Study explores how people react to learning they have genital herpes

November 09, 1999

Thanks to new tests coming on the market, a flood of people may learn in coming months that they are part of a huge epidemic of genital herpes. A University of Washington scientist is leading a team that will study how health care professionals can help educate people about the disease and prevent it.

The study will examine how people feel and what they do when they learn they have the viral disease. Among the questions: What will this do to someone's self-esteem? And what will he or she tell current or prospective sexual partners?

So far, it's been difficult to diagnose genital herpes, or HSV-2, because older blood tests confuse it with herpes type 1. Estimates are that 22 percent of people in the United States are infected with HSV-2; only one in five of them knows that he or she has the disease. Most people either don't have symptoms, or think mild symptoms are caused by something else.

But new blood tests will make it easier to diagnose people with genital herpes, says Dr. Anna Wald. She is director of the University of Washington Virology Research Clinic and an assistant professor of allergy and infectious diseases in the UW School of Medicine and of epidemiology in the School of Public Health and Community Medicine.

"There's a lot of concern about the psychological impact of telling someone they have HSV-2, if they've never been bothered by it," Wald says. "But my experience is that most people want to know. It's important to know, because you may transmit it to a partner. It's not good news to tell someone they have an HSV-2 infection, but in most cases, people deal with it quite well."

The Centers for Disease Control recently approved a $500,000 grant - the first of its kind -- for a team led by Wald. The grant will allow substantial surveys and follow-ups at five different sites in the Seattle area to measure the psychological impact of the news, as well as how it affects relationships. There will be repeat assessments at three months and six months. The grant will also pay for studies to determine the economic cost of the herpes epidemic.

"There's been a feeling that there is nothing we can do about it: We can't diagnose it. We can't cure it. We don't know how to prevent it. So why even talk about it?" Wald says. "This grant from the CDC is the first money put toward exploring issues surrounding control of herpes. This is recognition that this is a problem that we can do something about."

One question is what people will do differently, if anything, in relationships. Some people will be in relationships with other people who have genital herpes. Others will have partners who are not infected, while others may have to decide how to adjust their social lives.

The grant was part of a $12.5 million Prevention Research Initiative recently announced by the CDC, for 50 projects aimed at preventing disease and injuries. The CDC issues clinical practice guidelines to health care providers about the use of testing and about educational counseling related to herpes, as well as treatment options.

"The nation does not really have a genital herpes prevention program in place. Before you can develop one, you have to have information about the pieces of the program," says Dr. Katherine Stone, assistant chief for science in the CDC's Division of Sexually Transmitted Disease Prevention. "Dr. Wald's research will allow the public health community to design prevention strategies that will work in the real world."

The UW Virology Research Clinic has several other research programs related to other aspects of the disease. For example, Wald and colleagues are about to start testing a new vaccine that might improve conditions for people who have genital herpes. Another vaccine is being tested in people who do not have herpes. And UW scientists are testing what kind of medicine might help prevent transmission of the disease from an infected person to an uninfected partner.

People interested in participating in HSV-2 studies can call the Virology Research Clinic at 206-720-4340.

University of Washington

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