talk to a gynecologist. The whitish discharge may be either a normal physiologic discharge, or a vaginal yeast infection.

Good luck!

---------- FOLLOW-UP ----------

QUESTION: I forgot to mention that I do not, in fact, have a normal immune system. It is weekend from previous existing conditions I have. I did not get a blood test looking for the antibodies, I only had a swab of one of the lesions (which could have been compromised during transportation I was told).

Hi Again, Sophia,
I don't know the type of swab you had, but in most cases, the method of transportation from collection to the lab for processing should abide by the manufacturer's guidelines. In spite of how weakened your immune system may be, herpes should not last for as long as you mentioned earlier. But I do not wish to speculate about something without knowing the results of any of your specific lab tests. That is something to discuss with your doctor(s).

Good luck!

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Mark P. Behar


Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. 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 “pre-screen” 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 consequences 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!


Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered 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.

Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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