Background:
Recent research has provided new understanding of how genital herpes (GH) is transmitted and what measures reduce risk. It is unclear how those affected by GH have interpreted this information in making decisions about risk behaviors and how new prevention messages should be crafted.

Objective:
This study assessed perceptions of the effectiveness of condoms and suppressive antiviral medication in reducing GH transmission risk; factors encouraging or discouraging use of condoms and antiviral medication; and opinions about risk reduction messages.

Method:
The survey was posted to four Web sites in 2005, and 1,849 of the 2,002 respondents were eligible (over age 13; U.S. resident; and had GH diagnosis and history of sexual activity with an uninfected partner or did not have GH diagnosis but had a partner with GH).

Result:
Most respondents had adequate knowledge of the protective abilities and limitations of condoms in reducing transmission risk, but perceptions of antiviral medication varied widely. ‘Common sense' was most often selected as the source of information on condom efficacy (32%); ‘healthcare provider' was selected for antiviral medication (33%). Top barriers to condom use included partners' willingness to accept risk of acquiring GH or dislike for condoms. The top barrier to antiviral medication was outbreaks weren't severe or often enough to warrant suppressive therapy. Respondents rated proposed prevention messages as effective.

Conclusion:
Historically, condoms have been at the center of safer sex mantras, but the notion that medication can reduce STD risk is not yet pervasive among individuals with GH and partners. This survey generates insight into crafting comprehensive risk reduction messages.

Implications:
Accurate information about transmission between outbreaks, condom efficacy, and the role of antiviral medication is critical to preventing the spread of GH. Current research describing efficacy of risk reduction methods combined with common patient concerns and misconceptions should be accurately translated and broadly disseminated.