Background HSV-2 is the main cause of genital ulcer disease worldwide. It is frequently under- recognised because it is often clinically silent. Serologic testing for HSV antibody reliably identifies individuals infected with HSV-2. There is little literature investigating whether serologic screening of asymptomatic patients changes sexual behaviour and risk reduction.
Methods Patients >18 yrs old who came to an urban STD clinic in Brooklyn with no previous history of HSV or HIV, no genital ulcer at initial visit, and sexually active in the preceding 3–6 months were administered a questionnaire. HSV1/2 IgG testing using HerpesSelect (Becton Dickinson and Company in Sparks MD) was used and patients were told about the results after 1 week. Participants were educated regarding natural history of HSV and asked to come back after 3 months to complete a follow-up questionnaire. Changes in sexual behaviour including number of sexual partner, condom use and psychological stress were the primary outcome of interest of this study.
Results A total of 193 eligible participants were included for analysis and follow-up is available for 101(51%). There was no significant difference among baseline characteristics (age, gender, no. of sexual partners) among participants. Majority of participants were heterosexuals (95.8%) and black immigrants (92.3%). The seroprevalence of HSV2 IgG was 35%. More women were HSV + (67%) and more HSV + participants reported having non-steady partners (p 0.027). When analysing change (from baseline to follow-up), there was a significant decrease in number of non-steady partners among HSV + and HSV—participants (p 0.004 and p 0.0049 respectively). There was no statistically significant difference in the frequency of condom use between HSV + and HSV—participants (p=0.448 and p=0.91). Discussion: There was a significant decrease in the number of non-steady partners after knowing HSV status among both HSV+ and HSV- participants but no change in frequency of condom use. This finding is important because this suggests that knowledge of HSV status may impact sexual behaviour that can potentially reduce risk of transmission. However, both groups had a significant change in the number of non-steady partners regardless of HSV results, which may suggest that being tested for HSV-2 is enough to alter certain risky sexual behaviours. This can be potentially useful to patients visiting STD clinics for screening.
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