Sexually Transmitted Diseases/Herpes

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Question
I was just tested for std's upon my request to have one done.  The result came back that I have a 2.9 Igm.  My doctor said I was recently infected HSV in the past 4-6 weeks.  Not sure though if it type 1 or 2, a retest will be done in 4 weeks.  
My question is:  How could I have come infected with that if I was not having sex during that time?  I did kiss 2 people about 5 to 7 weeks ago, though I do not recall seeing any blisters when I kissed them.  Are there any other reasons my Igm read high numbers?

Answer
Hello Christy,
I presume you had an IgM blood test for herpes type 1 and 2 (in other words, impossible to detect which herpes type you had, as they are combined tests). The test DOES NOT tell you that you were recently infected; it tells you if you had a recent outbreak-- it may have been an initial infection, or a reinfection. If an IgG test were done at the same time and was negative, then you could conclude that it was a NEW infection, not a recurrent outbreak. This would mean that your infection was new and recent. But that information is missing from the information you have provided. So we don't know whether this is an initial or an existing infection. Since initial infections usually are more clinically apparent-- more noticeable to you, I suspect that this was a recurrence.

You could have gotten this as a child or from any friend or family member shedding herpes but without a clinically apparent infection, who kissed you as a child, during rough and tumble play, a friend sharing a drink, etc. Your "cold sore" is the polite term for herpes around the mouth or nose, but this can occur with either of the herpes viruses.

Hope this is somewhat helpful. Good luck!
--mark  

Sexually Transmitted Diseases

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Mark P. Behar

Expertise

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!

Experience

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.

Organizations
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)

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

Education/Credentials
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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