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Original article
Herpes simplex virus type 2 serological testing and psychosocial harm: a systematic review
  1. Kaile Ross1,
  2. Christine Johnston1,2,
  3. Anna Wald1,2,3,4
  1. 1Department of Medicine, University of Washington, Seattle, Washington, USA
  2. 2Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
  3. 3Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
  4. 4Department of Epidemiology, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Christine Johnston, University of Washington Virology Research Clinic, Box 359928, 325 Ninth Avenue, Seattle, WA 98104, USA; cjohnsto{at}


Background Serological testing for herpes simplex virus (HSV) type 2 in persons without a history of genital herpes is not recommended, partly because of concerns that an HSV-2 diagnosis would lead to negative psychosocial sequelae. This review aimed to examine the evidence regarding the psychosocial effects of HSV-2 serological testing.

Methods Eight electronic databases were searched for empirical studies indexed before March 2010. Abstracts from relevant conferences were reviewed and senior authors contacted to find unpublished materials. Eligible studies examined participants without a history of genital herpes who underwent HSV-2 serological testing and reported data from at least one quantitative or qualitative psychosocial assessment conducted after receiving HSV results.

Results Of nine studies that satisfied the inclusion criteria, seven reported that HSV-2 diagnosis by serological test did not have a persistent negative impact on 309 participants' mental health or sexual attitude and satisfaction. Two studies reported a negative impact of testing; one found that five HSV-2-seropositive college students had increased distress 3 months post-testing compared with HSV-2-negative individuals, and the other found self-reports of sexual undesirability up to 1 year after diagnosis in some people. The perceived severity of a genital herpes diagnosis was moderately severe for participants before testing; however, post-testing, the reported severity of a herpes diagnosis was lower among those testing HSV-2 positive.

Conclusions HSV-2 diagnosis by type-specific serological testing did not result in long-term psychosocial harm in most persons without an identified history of genital herpes. Concerns about sustained emotional impact should not deter clinicians from offering HSV-2 serological testing to appropriate patients.

  • Diagnosis
  • genital herpes
  • herpes simplex (clinical)
  • HSV
  • psychosocial
  • serological testing
  • serology
  • testing

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  • Presented in part at the 19th International Society of STD Research Conference, Quebec City, Canada, 10–13 July 2011.

  • Funding This work was supported by the National Institutes of Health/NIAID grants P01-AI030731 (AW) and K24-AI071113 (AW), K23-AI079394 (CJ). CJ has received grant support from GlaxoSmithKline and is a research investigator for AiCuris. AW has received research funding from GlaxoSmithKline and is a consultant for AiCuris.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.