Possible asymptomatic herpes and HPV--should I disclose?
October 8, 2014 10:04 AM   Subscribe

Dude, here. 1) My ex-girlfriend of on-and-off three years had periodic oral herpes outbreaks. I've never had an outbreak. Want to kiss new girl. Do I disclose so she can make an informed decision? 2) Two ex-girlfriends in distant past had abnormal pap smears. Do I disclose?

1. HSV: When when my ex suspected symptoms were coming on, and she was usually right, we meticulously refrained from oral-oral and oral-genital contact for an entire week after symptoms completely disappeared, every time. I'm 34, new girl (woman) is 27, one in six people, etc., etc.

I think I would probably want to know this about someone. And, for whatever relevance, I'm probably smooth enough to work this into a conversation in a non-awkward way. If you were her, would you want to know? I'm leaning towards of course tell her, but I want to make sure I'm not projecting my own paranoia, or something.

So, do I look for an opening to bring it up, if it looks like we're heading towards kissing?

2. HPV: Both abnormal pap smear relationships were 5+ years ago. Assuming I have a normal immune system, which maybe I don't, there's a 90% chance I've cleared the virus after two years, right? I disclosed to my ex of three years, who never had abnormal results, with continuous unprotected sex.

Do I look for an opening to bring this up with new person, if it looks like we're heading towards sex?

(Bonus question: I haven't been tested for anything for years and years, which is ironically irresponsible, and I think I should probably get tested in 12 weeks post ex contact, for what I can. Googling is telling me that HSV tests have varying levels of accuracy, etc., etc. and that some doctors don't like to do it. Question: Accuracy and cost minimization tips? Catastrophic health insurance only.)
posted by zeek321 to Health & Fitness (25 answers total) 2 users marked this as a favorite
For cost minimization I would get testing done somewhere like a state health dept run clinic or Planned Parenthood rather than a regular doctor.
posted by poffin boffin at 10:10 AM on October 8, 2014 [1 favorite]

So, do I look for an opening to bring it up, if it looks like we're heading towards kissing?

Yes. You were exposed to a communicable STD. Your partners should know that.

Do I look for an opening to bring this up with new person, if it looks like we're heading towards sex?


Assuming I have a normal immune system, which maybe I don't, there's a 90% chance I've cleared the virus after two years, right?

Yes. Not 100%. So get checked and be honest with your sexual partners.
posted by qi at 10:42 AM on October 8, 2014 [3 favorites]

Just go get an HSV 1 & 2 test. If the doctor won't do it, find another. You should get tested for everything anyway (as you yourself said). But this'll put your mind to ease about the HSV. Call around. Took me a while last time to find a place willing to do a full panel test, but they exist. Planned Parenthood is probably a good start, especially wrt to cost.

HPV - could disclose; but given the prevalence of the disease it really isn't "an issue" imho. HPV, I've never concerned about personally. Without any symptoms it's one of those things that (to me) is like "well, you've had sex with multiple partners, you've probably been exposed - just like everyone else." There are no tests for it, so all you can do is disclose and shrug. Could ask if the new lady has the vax for it, which would put everyone's mind at ease.
posted by ish__ at 10:43 AM on October 8, 2014 [1 favorite]

I don't think you have to disclose that an ex got cold sores, if you've never had cold sores or any other symptoms. You can ask for an HSV test, sure.

IMO you also do not have to disclose that half a decade ago women you dated had abnormal paps. Your current girlfriend should be aware that HPV is incredibly common, and be getting regular Pap smears. At 27 it's likely she's also had the vaccination.

On the other hand, it's pretty irresponsible that you haven't been tested regularly. Get tested.
posted by amaire at 10:52 AM on October 8, 2014 [8 favorites]

Independently of your experiences with previous partners, you should get tested because if you're sexually active you should be getting tested pretty regularly. I would do this before having sex with this new woman (at least unprotected sex).

The oral herpes is not something I would disclose or expect someone else to disclose, honestly. Doesn't something like 90% of the population have this? I consider it a pretty run-of-the-mill deal. YMMV, I don't think it hurts to bring it up, but I definitely think it is common and benign enough that it wouldn't need to be disclosed before kissing.
posted by rainbowbrite at 10:53 AM on October 8, 2014 [2 favorites]

Don't ruin your exciting pre-kiss moment with an unnecessary disclosure! Almost everyone has oral herpes; some people break out with cold sores and some people don't. My doctor said most people pick it up during childhood. It is super, super, super not a big deal. Unless you were to go down on your partner when you had a cold sore. But that's not the issue here. Kissing is fine.

I can't speak to the abnormal pap smears, though. Discuss that with the doctor or nurse at the health department when you go to get tested.
posted by magdalemon at 10:59 AM on October 8, 2014 [4 favorites]

Since you have no reason to believe you're the carrier of anything, you do not need to disclose.
posted by metasarah at 11:24 AM on October 8, 2014 [1 favorite]

go to planned parenthood - get tested for everything they'll test you for.

i personally wouldn't disclose kissing someone who had cold sores when you've never gotten one, it honestly wouldn't have occurred to me that it would be an issue. 90% of the population has had a cold sore, 40% of adults get reoccurring cold sores. you've never had one which puts you in the vast minority.
posted by nadawi at 11:37 AM on October 8, 2014 [4 favorites]

Well, if you don't disclose the HSV-1, and she thinks she doesn't have it (arguably most people either don't have it or don't know they have it), she might end up hating you when she eventually gets a cold sore.

Given the advice in this thread that you "do not need to disclose", the prudent thing to do is to abandon faith in humanity and both get full panel STD tests.
posted by sninctown at 12:19 PM on October 8, 2014 [3 favorites]

Have you ever heard of asymptomatic diseases? Herpes is one of those diseases that can be asymptomatic and you may never know you have it unless you've been tested. Do not rely on lack of symptoms as a diagnostic tool. Ignore people who tell you otherwise. Many people who have herpes don't know they have it until they get tested.

You should always disclose possible STDs to potential partners. Always. HSV is complicated because shedding can happen even when there are no symptoms. Don't assume she has HSV so you can ignore your responsibility to discuss it and don't assume you don't have HSV when you don't know for sure. Go to Planned Parenthood, they do sliding scale fees, and get tested for everything you can, as nadawi says.

Also, people are completely wrong when they claim HSV-1 infection rates are 90%, and using that statistic (or any reason, really) to justify the possibility of passing on HSV-1 without disclosure is morally reprehensible. According to Wikipedia, worldwide infection rates are 35%-40% for both HSV-1 and HSV-2 and US statistics for HSV prevalence are 58% for HSV-1 and 16% for HSV-2. Since oral herpes is typically HSV-1, that means that no, your new friend doesn't automatically have herpes and you should wait until you've gotten tested to kiss her.

Would I want to know? Hell yes! I don't have HSV (tested) and if you kissed me knowing you had been exposed without getting tested I'd dump you so fast you'd see stars. I don't care how blasé other people (here and elsewhere) are about it, I wouldn't want to be exposed to a disease that has no cure because someone was too broke, lazy or selfish to get tested.

And please ask yourself how you would feel if your situations were reversed. Would that feel like a great relationship built on trust when you found out later that you might have HSV because your partner didn't get tested and didn't disclose? If you progress to oral sex and still haven't been tested, are you going to stop and tell her you can't go down on her because you might have HSV? Or are you going to keep assuming you don't and possibly give her genital herpes? Also, how do you think she would react if you discussed it before oral sex but not before you kissed her? Think about it.

Please get tested. Please talk to her about it.
posted by i feel possessed at 1:06 PM on October 8, 2014 [8 favorites]

Response by poster: Huh, I'm actually surprised at the diversity of responses. It seems like the only downside of disclosure is repairable awkwardness, and if it's not repairable (if she's weirded out for whatever reason) then it wasn't meant to be. I guess I would want to know if it were me, and it sets the stage for deeper trust and intimacy. Huh. Thanks, everyone. Still watching this thread.
posted by zeek321 at 1:30 PM on October 8, 2014 [3 favorites]

I agree not to disclose. Not because you're hiding anything but because this really isn't an issue. I've read from various sources between 80% to 90% of the adult population has oral herpes. This mostly benign virus is a fact of life and in my opinion people need to accept that.

Of course the first move should be to get tested for both of these viruses and then decide how to act based on test results.
posted by deeba at 1:50 PM on October 8, 2014 [2 favorites]

I agree with I feel Possessed OP. I think you should definitely get tested to be sure. Honestly, you should both get tested if you're going to be having relations of any kind as a good faith gesture that this relationship could go somewhere, you would want to know you're both ok in that department. Simply as a peace of mind kind of thing. But don't bring it up without knowing the results, whether negative or positive, it's a great way to begin a conversation showing that you're responsible in that department and it's a plus in my book that you're proactive about your sexual health and sex life. Segue that into full disclosure of sexual partners if you think your relationship could get serious and for her to get tested as well. It's only as awkward as you make it and in my opinion, the right "adult" thing to do. Honesty truly is the best policy.
posted by lunastellasol at 1:59 PM on October 8, 2014

Wait, why would you disclose something that you haven't been tested for? You already know you've been exposed in at least 3 instances, so yes, definitely do the testing. And then go from there.
posted by poffin boffin at 2:03 PM on October 8, 2014

Response by poster: Wait, why would you disclose something that you haven't been tested for?

Because I want to wait another eleven weeks before getting tested (to make sure anything I've got shows up, however unlikely I got it right before breaking up after three years), instead of getting tested now and later and paying twice. And I want to ethically kiss her now, if she doesn't care and wants to kiss me. Yes, it seems both thrifty and anal. But that is me. Hereafter I will just start always getting tested every three months after a new partner, or something like that. Ok, no more threadsitting.
posted by zeek321 at 2:33 PM on October 8, 2014 [1 favorite]

Oral herpes and HPV are both common enough that many people don't consider them a big deal; on the other hand, many do. By disclosing your status, you're giving your future girlfriend the chance to decide for herself if it's a problem; by not disclosing, you're deciding for her.

Do get tested as soon as circumstances allow it. Call Planned Parenthood and see how much the tests cost.
posted by Metroid Baby at 2:35 PM on October 8, 2014 [1 favorite]

Go ahead and get these tests. If they're negative, yay. If you have oral HSV, you can join me in feeling like a disgusting leper whenever it comes up, and people start railing about what an abominable disease vector you are. (Seriously, you would be surprised at how cruel people will be about such a common infection.)

But yeah, get the tests and be done with it. FWIW no one I've ever dated has shunned my contaminated face when I told them I've had cold sores since childhood.

But if I were in your shoes, I'd skip these revelations unless I actually tested positive. And wouldn't expose anyone else in the meantime.
posted by Coatlicue at 2:52 PM on October 8, 2014 [4 favorites]

A guy I dated over a decade ago had no symptoms of any STDs. He assumed that meant he was clean, and left out his assumption when he told me he didn't have anything. When I wound up with genital herpes, he accused me of cheating on him and refused to listen to any explanation or reason. With a friend's help, I tracked down a couple of his exes. They both had it, too. Don't be that guy.
posted by The Almighty Mommy Goddess at 3:08 PM on October 8, 2014 [5 favorites]

HPV and oral HSV are so common that I don't think they need to be disclosed. I personally think that we should just assume that everyone has them and accept the risk. However, i think that since it's on your mind, you might have to just disclose to her so that you don't keep worrying about it. In regards to the HPV, though, i wonder if you having two girlfriends with abnormal pap smears is just more likely because you're in your 30s? I'm in my 20s and know of at least one person who has had an abnormal pap and i expect that that number will increase over the next decade.
posted by kinddieserzeit at 4:38 PM on October 8, 2014 [2 favorites]

There is no test for HPV for you, FYI. Also no reason to assume that your past girlfriends' abnormal paps either were because of you (unless you were their only partner ever) or that they mean you have HPV now.
posted by lakeroon at 5:11 PM on October 8, 2014 [3 favorites]

This page from the national cervical cancer coalition - as I understand it - seems to indicate you may not be tested for or need to disclose your exposure to the strain of the virus that shows up as an abnormal smear/pap.

But it does mention exposure to the strain of the virus that causes genital herpes/warts as a thing you should talk about.

And yes, I get cold sores, caused by another strain (I think they're all different?) and I always tell about them (though if you know me, you probably already know, sigh).
posted by symphonicknot at 5:23 PM on October 8, 2014 [1 favorite]

As someone who has never come down with these "common" issues, I would be very unhappy if you did not disclose and then I came down with something. I don't like this attitude of "everyone has it, EVERYONE, so who cares." Not cool. Some people do come down with more severe health complications from HSV or HPV than "everyone," and I don't think it's right to put her at risk because "who cares, everyone has it."
posted by jenfullmoon at 5:39 PM on October 8, 2014 [7 favorites]

everyone suggesting testing for hsv might want to follow up with which test you should get. as you've never had an outbreak, you can't get tested with open sores so you'll have to get a blood test. in my research, all of the blood tests suffer from being fairly unreliable in one way or another. for instance, with one of them it might tell you that you have hsv if you've ever had chicken pox. many doctors recommend against the antibody tests specifically because the results aren't as conclusive as many think they are. if you find someone to do the test you will probably pay heartily for the privilege.
posted by nadawi at 6:10 PM on October 8, 2014 [4 favorites]

you could say something like, "do you get coldsores? i'm pretty sure that i've been exposed to the virus that causes coldsores, though i've never had one myself." If she gets coldsores sometimes, then she has it too anyway. If she doesn't get them and she's concerned about it, she could get a blood test to see if she has antibodies (a lot of people have antibodies but don't get coldsores) and if she has no antibodies, it's up to her. Don't make it sound like a big deal, because it's really not a big deal.

I'd really love to see the stats if all the people in this thread claiming that they don't have HSV got tested for the antibodies. Do they seriously think they've not kissed a single person who was a carrier?
posted by kinddieserzeit at 8:16 PM on October 8, 2014 [3 favorites]

I'm kind of in the 'this is so common that it shouldn't be a huge deal and I wouldn't worry about it and if she's had multiple partners she's almost certainly been already exposed' camp.

However, reading through this apparently there are lots of people who feel more strongly about it than me, so it looks like the 'right' thing to do would be disclose. If it's not a big deal to her, then it's not a big deal, but if it is a big deal to her then it's good you told her, I guess.

About getting tested... Honestly, I would not personally spend the time and money to get treated for HSV. The majority of the population has it. You've been exposed. Okay-- pretty much everyone has been exposed. This idea that the only responsible course of action is to get an HSV test in advance of every time you kiss someone or share a drink with someone is not very grounded in reality in my opinion. What are you going to do if you have it? Never kiss anyone ever again? Anyway, if you feel the pressing need to disclose, then let this girl know that your ex got cold sores and you'll get tested if she'd like you to. Personally, I would laugh and kiss you.

As far as HPV, as far as I know there's not an approved male test so that may not happen either. I do think this one is something that should be disclosed more readily as it has the potential for more problematic effects (like cancer) and also the stigma of being AN STD OMG.

Your past girlfriend's abnormal paps are not definitively caused by HPV, fwiw. There are other things that can cause an abnormal pap.
posted by geegollygosh at 8:55 PM on October 8, 2014 [5 favorites]

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