Psychosocial impact of type-specific herpes simplex serological testing on asymptomatic sexual health clinic attendees

Abstract

The usefulness of type-specific testing for herpes simplex virus type 2 (HSV-2) is much debated with proponents arguing for likely change in the sexual behaviour of asymptomatic carriers and opponents suggesting that testing may have significant adverse psychological impact while not promoting behaviour change. In the present study we examine the impact of HSV-2 serological testing on psychological well-being, self-esteem, anxiety, sexual self-perceptions and sexual practices among a sample of 180 clients of a sexual health clinic. Of the participants, 21 (11.7%) were HSV-2 positive at entry to the study. No adverse psychological consequences of a positive test were observed among those participants followed for 3 months (n=124) or for 6 months (n=97). There was little significant change observed in sexual behaviour although a general but not significant pattern of decreased sexual behaviour with casual partners was observed among participants who tested HSV-2 negative. While supportive of the value of HSV-2 testing, these findings require replication in larger samples and different populations.

Herpes simplex virus type 2 serological testing and psychosocial harm: a systematic review

“…There were no changes in mental health scores, depression, anxiety or mood scores when compared with baseline,28 32 when compared with HSV-2-seronegative participants28 32 or when compared with HSV-2-seropositive individuals with a previous diagnosis of genital herpes 33. Similarly, Meyer et al 27 tested patients in an urban HIV clinic and found no significant changes in mood disturbance for patients who tested positive compared with pre-test baseline or when compared with those with a previous history of HSV-2.…”

“…Among the six studies that assessed mental health impact, four reported no mental health impact from HSV serological testing on 203 participants 27 28 32 33. There were no changes in mental health scores, depression, anxiety or mood scores when compared with baseline,28 32 when compared with HSV-2-seronegative participants28 32 or when compared with HSV-2-seropositive individuals with a previous diagnosis of genital herpes 33.…”

“…Four studies also compared participants who tested HSV-2 positive with participants who tested HSV-2 negative 25 28 31 32. Three studies compared responses in HSV-2-positive participants with and without a history of genital herpes 27 30 33…”

Recommendations for the Selective Use of Herpes Simplex Virus Type 2 Serological Tests

“…A Should always be offered; both strong evidence for efficacy and substantial benefit supports recommendation for use B Should generally be offered; moderate evidence of efficacy, or limited evidence with expert consensus, supports a general recommendation for use C Should be offered to select patients; evidence for efficacy is insufficient to support a general recommendation for use D Should generally not be offered; moderate evidence for lack of efficacy or for adverse outcome supports a recommendation against use E Should never be offered; strong evidence for lack of efficacy or for adverse outcome supports a recommendation against use minimal to no psychosocial dysfunction after the diagnosis of asymptomatic herpesvirus infection [21][22][23].…”

Challenges in Genital Herpes Simplex Virus Management

“…[35]. In addition, physicians are frequently uncomfortable discussing the complex issues of acquisition and the consequent emotional burdens that genital herpes causes in patients' lives [38,39]. Studies of subclinical shedding have identified the risks of potential transmission to partners and the consequence of frequent reactivation for transmission.…”