This is a question I am often asked, and my opinion may not match everyone’s on this topic, but here it is anyway.
If you’ve had a partner in the past who has had herpes, you might want to find out if you got infected and didn’t know it.
If your current partner has herpes, and you are wondering how to reduce the risk of transmission, the first step is to determine that you are indeed, not infected! Why go to all the trouble to reduce transmission risk when you may already have the virus, and would need to make no changes in your sexual practices to accommodate your partner’s herpes?
If you have had lesions or sores or breaks in the skin in the past, and they have been swabbed for herpes and you’ve had negative swabs, you need a blood test to confirm that you are actually not infected. Swab tests often have false negative results, and you can take the extra step to find out that you actually are or are not infected.
If you have new symptoms, and you want to know if this is actually your first infection or reactivation of an old one, you can use a combination of swab test and blood test to sort that out. If you have a positive swab test for HSV 2, let’s say, and a negative antibody blood test for HSV 2, that tells you this is your first infection. You’ve got virus present on the skin, but have not yet had a chance to develop antibody to the virus – it is too soon, because this is your very first infection.
If you’ve had a clinician look at your genitals and tell you by physical exam that you have genital herpes, you may wish to get an antibody test to confirm that diagnosis and/or determine whether you have HSV 1 or HSV 2 – you can’t tell from a look.
If you are pregnant, you may wish to know if you have herpes or not. This test is not usually included in pregnant screening – this is a topic to raise with your OB provider, if you wish. If you are starting a new relationship or coming out of an old one and would like to know which, if any STDs you bring to the table, so to speak, antibody testing for HSV is important to be comprehensive, and often isn’t included in routine STD screens.
So there are a few ideas for you about who may benefit from antibody testing for herpes. Be certain you get IgG testing, not IgM testing, and that it is truly type specific – there are good and not good blood tests for herpes. Feel free to post on the message board if you have questions about antibody testing.