Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

Is suspicion of genital herpes infection associated with avoiding sex? A clinic-based study

Richard A. Crosby A D , Sara Head A , Gregory Moore B and Adewale Troutman C
+ Author Affiliations
- Author Affiliations

A College of Public Health, University of Kentucky, Lexington, KY 40506, USA.

B University Health Service, University of Kentucky, Lexington, KY 40506, USA.

C Louisville Metropolitan Health Department, 400 East Gray Street, PO Box 1704, Louisville, KY 40201, USA.

D Corresponding author. Email: crosby@uky.edu

Sexual Health 5(3) 279-283 https://doi.org/10.1071/SH08002
Submitted: 10 January 2008  Accepted: 15 May 2008   Published: 6 August 2008

Abstract

Objective: The present study tested the research hypothesis that sexually transmissible disease (STD) clinic patients suspecting genital herpes infection would be more likely than their ‘non-suspecting’ counterparts to abstain from sex to avoid transmission of a perceived STD. Methods: Recruitment (n = 351) occurred in a publicly-funded STD clinic located in a metropolitan area of the southern USA. Participants were tested for herpes simplex virus type 2 (HSV-2) using a rapid test manufactured by Biokit (Lexington, MA, USA) and they completed a self-administered questionnaire (using a 3-month recall period). Results: Well over one-third (38.7%) of those indicating suspicion also indicated avoiding sex with steady partners because of concerns about STDs as compared with 28.0% among those not indicating suspicion (prevalence ratio = 1.38; 95% CI = 1.02–1.87, P = 0.036). The relationship between suspicion and avoiding sex with non-steady partners was not significant (P = 0.720). The relationship with steady partners only applied to people who were female (P = 0.013), single (P = 0.017), reported symptoms of genital herpes (P = 0.003), perceived that genital herpes would have a strong negative influence on their sex life (P = 0.0001), and who subsequently tested positive for HSV-2 (P = 0.012). Conclusions: Among STD clinic attendees, suspicion of genital herpes infection may translate into partner protective behaviour, but only for a minority of people and only with respect to sex with steady partners. Clinic-based and community-based education programs may benefit public health by teaching people (especially single women) how to effectively recognise symptoms of primary genital herpes infections. Reversing the often prevailing ethic of genital herpes as a ‘community secret’ will clearly be a challenge to these education programs.

Additional keywords: genital herpes, sexual behaviour, sexually transmissible diseases, symptoms.


Acknowledgements

Support and funding for this project was provided by a grant from GlaxoSmithKline to the first author. We gratefully acknowledge the assistance of the Clinic Director (Deborah Snow) and the clinic staff members.


References


[1] Fleming DT,  McQuillan GM,  Johnson RE,  Nahmias AJ,  Aral SO,  Lee FK, et al. Herpes simplex virus type 2 in the United States, 1976 to 1994. N Engl J Med 1997; 337 1105–11.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[2] Corey L,  Handsfield HH. Genital herpes and public health: addressing a global problem. JAMA 2000; 283 791–4.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[3] Lafferty WE,  Downey L,  Celum C,  Wald A. Herpes simplex virus type 1 as a cause of genital herpes: impact on surveillance and prevention. J Infect Dis 2000; 181 1454–7.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[4] Xu F,  Sternberg MR,  Kottiri BJ,  McQuillan GM,  Lee FK,  Nahmias AJ, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA 2006; 296 964–73.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[5] Ribes JA,  Steele AD,  Seabolt JP,  Baker DJ. Six-year study of the incidence of herpes in genital and nongenital cultures in a central Kentucky medical center patient population. J Clin Microbiol 2001; 39 3321–5.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[6] Roberts CM,  Pfister JR,  Spear SJ. Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students. Sex Transm Dis 2003; 30 797–800.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[7] Melville J,  Sniffen S,  Crosby R,  Salazar L,  Whittington W,  Dithmer-Schreck D, et al. Psychosocial impact of serological diagnosis of herpes simplex virus type 2: a qualitative assessment. Sex Transm Infect 2003; 79 280–5.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[8] Meyer JL,  Crosby RA,  Whittington WLH,  Carrell D,  Ashley-Morrow R,  Meier AS, et al. The psychosocial impact of serological herpes simplex type 2 testing in an urban HIV clinic. Sex Transm Infect 2005; 81 309–15.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[9] Miyai T,  Turner KR,  Kent CK,  Klausner J. The psychosocial impact of testing individuals with no history of genital herpes for herpes simplex virus type 2. Sex Transm Dis 2004; 31 517–21.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[10] Rosenthal SL,  Zimet GD,  Leichliter JS,  Stanberry LR,  Fife KH,  Tu W, et al. The psychosocial impact of serological diagnosis of asymptomatic herpes simplex virus type 2 infection. Sex Transm Infect 2006; 82 154–7.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[11] Smith A,  Denham I,  Keogh L,  Jacobs D,  McHarg V,  Marceglia A, et al. Psychosocial impact of type-specific herpes simplex serological testing on asymptomatic sexual health clinic attendees. Int J STD AIDS 2000; 11 15–20.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[12] Richards J,  Scholes D,  Caka S,  Drolette L,  Magaret AM,  Yarbro P, et al. HSV-2 serologic testing in an HMO population: uptake and psychosocial sequelae. Sex Transm Dis 2007; 34 718–25.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[13] Brown ZA,  Gardella C,  Wald A,  Morrow RA,  Corey L. Genital herpes complicating pregnancy. Obstet Gynecol 2005; 106 845–56.
PubMed |

[14] Blower S,  Ma L. Calculating the contribution of herpes simplex virus type 2 epidemics to increasing HIV incidence: treatment implications. Clin Infect Dis 2004; 39 S240–7.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[15] Duffus WA,  Mermin J,  Bunnell R,  Byers RH,  Odongo G,  Ekwaru P, et al. Chronic herpes simplex virus type-2 infection and HIV viral load. Int J STD AIDS 2005; 16 733–5.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[16] Renzi C,  Douglas JM,  Foster M,  Critchlow CW,  Ashley-Morrow R,  Buchbinder SP, et al. Herpes simplex virus type 2 infection as a risk factor for human immunodeficiency virus acquisition in men who have sex with men. J Infect Dis 2003; 187 19–25.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[17] Wald A,  Link K. Risk of human immunodeficiency virus infection in herpes simplex virus type 2-seropositive persons: a meta-analysis. J Infect Dis 2002; 185 45–52.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[18] Corey L. The current trend in genital herpes. Progress in prevention. Sex Transm Dis 1994; 21 S38–44.
CAS | PubMed |

[19] Wald A,  Krantz E,  Selke S,  Lairson E,  Morrow RA,  Zeh J. Knowledge of partners’ genital herpes protects against herpes simplex virus type 2 acquisition. J Infect Dis 2006; 194 42–52.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[20] Alexander L,  Naisbett B. Patient and physician partnerships in managing genital herpes. J Infect Dis 2002; 186 S57–65.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[21] Patel R,  Boselli F,  Cairo I,  Barnett G,  Price M,  Wulf HC. Patients’ perspectives on the burden of recurrent genital herpes. Int J STD AIDS 2001; 12 640–5.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[22] Patel R,  Tyring S,  Strand A,  Price MJ,  Grant DM. Impact of suppressive antiviral therapy on the health related quality of life of patients with recurrent genital herpes infection. Sex Transm Infect 1999; 75 398–402.
CAS | PubMed |

[23] Spencer B,  Leplege A,  Ecosse E. Recurrent genital herpes and quality of life in France. Qual Life Res 1999; 8 365–71.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[24] Ashley RL,  Wald A,  Eagleton M. Premarket evaluation of the POCkit HSV-2 type-specific serologic test in culture-documented cases of genital herpes simplex virus type 2. Sex Transm Dis 2000; 27 266–71.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[25] Corey L,  Wald A,  Sacks SL,  Tyring SK,  Warren T,  Douglas JM, et al. Once-Daily Valacyclovir to Reduce the Risk of Transmission of Genital Herpes. Obstet Gynecol Surv 2004; 59 260–1.
Crossref | GoogleScholarGoogle Scholar |