Herpes testing and treatment NYC, New York
Accurate and confidential

To determine the type of herpes test you need, two questions must be answered:

• Do you currently have symptoms?
• If not, how long ago were you exposed to a herpes-positive person?

If you have symptoms

• If you have a skin blister or sore that appears to be herpes, you can get the most accurate test, a culture herpes test
• These limitations apply to a culture test:
  • You must have a visible herpes sore
  • Ideally, the test is performed within 24 hours of the appearance of herpes blisters (if necessary, it can be done within 48 hours)
  • It is best for your herpes blister to be intact and broken only by the health provider at the time of the test
  • The herpes sore must be wet so a swab can be done (dry, crusted sores cannot be swabbed)

If you do not have symptoms

• If at least three weeks have passed since your exposure (but ideally, three months), you can get a herpes IgG antibody test
• With no symptoms, a swab herpes test can’t be done because there is nothing to swab

When your herpes test results are available, they must be interpreted. This is not necessarily straightforward.

In this table, we summarize what positive and negative results for each herpes test mean—assuming the test is done at the right time (see above).

Herpes treatment is given in three situations:

• The patient has a current herpes outbreak
• The patient has frequent herpes outbreaks
• The patient wants to decrease the risk of passing herpes to a partner

HSV treatment regimen for the first herpes outbreak

• The first herpes outbreak is the most severe, with more discomfort and more skin lesions, and it lasts the longest
• For that reason, treatment for the first herpes outbreak involves a higher dose of medication and a longer course of treatment than treatment for later outbreaks

HSV treatment regimen for recurrent herpes outbreaks

Recurrent outbreaks are any outbreak after the first one.

• Outbreaks are more common with herpes 1 than with herpes 2
  • HSV-1: 25% chance
  • HSV-2: 60%–90 % chance
• Outbreaks are more common during the first few years

The herpes treatment regimen (dose and duration of medication) depend on the anatomic location of the outbreak, not the herpes type.

“Suppressive” herpes medication to reduce frequent outbreaks

Very few herpes-positive people have frequent (more than five a year) herpes outbreaks. Herpes medication reduces the frequency of outbreaks by 70%–80%.

Daily antiviral therapy is recommended for people who have frequent herpes outbreaks. Your doctor should reevaluate your treatment 6 to 12 months after it begins.

No, it is not important for you and your doctor to know which type of herpes you have because this knowledge won’t change the herpes treatment plan or your prognosis (expected outcome).

Although there are some differences (for example, type 2 tends to cause more frequent outbreaks and be transmitted more easily, especially during the first three months after exposure), the herpes treatment plan and prognosis are the same for both types:

• Most people have a great long-term outcome. The exception can be people whose immune systems are suppressed (for example, people with HIV and people undergoing chemotherapy), who can develop serious complications from herpes of either type
• Recurrent herpes treatment is based on the anatomic location of the virus in the body rather than the type of herpes (as you may recall, both herpes types can affect either the oral or genital area of the body)

Herpes stigma

Although we know that both types of herpes may be transmitted orally (through kissing or an oral sex) or genitally and can affect virgins and people with only one sexual partner, some people feel stigmatized if they learn that they have HSV-2 because it is considered as a sexually transmitted infection and is commonly called “genital herpes.”

• IgG herpes test: 3 to 4 business days
• Washington University Western blot herpes test: one month or longer
• Swab or culture test: 4 to 5 business days

The Washington University herpes test is the gold standard of herpes blood tests. It is more accurate and carries less risk of false positive and false negative results.

This test detects specific herpes antibodies. The term “gold standard” means that commercially available IgG herpes tests are compared to this test to rate their accuracy.

This test is performed only at the University of Washington Virology Department, which makes this test less available to the general public. It is usually not covered by health insurance.

In the table below, we compare the Washington University HSV test and commercially available, commonly used Herpes Select® IgG antibody tests with respect to common practical parameters.

It’s not possible to eliminate the risk of giving your partner herpes because all preventive measures offer only partial protection. However, there are ways to significantly reduce the risk:

Avoid sex and kissing during herpes outbreaks

This is when you are most contagious because your fluid-filled blisters and sores have a high concentration of herpes virus (HSV-1 or HSV-2).

Pay attention to prodrome symptoms

Prodrome herpes symptoms are usually very nonspecific symptoms (meaning they can occur with many health conditions), such as fatigue, mild skin tingling, and shooting pain where the outbreaks usually occur (in the oral or genital area). Herpes virus (HSV-1 or HSV-2) is likely to shed during that period.

Avoid skin trauma during sexual intercourse

Damaged skin is more vulnerable to herpes infection. Use silicon-based lubricant during vaginal or anal sex.

Maintain proper hand hygiene

The herpes virus may stay on your hand after you touch your blisters or sores, and you can easily transmit the infection if you touch your partner. Always wash your hands with soap after you touch your herpes lesions.

Do not share utensils during oral herpes outbreaks

There is a theoretical risk of herpes transmission via utensils since it is possible to exchange virus-containing fluids via utensils, bringing the skin around the mouth or the oral mucosa into contact with the virus. The likelihood of this happening is unknown and considered extremely low.

Use condoms

Condoms may decrease the chance of herpes transmission (per multiple sex acts) by 50%.However, unlike the majority of common STDs (sexually transmitted diseases), herpes is easily transmitted via skin-to-skin contact (just like the HPV), therefore the parts of the genitals that are not covered by condoms will still be exposed to the virus.

Take antiviral herpes medication

Appropriate antiviral herpes therapy cuts the risk of herpes transmission (whether you have symptoms or not) in half.

The fact that it is possible to pass herpes when you don’t have symptoms makes protecting your partner complicated. People want to be ethical and protect their partner, but it’s not always possible.

Many unanswered questions remain despite asymptomatic herpes transmission having been researched. We still must make a lot of educated assumptions.

Here’s what’s known about asymptomatic herpes transmission (“silent virus shedding”):

How it occurs

Asymptomatic herpes transmission (HSV-1 or HSV-2) is believed to happen this way: Activated herpes virus from a local nerve ganglion travels to the surface of the skin. Transmission occurs with skin-to-skin contact where the virus is active. It is still unclear how high a concentration of HSV virus must be on the skin for transmission to occur.

When it occurs

This is not completely clear. It is believed that the same factors that cause herpes flare-ups (stress, exhaustion, and disease) can increase the likelihood of asymptomatic herpes transmission. And it is believed that when this occurs, it’s because the patient’s immune system is strong enough to suppress the HSV virus quickly, preventing visible skin lesions.

Riskiest time

• Herpes transmission rates are highest in the first year after infection
• Herpes transmission is most likely in the few days before and after an outbreak

The commercially available IgG herpes antibody testing and the culture herpes swab test are covered by health insurance. The Washington University western blot herpes test is not.

If you want to be sure that your particular insurance plan covers the herpes testing, call your insurance company and ask:

1. The name of their preferred lab (e.g., Quest, Labcorp, Northwell)—they probably have contractual pricing arrangements with certain labs

2. Whether a herpes culture test and herpes IgG test are covered

If the insurance company representative asks you for ICD and CPT codes, give them these:

• ICD B00.9
• CPT 86695 or 86696

3. Ask what the patient responsibility is for the herpes testing (after a deductible or coinsurance)

The herpes testing can be done in primary care offices, urgent care clinics, gynecology clinics, planned parenthood clinics, and our specialized STD clinic (also known as sti testing clinic). Free STD testing centers usually require long wait times and do not perform herpes blood testing since it is not recommended by the CDC.

All 5 NYC boroughs Manhattan, Brooklyn, Queens, Staten Island, and the Bronx have plenty of health care centers and std testing places where the herpes testing can be safely conducted.

This is the list of few offices offering std testing services that we have selected for you by typing into Google “herpes testing near me” in 5 different NYC boroughs.

Manhattan

• STDcenterNY – is our walk-in STD specialized clinic (sexual health clinic) located near Grand central terminal in Midtown Manhattan, NY 10016
• Planned parenthood clinics located in this zip code NY 10012
• City MD Urgent care clinics have numerous locations in the following Manhattan zip codes: NY 10003, 10451,10010, 10016, 10022, 10065, 10021, 10028, 10029, 10005, 10002, 10012, 10007, 10025, 10027, 10024, 10023, 10019, 10018, 10036

Brooklyn

• Planned parenthood clinicslocated in this zip code NY 11201
• City MD urgent care clinic have multiple clinics in the following zip codes:NY 11214, 11204, 11235, 11237, 11201, 11213, 11210, 11215, 11217

Queens

• Planned parenthood clinics located in this zip code NY 11101
• City MD urgent care clinic have multiple clinics in the following zip codes:NY 11368, 11375, 11374, 11105, 11103, 11365, 11372, 11432, 11101, 11373, 11417, 11428

Staten island

• ü Planned parenthood clinicslocated in this zip code NY 10301

Bronx

• Planned parenthood clinics located in this zip code NY 10451
• City MD urgent care clinic have a clinic in the following zip code: NY 10461

Herpes, like gonorrhea, syphilis, or chlamydia, increases the risk of contracting HIV. Moreover, people with herpes are 3 times more likely to get HIV.However, having herpes is not an indication for HIV testing.