Providing accurate up-to-date information in a non-judgmental way is key to assisting a person to understand and come to terms with herpes.
The psychological morbidity of a diagnosis often far outweighs physical symptoms.
Recommended resource for patients www.herpes.org.nz or the Herpes Helpline tollfree 0508 11 12 13.
Genital herpes is a common and, medically speaking, usually a relatively minor condition in people who are sexually active. However, conditioning and social values contribute to individuals having a range of emotional responses when given a diagnosis of genital herpes.104-107
Emotions related to the diagnosis of genital herpes
Some people cope well without any problems, however, for others a diagnosis of genital herpes may be the most challenging health disruption they have experienced, given the stigma and societal conditioning associated with it.
The diagnosis of genital herpes can provoke confusion and a grief reaction causing feelings such as guilt, anger, fear, shock, denial and a sense of injustice.
Common concerns of patients relate to social stigma, transmission, fear of rejection upon telling potential sexual partners, and how herpes will affect their sex life and social activities.106, 108
Patients with genital herpes are usually very concerned about the diagnosis, and its potential impact on their relationships.109,110
The diagnosing clinician should address patient concerns at the first presentation, even if the patient is referred elsewhere for counselling.111
Herpes Helpline tollfree 0508 11 12 13 provides counselling and education in both acute and non-acute situations.
Not all patients will take up the offer of initial counselling and support. It is very important to advise all patients of resources as these are often accessed at a later date, for example, when establishing a new relationship or wanting to conceive. www.herpes.org.nz
Successful psychosocial management of genital herpes is time-intensive. The impact of the diagnosis is influenced by the person’s coping strategies, level of social support and underlying beliefs about sexuality and sexual health. A diagnosis of herpes can also trigger worries about:
Acquisition of HIV or other STIs.
They are seen as promiscuous and that the doctor has a low opinion of them.112
In all cases (whether primary, non-primary or first symptomatic reactivation), the emotional consequences and perceived social stigma of the infection should be addressed. No matter the time since diagnosis, do not assume that another clinician has spoken with the person about genital herpes.109, 113
Patients’ Concerns Are Predominantly About Relational Issues
Fear of discovery – when and how to tell a partner
Intimate relationships and sex life affected
Social activities and lifestyle altered
Social stigma of STI
Condition is 'incurable'
Fear of transmission or contagion
Fear of disclosure and subsequent rejection
Inaccurate online material may exacerbate above points
Reassure patients that they are not alone in having genital herpes. The NZ Herpes Foundation www.herpes.org.nz or Helpline tollfree 0508 11 12 13 provide specialist support, education and counselling, or refer for specialist counselling at the local sexual health clinic. Advise about reputable internet resources and stress that the online ‘cure’ claims are not scientifically supported.
The above section on counselling is based on internationally accepted standards of practice. Grade C
The Guidelines are a consensus opinion of the STIEF Professional Advisory Group (PAG). The PAG has representation from nationwide medical, nursing and allied disciplines involved in the management of STIs. The Guidelines are produced by considering available literature, both New Zealand wide and international, and by basing the medical recommendations on the evidence in the literature or reasonable supposition and opinions of medical experts.