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Patients have no appetite for HSV-2 screening

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Halting the spread of herpes simplex virus type 2 (HSV-2) in the UK remains a distant prospect, after a pilot study has shown that uptake of a type specific herpes antibody test would be too low to be effective.

The study examined attitude to theoretical and actual testing and uptake of the test among men and women attending a genitourinary (GUM) clinic in a district general hospital in southeast England.

About half of the patients—whether new consecutive attendees (207) or reattendees (205)—said they would have liked the test if had been available. In another group of 434 consecutive attendees only about 40% of men or women wished to take up the offer of actual testing. Refusal was explained variously by dislike of blood tests; no time for counselling, getting the results, or both; ambivalence about the result; and known acute genital herpes infection.

In the event, 38% of patients had the test, and 16 new cases of HSV-2 were diagnosed—way below the 72 new cases calculated from the known ratio of HSV-1 to HSV-2 infection in this population and the proportion likely to be diagnosed.

HSV-2 infection is more commonly seen in GUM clinics than among blood donors, women, and homosexual men. Infected persons tend to be older and unaware of the infection, increasing the likelihood of spread, given the propensity of HSV-2 for asymptomatic shedding. A preliminary study in Leeds in the late 1990s suggested strong support among patients for HSV-2 screening.