Background A recent UK prison sentence for transmission of genital herpes simplex virus (HSV) type 2 has caused STI clinics to reassess patient advice on disclosure. Crown Prosecution Service (CPS) guidance, applicable to England and Wales, determines how STI transmission allegations should be handled, including the defensive value of disclosure. Aim: Does advice reflecting CPS guidance alter intended disclosure of STIs and do patients wish to receive this?
Methods Questionnaire study of patients attending a level 3 English STI clinic assessing intended disclosure of STIs and actual disclosure (those with a chronic STI other than HIV) before and after reading CPS guidance on the protective value of disclosure. Likelihood of patients considering legal redress if infected, and whether they wished to receive information on this in STI clinic was reviewed.
Results Of 307 patients the majority intended to disclose an STI diagnosis to regular and casual partners, with generally no significant increase in intended disclosure after disclosure advice. Patients with warts were significantly less likely to disclose to casual than regular partners prior to disclosure advice (p = 0.0138), but this difference disappeared after advice. Excluding patients with HSV disclosing to regular partners, intended disclosure was greater than actual disclosure, which was significant in patients with warts (p = 0.0007). 49% patients would consider legal redress if infected with a chronic STI and 66% patients would like to recieve information on this in GUM clinic.
Conclusion The study demonstrates that most patients intended to disclose an STI to partners, but that in those with a chronic STI, actual disclosure was lower than this. Advice on the protective value of disclosure did alter disclosure intentions for those with some chronic viral diseases. UK STI clinics should consider raising the issue of the law in relation to the transmission of STIs to reflect patient demand.
- Chronic viral STIs
- Crown Prosectution Service
- Herpes simplex virus type 2