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paulmistyesterday at 4:10 PM2 repliesview on HN

In Europe I don't think it's commonly done. For example, the standard Dutch MSM STI test [1] covers HIV, Syphilis, Chlamydia, and Gonorrhoea only while Trichomoniasis, HPV 2 and Herpes are rather common. That being said, it's freely available at most hospitals.

[1] https://www.mantotman.nl/


Replies

Teknoman117yesterday at 5:59 PM

Herpes screening is discouraged in the US unless symptoms are present as the widely available IgG tests have terrible specificity. While the false negative rate is practically 0, they have a false positive rate of around 20%. The only high-accuracy confirmatory test (at least in the US) is the Western Blot but there's only a handful of labs in the country that offer it.

The current tests would result in a substantial fraction of the population running around thinking they have a highly stigmatized STI that they in fact do not have with little to zero ways of getting a more accurate test.

jijijijijyesterday at 7:00 PM

> HPV 2 and Herpes are rather common

Seems like both HSV-1 and HSV-2 seroprevalences are actually rather low in the Netherlands.

As for STI testing: Serological testing is pretty meaningless regarding infection risk and direct viral detection is only done on visible lesions for differential diagnostics AFAIK. You can shed the virus without lesions, HSV-1 can be contracted without direct mucosa contact, and while HSV-1 is associated with oral herpes and HSV-2 with genital herpes, both types can cause lesions anywhere on the body. Sure someone without positive antibody status very likely can't transmit it, but that's a very small minority of people of relevant age.

I believe talking to Americans about "herpes" can be misleading, as it's weirdly stigmatized over there and people seemingly conflate visible "cold sores", genital herpes and antibody status.

Incidentally, genital herpes and HSV-2 in general is more common in the US, which may be a direct outcome of this cultural dynamic. Due to lower incidences of early oral HSV-1 infections, compared to most western Europe, Americans are more likely to get infected with genital herpes of either type, but in particular HSV-2, too. Prior oral HSV-1 infections are somewhat protective.

https://en.wikipedia.org/wiki/Epidemiology_of_herpes_simplex

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