STI guide
Genital herpes: symptoms, testing and what a result means
Most people carrying herpes have never had a noticeable sore. Which test you need depends entirely on whether you have one right now.
Basically
- If you have a sore, swab it now. A PCR swab detects the virus itself and names the type, and it only works while the sore is there.
- If you have no sore, it is a blood test. R269 for HSV-1, R269 for HSV-2, R538 for both, results in 2 to 3 working days.
- The Small panel at R1,235 includes herpes type 2. The Medium at R1,580 includes both types.
- No test can tell you when you got it or from whom. Anyone claiming otherwise is guessing.
- A positive HSV-1 result does not mean genital herpes. Most people acquire HSV-1 in childhood as oral cold sores.
- It is not curable, and for most people it is not dangerous. Antivirals from a doctor shorten outbreaks and reduce transmission.
- Epicentre does not treat it. If you want antiviral medication, that is a doctor.
What genital herpes is
Herpes is caused by the herpes simplex virus, of which there are two types. HSV-1 is the one most people meet in childhood, traditionally as cold sores around the mouth. HSV-2 has traditionally been the genital one. That division has largely broken down: HSV-1 now causes a large and growing share of first-episode genital herpes, mostly through oral sex.
The World Health Organization estimates that around two thirds of the world's population under 50 carries HSV-1. Most of them do not know, because most of them have never had a noticeable sore.
Herpes is extraordinarily common, it is not dangerous for most people who have it, and it does not shorten anyone's life. What it does do is stay, because the virus lives in nerve cells between episodes. The reason to know is so that you can make informed decisions with partners and, if you are pregnant, so that your doctor knows.
How it spreads
Through skin-to-skin contact with an area where the virus is active, which includes vaginal, anal and oral sex. It can transmit when there is no visible sore, because the virus sheds from the skin intermittently without symptoms. Condoms reduce the risk considerably but do not remove it, because they do not cover every area of skin involved.
Symptoms, if there are any
Most people with herpes have never had a recognisable outbreak. Where a first episode does occur, it is usually the most pronounced one and appears 2 to 12 days after exposure.
- Small blisters or open sores on the genitals, buttocks, thighs or around the anus
- Tingling, itching or burning in the area before anything is visible
- Pain when urinating, if a sore is near the urethra
- Flu-like feeling, swollen glands in the groin, aching, during a first episode
Later episodes, if there are any, are typically shorter and milder, and many people have none at all after the first.
How herpes is tested, and why there are two answers
This is the one infection where the right test depends entirely on whether you have a sore right now. The two tests answer different questions and they are not interchangeable.
If you have a sore: PCR swab
A swab taken directly from the sore detects the virus itself and tells you which type it is. It is the more definitive answer, and it is only possible while the sore is there. Do not wait for it to heal.
| Test | What it covers | Price |
|---|---|---|
| Small Sexual Health Package | Includes herpes type 2 only, alongside chlamydia, gonorrhoea and trichomoniasis. | R1,235 |
| Medium Sexual Health PackageBoth types | Includes both herpes type 1 and type 2, plus HPV, ureaplasma, E. coli O18 and Mycoplasma genitalium. | R1,580 |
| Large Sexual Health, vaginal swab | 17 targets for anyone with a cervix, including herpes, plus the vaginal flora and HPV. | R1,925 |
| Large Sexual Health, penile swab | 17 targets for anyone with a penis, including both herpes types, syphilis and chancroid. | R1,925 |
| Extra Large Sexual Health | 34 targets including both herpes types. Our most thorough screen. | R3,305 |
| Essential Oral Sexual Health | A throat swab, including both herpes types, where the exposure was oral. | R1,580 |
A lesion swab is run as part of a panel rather than sold as a single test, which is why the cheapest route to a PCR herpes answer is the Small panel. If you want both types covered by PCR, start at the Medium.
If you have no sore: blood antibody test
Between episodes there is nothing to swab, so the question becomes whether your body has ever made antibodies to the virus. That is a blood test, and it is type specific.
| Test | What it covers | Price |
|---|---|---|
| Herpes (HSV-1) antibodies | Blood. Whether you have ever been exposed to type 1. Results in 2 to 3 working days. | R269 |
| Herpes (HSV-2) antibodies | Blood. Whether you have ever been exposed to type 2, the usual cause of genital sores. Results in 2 to 3 working days. | R269 |
| Both types together | The two tests above ordered at the same time. | R538 |
| Sexual Health Express | Blood. Includes herpes type 2 alongside HIV, syphilis, hepatitis B and a chlamydia antibody. Results in 2 to 5 working days. | R1,078 |
It cannot tell you when you were exposed, or from whom, or where on your body the virus is. Antibodies take weeks to develop, so a blood test very soon after a possible exposure can be negative while the infection is establishing. And because HSV-1 is so widespread from childhood, a positive HSV-1 antibody result on its own does not mean you have genital herpes.
When to test after exposure
With a sore: swab it now, while it is there. This is the one situation where waiting makes the test worse rather than better.
Without a sore: antibodies generally take a few weeks to become detectable, so a blood test around 6 to 12 weeks after the exposure you are worried about is more informative than one taken immediately.
If you are pregnant
Herpes matters more in pregnancy than outside it, because a first episode late in pregnancy carries a risk to the baby at birth. If you are pregnant or planning to be, this is worth knowing about and worth telling your doctor, who can plan around it. Epicentre can run the test; the planning is a doctor's job.
Your result, and what happens next
You get one report, emailed to you and to nobody else. It is the YourGenes patient report: colour coded, in plain language, with a line for every organism on your panel saying whether it was detected. There is no second document, and no separate practitioner version. This report is what your doctor reads too.
If herpes is detected, Epicentre does not treat it. We are a diagnostic laboratory. We collect samples, run tests and report results. We do not diagnose, prescribe medication or provide treatment, anywhere, including on WhatsApp. You have two equally good routes from here:
- Your own doctor, clinic or pharmacy clinic. Take the report. It names the organism, which is exactly what they need.
- An independent doctor we work with, who consults online or in person on sexual health results. She prescribes on her own responsibility, not as an Epicentre service.
This is the part people skip. If one of you is treated and the other is not, the infection comes straight back at the next exposure. Your partner should be tested, whatever your result says about you.
For herpes specifically, treatment does not remove the virus. What antiviral medication does is shorten and reduce outbreaks and lower the chance of passing it on. Whether you need it, and in what form, is a conversation with a doctor.
Where to test
Cape Town
24 Lower Main Road, Observatory, 7925
Monday to Friday, 08:30 to 16:00
Durban
2 Knelsby Avenue, Hillcrest, 3650
Monday to Friday, 08:30 to 16:00
Johannesburg
02 7th Avenue, Parktown North
Monday to Friday, 08:30 to 16:00
Walk in during those hours, no appointment and no doctor's referral. All three branches are closed on South African public holidays. If you would rather not come in, a home kit is couriered to you in discreet packaging and a free courier collects the sample.
You do not need a reason to get tested
No doctor's referral, no appointment, no awkward conversation first. Results are emailed to you and to nobody else.
Common questions
Should I have a swab or a blood test for herpes?
If you have a sore right now, a PCR swab of the sore, because it detects the virus itself and identifies the type. If you have no sore, a blood antibody test, because there is nothing to swab. They answer different questions and one does not replace the other.
How much does a herpes test cost in South Africa?
A blood antibody test is R269 for HSV-1, R269 for HSV-2, or R538 for both. A PCR swab is run as part of a panel, starting at R1,235 for the Small panel, which includes herpes type 2; the Medium at R1,580 includes both types. The blood-based Sexual Health Express at R1,078 includes herpes type 2 alongside HIV, syphilis and hepatitis B.
Can a herpes test tell me when I got it or who from?
No. Neither test can date an infection or identify a source. An antibody test tells you that your body has met the virus at some point, and a swab tells you the virus is active in that sore now. Anything beyond that would be guesswork.
Does a positive HSV-1 result mean I have genital herpes?
Not on its own. HSV-1 is extremely common and most people acquire it in childhood as oral cold sores. A positive HSV-1 antibody result tells you the virus is present somewhere in your body, not where. HSV-1 can cause genital herpes, usually through oral sex, which is why a swab of an actual sore is more informative when there is one to swab.
How long do herpes results take?
Blood antibody tests take 2 to 3 working days. PCR swab panels take 5 to 7 working days.
Can I test for herpes at home?
The PCR swab yes, from a home kit couriered to you. The blood antibody test no, because it needs a blood draw, which has to happen at a branch.
Is herpes curable?
No. The virus stays in nerve cells for life. Antiviral medication from a doctor can shorten outbreaks, reduce how often they happen and lower the chance of transmission, but it does not clear the virus. Epicentre does not prescribe or treat.
Can I pass herpes on without having a sore?
Yes. The virus sheds from the skin intermittently without symptoms, which is how most transmission happens. Condoms reduce the risk but do not remove it, because they do not cover all the skin involved.
Does herpes affect pregnancy?
It can, particularly a first episode late in pregnancy. If you are pregnant or planning to be, tell your doctor so they can plan around it. We can run the test; the clinical planning is theirs.
Why people trust us with this
Ready to test
No appointment and no doctor's referral. Walk into any of our three branches, or have a kit couriered to you in discreet packaging.
Not ready yet
That is normal, and there is no rush. Take the prices away with you, or ask us something without booking anything.
Other infections in this guide
Important. Epicentre Walk-In Labs is a diagnostic laboratory operated by Epicentre Aids Risk Management (Pty) Ltd. We collect samples, run tests and report results. We do not diagnose conditions, prescribe medication or provide treatment, and nothing on this page is medical advice. Results are released to the person tested. If you have symptoms that worry you, or think you may need urgent care after an exposure, see a doctor or clinic without waiting for a test result.
