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Sexual health testing guide · 2026
Herpes testing produces more distress per test than almost anything else in sexual health, largely because the wrong test gets ordered.
If you have a lesion, swab it — PCR of a lesion swab is the test of choice for herpes and identifies whether it is HSV-1 or HSV-2. Blood tests are a different proposition: type-specific IgG serology tells you whether you have been infected at some point but not where, when or from whom, and guidelines advise against using it for general population screening because of false positives and the limited value of the result. HSV IgM testing is not recommended at all — it is unreliable and cannot distinguish new from established infection. HSV-1 now causes a large share of first-episode genital herpes.
| Best test with a lesion | PCR of a swab from the lesion base or blister fluid, taken early |
|---|---|
| Blood test | Type-specific IgG (HSV-1 and HSV-2 glycoprotein G) — limited use |
| Avoid | HSV IgM — unreliable and not recommended by guidelines |
| Serology window | Antibodies may take up to 12–16 weeks to develop |
| Collection | Clinic, at-home in Bangkok or 20+ MedEx sites nationwide; at-home kits also available |
| Price | Listed on the MedEx STD and STI testing page and the lab test catalogue |
PCR on a swab taken directly from a lesion is more sensitive than viral culture and gives a definitive answer: virus present or not, and which type. Timing matters — yield is highest when the lesion is new, ideally a fresh blister or a freshly unroofed ulcer, and falls as the lesion crusts and heals.
A negative swab from an old, crusted lesion does not exclude herpes. If the swab is negative but the clinical picture fits, the clinician may repeat it at the next episode.
Because timing is decisive, an early appointment matters. The 24/7 doctor on call or a same-day clinic slot is more useful than waiting several days for a convenient time.
Have a lesion now? A swab taken early gives a definitive answer.
Type-specific IgG serology detects antibodies to glycoprotein G of HSV-1 or HSV-2. It answers one question: have you been infected with this type at some point?
What it does not tell you:
Low-positive HSV-2 IgG results are a recognised problem, with false positives common near the cut-off. Guidelines therefore advise against routine HSV serology screening in the general population. It has a role in specific situations: recurrent genital symptoms with repeatedly negative swabs, a partner with known herpes, assessment in pregnancy in certain circumstances, and sometimes to inform a discussion about transmission risk within a couple.
| HSV-1 | Traditionally oral, but now causes a large and rising share of first-episode genital herpes, transmitted through oral sex. Genital HSV-1 tends to recur less frequently than genital HSV-2. |
|---|---|
| HSV-2 | Predominantly genital. Recurs more often and sheds asymptomatically more frequently, so transmission risk between episodes is higher. |
The type therefore matters for prognosis and for the conversation with a partner, which is a further reason to swab a lesion rather than rely on a blood test that came back positive for something acquired years earlier.
Both types can be transmitted when no lesion is present, through asymptomatic viral shedding. This is why herpes is so common and why the diagnosis rarely identifies a culprit.
There is no cure, but antiviral treatment is effective and well established. Two approaches exist: episodic treatment started at the first sign of an outbreak, and suppressive treatment taken daily, which reduces both recurrence frequency and the risk of transmission to a partner. The choice depends on how often outbreaks occur and what matters most to you.
Practical measures that reduce transmission: avoid sex during an outbreak and from the first prodromal tingling until lesions have fully healed; consistent condom use, which reduces but does not eliminate risk; and suppressive therapy for the positive partner in a discordant couple.
The psychological impact is often larger than the physical one, and it is worth saying plainly that herpes is extremely common, generally causes intermittent minor symptoms, and does not affect fertility. Where pregnancy is involved, particularly a first episode in the third trimester, specialist advice is needed — arrange through a specialist teleconsultation.
Antiviral prescriptions are available following a doctor consultation, with delivery through medicine express.
If you have a lesion, PCR of a swab taken from the lesion base or blister fluid is the test of choice. It is more sensitive than culture and identifies whether the virus is HSV-1 or HSV-2. Take it as early in the outbreak as possible.
Type-specific IgG serology has limited value and is not recommended for general population screening. It cannot tell you where the infection is, when you acquired it or from whom, and false positives near the cut-off are a recognised problem.
No. HSV IgM is unreliable, cannot distinguish new from established infection and can be positive during recurrences. Guidelines advise against using it.
Yes, and it now accounts for a large and rising share of first-episode genital herpes, transmitted through oral sex. Genital HSV-1 tends to recur less often than genital HSV-2.
Antibodies may take up to 12 to 16 weeks to develop, which is why a negative blood test soon after a possible exposure does not exclude infection.
Yes. Asymptomatic viral shedding occurs between outbreaks, which is why the infection is so common. Consistent condom use and daily suppressive antiviral treatment both reduce, but do not eliminate, transmission risk.
Recurrent outbreaks? Suppressive treatment reduces both episodes and transmission.
Medical disclaimer: This article is general health information and does not replace medical advice, diagnosis or treatment. Laboratory reference ranges differ between laboratories and results must be interpreted alongside your symptoms, medicines and medical history. Speak with a qualified clinician before starting, stopping or changing any treatment. Service details, inclusions and prices can change — confirm them with MedEx before booking.
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