Healthcare seeking and sexual behavior among patients with symptomatic newly acquired genital herpes

Abstract

Background: Symptoms among patients with first episode herpes simplex virus (HSV) likely influence health seeking and sexual behavior. An improved understanding of this relationship provides insight into the experience of having genital herpes and has implications for counseling.

Objective: To describe the healthcare seeking and sexual behavior in patients with symptomatic laboratory confirmed first episode HSV infection.

Methods: Two hundred thirty-six patients (94 men and 142 women) with newly acquired genital herpes were asked to complete a demographic and sexual history questionnaire. To confirm initial HSV diagnosis, swabs of lesions were collected for viral culture and HSV DNA polymerase chain reaction and blood was drawn for confirmation of HSV serostatus using the Western blot.

Results: Women reported pain and men reported lesions as the most frequent and bothersome symptom or sign causing each to seek healthcare. Forty-three percent of all participants missed some work or school because of their symptoms; women missed more school or work, sought care sooner, and saw more providers than men. Before diagnosis, most respondents (67%) suspected genital herpes was the etiology of the symptoms. Twenty-seven percent reported having sex after noticing their symptoms, though those who missed more school or work were less likely to engage in sexual intercourse.

Conclusions: Men and women have different experiences with first episode HSV, but morbidity is substantial, especially among women. Both men and women may continue to engage in sexual activity after onset of genital herpes, emphasizing the need for providers to counsel their patients to avoid exposing partners to the infection.

Figure 1

Most bothersome symptom reported for men and women. Pain includes symptoms of burning, itching, tingling, and discomfort. Other includes redness, swelling, flu symptoms, discharge, and other symptoms.