What to Do If You Receive Both a Positive and Negative Herpes Diagnosis

Getting tested for herpes can stir up a rollercoaster of emotions—fear, shame, confusion, relief—and sometimes all of them at once. But imagine going through all of that and then getting two completely different results. One test says you're positive. Another says you're negative. Now what?

This exact scenario came up recently in one of our Secret Society Support Group calls, and it sparked an emotional and eye-opening conversation.

“I was diagnosed with HSV-2 fifteen years ago and have been living with it ever since,” she shared. “I’ve never had an outbreak, but I accepted the diagnosis and moved forward. Now I’m dating someone new and wanted to get updated bloodwork to show him—and the test came back negative. I’m so confused. Was I misdiagnosed? Do I still have it? I feel like I’m in limbo again, even after all these years.”

Her vulnerability opened the floodgates—many other members shared similar stories of confusion, misdiagnosis, and the emotional burden of trying to understand their status. It reminded all of us that conflicting herpes test results are far more common than most people realize. And it’s why I knew I needed to write this post.

Why Do Herpes Test Results Conflict?

Most herpes testing relies on IgG antibody blood tests, which are convenient and widely used—but also imperfect. These tests don’t detect the virus itself. Instead, they look for antibodies your immune system produces in response to the herpes virus.

So what causes conflicting results?

Timing: If you test too soon after exposure, your body may not have produced enough antibodies yet, leading to a false negative.
Low-positive index values: Results between 1.1 and 3.5 often fall into a “gray zone” where false positives are common.
Cross-reactivity: Antibodies for HSV-1 can sometimes trigger a false positive for HSV-2.
Lab inconsistencies: Different labs use different thresholds, and not all report index values clearly.
Over time: Your antibody levels can decrease after many years, especially if you’ve never had symptoms, which may result in a false negative after years of being positive.

So yes—it’s very possible to receive conflicting herpes results, especially if you’re relying solely on IgG testing.

Misdiagnosis Is More Common Than You Think

Herpes misdiagnosis is a big issue that doesn’t get enough attention. In fact, studies show that up to 50% of positive HSV-2 IgG test results with index values under 3.5 are false positives when confirmed by the more accurate Western Blot test. (University of Washington, newsroom.uw.edu).

That means half of the people walking around thinking they have HSV-2… may not.

On the flip side, false negatives can also happen, especially for people who have had the virus for a long time, are asymptomatic, or tested during the early window of exposure.

The result? Thousands of people are walking around either misinformed or undiagnosed, and it deeply impacts how we approach relationships, self-worth, and disclosure.

What Is the Western Blot—and Why Is It More Accurate?

The Western Blot herpes test, offered exclusively through the University of Washington Virology Lab, is considered the gold standard of herpes testing. Unlike IgG tests that just measure whether antibodies are present, the Western Blot breaks down the antibodies into specific viral protein bands. This makes it significantly more accurate—especially for distinguishing between HSV-1 and HSV-2.

The Western Blot is your best option if:

You received a low-positive IgG test (index value between 1.1–3.5)
You’ve gotten conflicting results over time
You’re asymptomatic and confused about your status
You’re preparing to disclose to a partner and want clarity
You were diagnosed years ago but now want updated, definitive confirmation

Yes, the test is more expensive and takes longer to process—but it can save you years of confusion and emotional distress.

What Should You Do If Your Results Don’t Match?

Here’s a clear, grounded plan to help you navigate the chaos of mixed herpes results:

1. Seriously. Just pause. Conflicting results don’t mean your life is over or that you’ve done something wrong. It just means more information is needed.

2. Many doctors just say “positive” or “negative” without giving you the actual index value—and that number is incredibly important.

<0.9 = Negative
1.1–3.5 = Low positive (potential false positive)
>3.5 = Stronger positive (but not infallible)

If your result falls in the gray zone, it’s worth investigating further before fully accepting the diagnosis.

3. If you tested within 12 weeks of possible exposure, it may have been too soon for antibodies to develop. In that case, wait and retest after 12–16 weeks, or go straight to the Western Blot for clarity.

4. This is your best option for a definitive answer. Your healthcare provider can help you order the test, or you can use online services that work with the University of Washington. Members in the Secret Society can also point you to telehealth providers who understand the process.

5. When you’re not sure what’s true, the idea of disclosure becomes even more overwhelming. If you’re feeling stuck on how to have that conversation, the Tell Your Partner Toolkit is designed to help you feel more confident and clear. It includes scripts, strategies, and support so you can share your truth in a way that honors your journey and your relationship.

Why This Matters So Much

Herpes isn’t just a physical virus—it touches our emotions, our identities, our relationships, and our mental health. When the medical system gives us mixed messages, it’s not just confusing—it’s harmful.

If you’ve been living with a diagnosis for years and suddenly get a negative test, it’s valid to feel shaken. It’s okay to revisit the past, ask questions, and seek clarity. And if you’re newly diagnosed and unsure of what to believe, you deserve access to the most accurate testing—not just a rushed blood draw and a shrug from your doctor.

You deserve answers you can trust—and a support system that won’t let you walk through it alone.

As Always...

Whether you've just received a herpes diagnosis or are revisiting one from years ago, remember: you’re more than your test results. You are not defined by a virus or a lab report. You’re defined by your compassion, your courage, and your willingness to seek truth and healing.

The Secret Society is here for you, our calls are full of people who truly get it, and if you’re ever feeling lost in the numbers or the fear, you are not alone.

Hugs,

Alexandra

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