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MiddlesexMD

Q: How do I deal with my partner’s positive herpes test?

by Dr. Barb DePree MD


You say you’ve tested negative for herpes 1 and 2 antibodies, while your partner has tested positive for the herpes 2 virus, though he has not shown symptoms. I don’t find your situation unusual, and it does pose a bit of a conundrum. The reality is that using condoms is the most reliable way to prevent transmission, but in a long-term relationship, I understand that it’s not desirable.

I find that the most up to date and reliable information regarding HSV (and other STIs) is the Centers for Disease Control and Prevention (CDC), which is what I use to counsel patients:

  • HSV can be transmitted when lesions are not present.
  • Anyone with a HSV diagnosis is encouraged to inform current and future intimate partners, and to abstain from sex when lesions or their precursor symptoms are present.
  • Correct and consistent use of latex condoms might reduce the risk of transmission.
  • “Daily treatment with valacyclovir 500 mg decreases the rate of HSV-2 transmission in discordant, heterosexual couples in which the source partner has a history of genital HSV-2 infection. Such couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to prevent transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences. Episodic therapy does not reduce the risk for transmission and its use should be discouraged for this purpose among persons whose partners might be at risk for HSV-2 acquisition.”

What that last point means is that ongoing daily treatment with a prescription for an antiviral therapy by the affected partner can be effective protection to reduce the chances of transmission; “episodic therapy,” meaning the antiviral is taken only in cases of an outbreak of lesions, will not provide that protection.

I hope this is clear! You can have intimacy confidently, and I’m glad you’re researching the steps to take!


7 comments


  • TR, you will need to follow up with your doctor on your results. I am not familiar with this result.

    Dr Barb on

  • Me and my boyfriend went to get tested my results for herpes came back isolated what does that mean.

    TR on

  • Ariel, a swab test would be a culture to grow out the virus, which was + for HSV 1. It would be highly unusual for a culture to have both HSV 1 and 2 present. Now that a culture is positive for HSV 1, you will have antibodies to HSV 1 that will always be detectable (it takes a couple of weeks from infection to antibody detection). A blood test is looking for antibodies to previous HSV exposure, and for him it suggests previous exposure to both HSV 1 and 2. Your antibody testing may show the same (+ for HSV 1 and 2), but the lesion cultured or swabbed was only positive for HSV 1. Having antibodies to HSV doesn’t mean he has any active disease or clinical outbreaks, many people are positive and don’t remember ever having a lesion (oral or genital). This testing result is likely accurate.

    Dr Barb on

  • Recently my boyfriend and I were both tested for HSV 1&2. I had a swan test while he had a blood test. My results were positive for hsv 1 but not 2 while his we’re positive for both. Would you suspect an error in the results?

    Ariel on

  • CM, there are two issues to investigate and be aware of. First, since your partner tested positive, follow the advice in the article above. Second, since you tested negative for both varieties, I’d recommend going back to your doctor for a full STI panel, if you didn’t already have one. Thre are othr STIs that can cause symptoms like you describe. Whatever you learn, the appropriate treatment is available, and herpes is manageable and you can continue to have a full relationship with your partner, keeping in mind that there may be extra steps to take for health and comfort.

    Dr. Barb on

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