Dear Dating With Herpes:
I have had symptoms that sound like they might be genital herpes. The first time, my doctor did a visual examination and said it looked like chaffing. He took a swab from the area and did a “culture” test for herpes, which came back negative. The symptoms went away and I didn’t think much about it. Then several months later, I had some symptoms again. I did a little research and heard that there were some blood tests for herpes. So I went back to the doctor and asked if he would give me a herpes blood test, in addition to the culture test. He said that “there are no good herpes blood tests” and that “they are often inaccurate” and they are not worth using. So he gave me another culture test and again, it came back negative. So I still don’t know what I have. What should I do?
Many doctors are very out-of-date about herpes diagnosis. Although a culture test from an active sore is one of the most common ways to test for herpes – it can also result in many false negatives. This is because sores often start drying out within a few days, and there is often not enough virus present in the fluid of the samples to show up in a culture test.
Before 1999, there were no reliable herpes blood tests and the tests could not accurately distinguish between HSV-1 and HSV-2. Since most people already had HSV-1 (orally), they would test positive for herpes, whether or not they had oral herpes or genital herpes. So the old tests were not very useful. However, since 1999, there are several newer and very accurate herpes blood tests which can also distinguish between HSV-1 and HSV-2. These can be very useful diagnosing patients who have no noticeable symptoms, or who have recurring symptoms but the culture tests have come back negative.
Here is a downloadable PDF form from ASHA, the American Social Health Association, listing all of the newer, very accurate herpes blood tests: Herpes Blood Test Guide. Download this and bring it to your doctor and ask him to order one of the tests from this list. If he does not agree to do this, then unfortunately, you will need to find a new doctor.
You can also sometimes get a herpes blood test from Planned Parenthood (sometimes for a fee) or order your own anonymous herpes blood test from one of the several online herpes testing services listed on the Herpes Diagnosis page. A few of the ones we list are STDCheck.com* and STDTestExpress.com,*