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Background: Management of patients newly diagnosed with genital herpes is ill-defined.
Objectives: To describe the management of persons with newly diagnosed symptomatic genital herpes in Western Washington.
Methods: We used surveillance data collected in King and Pierce Counties, Washington, to identify persons ≥ 18 years of age with newly diagnosed symptomatic genital herpes, and interviewed patients and reporting clinicians regarding treatment. Patients were eligible for interview if they had newly diagnosed symptomatic genital herpes, spoke English, and their provider agreed.
Results: We interviewed clinicians regarding 246 (92%) of 267 reported cases, and interviewed 134 (63% of 212 eligible) patients. Patients had a median age of 27 (range 18-79) years and were 75% female, 65% White, 17% Black, and 95% heterosexual. Patients reported condom use was discussed in 78% of encounters, suppressive therapy in 68%, and suppressive therapy to decrease transmission in 40%; 26% reported taking suppressive therapy. A follow-up appointment was recommended for 34% of patients, and 21% reported attending a follow-up appointment. Only 30% of patients correctly responded that condoms are ~50% effective in preventing herpes transmission, and only 21% estimated that suppressive therapy is ~50% effective in preventing transmission, with most (60%) unsure of the effect of suppressive therapy on transmission. Both discussion of suppressive therapy and discussion of suppressive therapy for transmission prevention were associated with suppressive therapy use (p=0.003 and p<0.001 respectively).
Conclusions: Although clinicians usually discuss condoms and suppressive therapy with patients diagnosed with genital herpes, only a minority discuss suppressive therapy to prevent transmission and only a quarter of patients take suppressive therapy. Most patients could not estimate the effectiveness of condoms or suppressive therapy in preventing transmission, and few are offered routine follow-up care.
Implications for Programs, Policy, and/or Research: Research is needed to identify economical ways to improve the care and education of persons diagnosed with genital herpes.