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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.

by jijijijij16 hours ago|

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> 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

by Teknoman11712 hours ago|

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Most of the stigmatization of HSV in the US is mostly the result of pharmaceutical companies trying to create a market for HSV antiviral drugs. In the 1980s they ran ads that equated HSV with leprosy. Since that was also the time of the AIDS scare the public was probably very susceptible. Even in my childhood I remember ads on TV for the antiviral drugs promising a way of "living a normal life" despite HSV infection.

by jijijijij6 hours ago|

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That's crazy. Herpes can't be cured, so the implication of those ads can only be to "hide" the infection. Additionally, those antivirals aren't effective at preventing outbreaks unless you take them every day, which would be insane unless you are an unfortunate soul who is prone to constant outbreaks.