The CDC does not recommend herpes testing for people who have no symptoms. They point out that diagnosing genital herpes in someone lacking any symptoms does not lead to them making changes in their sexual choices. They are no more likely to use condoms or to refrain from having sex than if they hadn’t been tested.
Also, false-positive test results can happen. A false positive is a test result saying you have herpes when actually you do not.
Even if you have no symptoms of herpes or of any other sexually transmitted disease, though, you should talk frankly with your doctor or another healthcare provider about your sexual activities to see if you should be screened for STDs, including herpes.
There are some situations where herpes blood tests can be useful, says the CDC:
- If you have genital symptoms that could be related to herpes
- If you now have, or have had, a sex partner with genital herpes
- If you want a complete STD exam, especially if you have multiple sex partners
Testing Options for HSV
Your doctor can order one of two kinds of HSV tests:
- A test of some material taken from a lesion and then grown in a culture
- A DNA test
- An antibody blood test for HSV-1 and HSV-2
“The DNA test is generally more accurate. It picks up more infections than a culture,” says Handsfield.
DNA tests have become the more common HSV test in the United States, he adds, and suggests that you ask your doctor to order one if you’re being tested for herpes.
“If a test is done, also ask your doctor to request a determination of the virus type,” he says, to see if you have HSV-1 or HSV-2.
“The natural course of the disease and the need for treatment for HSV-1 and HSV-2 are different,” Handsfield says. With HSV-1, recurrent outbreaks are much less likely, and if they do occur are likely to be much more widely spaced.
“Forty percent of people with HSV-1 have no recurrent outbreaks in the year or two after infection, and often none after that,” says Handsfield.
In contrast, an infection with HSV-2 that produces symptoms often leads to outbreaks about four to five times each year. While a person with HSV-2 is more contagious during an outbreak, they remain contagious during symptom-free periods. “So transmission via sex is far more likely with HSV-2 than with HSV-1,” he says.
“If you have HSV-2, you are more likely to benefit from ongoing antiviral therapy,” says Handsfield, considering how frequent outbreaks can be with that form of the virus.
Remember, though, while a herpes blood test can help determine if you have herpes infection, the test cannot tell you who gave you the infection.
An earlier version of this article incorrectly stated that a person with HSV-2 is more contagious during symptom-free periods. It should have stated the opposite: a person is less contagious during symptom-free periods. Everyday Health regrets the error.