Can You Test for Herpes Without an Outbreak?

Herpes is a common sexually transmitted infection (STI) that many people carry without realizing it. Around one in seven Canadians carry the virus — caused by the herpes simplex virus (HSV) — but most people don’t have symptoms. This makes understanding and managing the virus even more important. 

There are two types of HSV: 

• HSV-1 is typically responsible for oral herpes, which causes cold sores around the mouth. In general, HSV-1 isn’t considered a sexually transmitted infection — most people get it during childhood from non-sexual contact with the saliva of someone with the virus. However, oral herpes can spread to the genitals through oral sex.
• HSV-2, or genital herpes, typically causes sores on or around the vagina, penis or anus. It’s rare for HSV-2 to spread to the mouth during oral sex. 

Genital herpes can be transmitted through sexual activity whether or not symptoms are present. HSV can’t be cured — once you’re infected with the virus, it stays in your body for life and may (or may not) cause periodic outbreaks of sores. 

Testing is important since early detection and treatment can help manage this chronic condition and prevent its spread. But can you test for herpes without an outbreak? You can, but the real question is, should you? Understanding how to get tested for herpes and making informed decisions is crucial. Read on to find out how common is herpes in Canada and the steps for effective testing, even without symptoms.

Understanding Herpes Testing

Herpes testing plays a crucial role in identifying and managing the herpes simplex virus (HSV), which has two main types: HSV-1 (often linked to oral herpes) and HSV-2 (usually causing genital herpes). Testing is essential for people experiencing symptoms and those who may have been exposed but show no signs. Confirming a herpes diagnosis allows individuals to manage symptoms effectively, minimize transmission risk, and explore treatment options.

Overview of Herpes Testing

The herpes virus can remain dormant in the body, with many people unaware of their infection due to a lack of symptoms. Herpes testing is available in different forms, each tailored to detect active infections or past exposure to the virus. Testing helps not only with diagnosis but also with the management of symptoms, reducing the likelihood of outbreaks and supporting informed decision-making around sexual health.

Types of Herpes Tests Available

• Viral Culture Test: A viral culture test is performed when there are active sores. A healthcare provider swabs a sore to collect viral material, which is then cultured in a lab to confirm infection. While specific, the viral culture test is most effective when sores are new and may not detect the virus in older or healing sores.
• Polymerase Chain Reaction (PCR) Test: PCR testing is a highly sensitive method that identifies herpes DNA from samples of blood, sores, or spinal fluid. This test can detect both HSV-1 and HSV-2 and is especially useful for diagnosing recurrent or asymptomatic infections due to its accuracy.
• Blood Test (Serology): Serology tests detect antibodies that the body produces in response to HSV-1 or HSV-2 infection. This test is often recommended for people without visible symptoms who want to know if they’ve been exposed to the virus. Blood tests do not indicate the specific site of the infection or whether it is currently active, but they confirm exposure to HSV.

Testing for Herpes Without Symptoms

Herpes testing is also available for individuals without symptoms concerned about possible exposure. Blood or serology tests are typically used in these cases, as they can detect the presence of antibodies for HSV-1 and HSV-2 even if the virus is dormant. This approach is particularly beneficial for individuals in new relationships, those with partners known to have herpes, or people who want clarity regarding their herpes status.

Who Should Get Tested for Herpes?

Not everyone needs to be tested for herpes. Unlike bacterial STIs like chlamydia and gonorrhea, which are very common and easy to diagnose and treat, genital herpes is a little more challenging to screen for. 

In general, HSV testing isn’t recommended for asymptomatic people due to the limitations of a blood test and a high possibility of false results — especially in people with a low risk for infection. A false positive result can have an undue, devastating impact on someone who doesn’t have HSV but thinks they do. 

The Public Health Agency of Canada does not recommend routine screening on people without a history of HSV lesions. 

Symptoms of Herpes

The most telling symptom of HSV is the occurrence of one or more sores or blisters on the mouth, genitals, anus, thighs, or buttocks. The sores often begin with a tingling or itching sensation before emerging as small bumps or blisters that eventually rupture, causing a painful ulcer. As the sores heal, they develop a crust and begin to slowly disappear, leaving no trace — for most people, herpes sores don’t scar.

Other symptoms of herpes may include: 

• Fever, body aches, swollen glands, or other flu-like symptoms, which may occur during the first outbreak
• Discharge from the vagina or, in people with a penis, the urethra

How To Get Tested For Herpes

Three types of tests are used to diagnose HSV. Your healthcare provider will determine which is best for your situation.

Viral Culture

A viral culture involves scraping or swabbing an active sore to get a sample. Special techniques encourage the virus to grow and multiply in a lab setting. The culture is then examined under a microscope to determine whether the virus is present. 

Viral cultures are widely available and can be used to determine the type of HSV (1 or 2) and antiviral resistance. This test is most accurate when the swab sample is taken within 48 hours of the sore developing when the viral load is highest. After that, the amount of HSV in the sample drops, and the risk of a false negative test result increases. 

Nucleic Acid Amplification Test (NAAT)

A NAAT test for HSV is usually performed on a swab sample taken from a sore. This highly accurate test is often the preferred test to confirm a herpes diagnosis, but may not be as readily available. 

Type-specific serology (TSS)

A TSS test is performed on a blood sample to detect the presence of antibodies, which the immune system produces to fight a virus. Since the body will produce antibodies if the virus is present — even if symptoms aren’t — this test can be useful when other tests are negative or not available and symptoms are present. An HSV TSS test can also determine whether the infection is caused by HSV-1 or HSV-2, but cannot detect where in the body the infection is.

Importance of Testing Herpes Without an Outbreak

Testing for herpes, even when no symptoms are present, is essential for early detection, prevention, and managing the potential risks associated with undiagnosed herpes. Understanding the benefits of testing without an active outbreak can help you make proactive choices about your health and that of your partners.

Early Detection and Prevention

• Identify Silent Infections: Herpes can be asymptomatic or have mild symptoms that go unnoticed, yet it remains contagious. Early testing without visible symptoms helps detect infections before they inadvertently spread.
• Manage Symptoms and Reduce Outbreaks: While herpes may not have a cure, antiviral medications can help reduce viral load, minimize outbreak frequency, and lessen the risk of transmission to partners.
• Empower Decision-Making: Knowing your HSV status allows you to make informed choices about safe sexual practices and take precautions that protect your health and that of others.

Risks of Undiagnosed Herpes

• Unintended Transmission: Undiagnosed herpes increases the risk of unknowingly spreading the virus to sexual partners, as HSV can still be contagious without visible sores.
• Complications for Immunocompromised Individuals: In people with weakened immune systems, untreated herpes can lead to more severe complications, including persistent, painful outbreaks and, in rare cases, infections of other organs.
• Health Risks in Pregnancy: For those who are pregnant, undiagnosed herpes poses risks during delivery, potentially leading to neonatal herpes, a serious condition in newborns. Early detection through testing allows for precautions to be taken to reduce transmission risk.

How to Test for Herpes Without an Outbreak

Testing for herpes (HSV) when you aren’t experiencing an active outbreak can help with early diagnosis and management, especially if you’ve been exposed to the virus or are at risk. Here’s an overview of the available options:

At-Home Testing Kits

• Convenience and Privacy: At-home herpes testing kits offer a discreet and accessible way to check for HSV without visiting a clinic. These kits typically involve collecting a blood sample via a finger prick or, in some cases, a swab sample.
• Process: After you order a kit online, the instructions will guide you through sample collection. Once the sample is ready, you’ll send it to a lab using pre-packaged materials. Results are often available within days and can be accessed through a secure online platform.
• Considerations: While convenient, it’s essential to choose an at-home test from a reputable provider for accurate results. At-home tests are useful for initial screening but may require confirmation from a healthcare provider if positive.

Telemedicine Options

• Virtual Consultations with Medical Experts: Telemedicine services connect you with healthcare providers who can discuss your symptoms, exposure risks, and appropriate testing options for herpes. This is an especially helpful option if you want personalized guidance without going to a clinic.
• Ordering Tests Online: Many telemedicine platforms allow providers to order blood tests or other lab work for you. They can then review the results with you virtually and provide recommendations based on your specific case.
• Privacy and Accessibility: Telemedicine consultations can be conducted from the comfort of home, making it an ideal choice for those who prefer not to visit a clinic in person.

Visiting a Healthcare Provider

• In-Clinic Testing: If you prefer direct support, visiting a healthcare provider is the most thorough option. They may recommend a blood test (often called an HSV antibody test) to detect HSV-1 or HSV-2, even without symptoms.
• Comprehensive Care: In-person visits allow for additional screenings if necessary, including tests for other STIs. Your provider can also discuss preventive steps, provide medication if needed, and answer questions about managing herpes in the long term.
• Follow-Up and Support: In-clinic care provides immediate access to follow-up support and resources for those who test positive, ensuring you have everything you need to manage your health effectively.

What If You Test Positive for Genital Herpes?

Testing positive for genital herpes can be overwhelming, but with proper management, it is possible to maintain a healthy, fulfilling life. Here’s what to expect and how to manage the diagnosis:

Managing Genital Herpes

• Initial Outbreak: The first outbreak of genital herpes can be intense, but it’s typically the most severe one. Subsequent outbreaks tend to be shorter and less painful.
• Frequency of Outbreaks: Outbreaks generally become less frequent over time, especially after the first year.
• Treatment Options:
  • Antiviral Medications During Outbreaks: Antivirals help reduce the severity and duration of symptoms during an outbreak.
  • Daily Antiviral Therapy: For those who experience frequent outbreaks, daily medication can help prevent them and reduce the likelihood of transmitting HSV to a partner.

Is Genital Herpes a Reportable STI?

• Reporting in Canada: Genital herpes isn’t a nationally reportable STI in Canada, but some provinces and territories may require healthcare providers to report cases to local public health units.
• Confidentiality: Reporting is confidential; your identity remains protected. A public health nurse may contact you to provide resources and support.
• Partner Notification:
  • Public Health Support: The nurse may request contact details of any partners who may have been exposed. They will reach out to inform them about the risk, ensuring that your identity remains private.
  • Self-Notification Option: If you prefer to inform your partner(s) directly, the nurse can provide guidance on how to have the conversation.

Communicating with Partners

Open communication and using proper precautions, like consistent condom use and avoiding sexual contact during outbreaks, are essential to prevent the spread of herpes. Managing herpes is possible with the right support and preventive practices, allowing you to maintain a healthy relationship and lifestyle.

How to Prevent Genital Herpes

Taking preventive steps can reduce the risk of transmitting genital herpes, although it may not completely eliminate it. Here’s how to manage and lower the risk:

Use Barrier Methods

• Condoms and Dental Dams: Condoms and dental dams can lower the risk of HSV transmission, although they don’t completely eliminate it. Internal condoms may offer more coverage and potentially provide additional protection.
• Consistent Use: Use condoms or dental dams with each sexual encounter to help reduce exposure to HSV.

Avoid Sexual Contact During Outbreaks

• Timing Precautions: If you or your partner has genital herpes, avoid unprotected sex, especially at the first sign of an outbreak, such as tingling or itching. This is when HSV is most likely to spread.
• Oral Contact: People with oral herpes should avoid kissing or sharing food and drinks during outbreaks to prevent transmitting the virus.

Use Caution with Shared Items

• Sex Toys: Use a barrier method like condoms on shared sex toys, and avoid sharing them without protection, as they can carry the virus between partners.

Antiviral Therapy for Suppression

• Medication Support: Partners with herpes can take daily antiviral medication to lower their viral load, which helps reduce the risk of transmission even when no symptoms are present.

When To Talk To Your Doctor About Herpes Testing

More than half of Canadians avoid getting tested for STIs due in part to the fear of getting a positive result back. But the consequences of an untreated STI can be serious — detecting and treating or managing it early on helps prevent the spread and reduces its negative impact on your life. 

If you develop symptoms of genital herpes, or if you think you’ve been exposed to HSV, talk to your healthcare provider about getting tested. If you don’t have a primary care provider— more than 6.5 million Canadians don’t — Maple makes it easy to take control of your sexual health and guides how to get tested for herpes.

A membership on Maple allows you to speak with a primary care provider, like a doctor or nurse practitioner, 24/7/365 over secure text, audio, or video call in minutes. Primary care providers on Maple can talk to you about any symptoms you may have, offer advice on having safe sex or talking to a partner about STI testing, and help you find a place to go for testing.

Final Thoughts

Understanding herpes and its transmission is crucial for managing this common but often misunderstood infection. Whether you have symptoms or are wondering, “Can you test for herpes without an outbreak?” knowing your status through reliable testing can help you make informed decisions about your health and that of your partners. While herpes can’t be cured, early detection and treatment are essential for managing outbreaks and reducing the risk of transmission, no matter how common herpes is in Canada.

The information presented here is for educational purposes and is not meant to replace the advice from your medical professional. Virtual care is not meant for medical emergencies. If you are experiencing an emergency like chest pain or difficulties breathing, for example, please call 911 or go to your nearest emergency room.