What to avoid saying to patients:
- Rather than using terms like "incurable," use softer language like "recurrence," "episode," or "flare-up."
- Refrain from saying "you'll have it forever" - this isn't commonly said for conditions like chickenpox, eczema, or psoriasis.
- Avoid insisting on partner testing unless they have symptoms; routine testing isn't necessary for asymptomatic partners.
- Don't alarm patients by saying they could face legal consequences if they don't disclose their condition. There's no legal obligation - provide them with accurate, informed advice.
It can happen to anyone: First diagnosis of genital herpes
Genital herpes a common infection that affects 'ordinary' people
Myths and ignorance abound. Good information helps make sense of diagnosis.
Why do I feel this way?
Common reactions:
A diagnosis is often unexpected and you may feel
- Confusion
- Uncertainty
- Anger and blame
- Or just have some questions
What is the herpes simplex virus (HSV)?
- A common viral infection that's been around for centuries
- Most people have no symptoms
- Causes facial herpes (HSV1) passed by kissing and genital herpes (HSV1 or HSV2) passed by oral sex (HSV1) or genital to genital contact (HSV1 or HSV2)
- A fragile virus that dies when it leaves living human cells - not passed on through non-sexual contact e.g. toilets and showers, trying on clothes, medical examinations
When did I contract the virus?
Often not possible to work out because:
- Most people contract herpes from a partner who did not know they have HSV
- Most have very mild, or no symptoms and go undiagnosed - may have genital herpes for months or years before diagnosed, if ever
- Only small % of people have severe symptoms - and this may indicate new infection
- HSV is not routinely tested for in sexual health check-up
How do people contract genital herpes?
Through direct skin to skin sexual contact including:
- Genital to genital and oral to genital
- Therefore virgins can and do contract genital herpes
- Condoms reduce transmission (condoms do stop many STIs)
- Partner has to be infected either facially or genitally – sore may not be obvious & the virus may be on the surface of the skin without symptoms on small % of days
Who did I contract the infection from?
- May be impossible to work out how long a personhas had the infection & who HSV came from
- If genital HSV1 - probably transmitted through oral sex, partner may have or had 'cold sores' on face
- If first symptoms are mild, may have had the infection for months or years
- Significant first symptoms ('flu-like illness, lots of blisters) may mean HSV contracted in past 2-20 days.
- If several recent partners may be impossible to determine who the infection came from. Genital herpes may appear in a long-term relationship with no outside partners involved
What next? Recurrences and treatment options
- Recommend oral anti-viral medication and pain relief to treat first episode
- Recommend provision of ongoing antiviral management - there are two treatment modalities recommended:
- Episodic treatment manages per recurrence. Needs to be started as soon as symptoms appear. Need to have tablets "on hand" to start immediately so provide "backpocket" antivirals.
- Suppressive treatment, an antiviral taken daily for as long as you want, this reduces or prevents recurrences, significantly reduces changes of transmission and can provide psychological comfort.
- If unwell take time off work - rest
- Prescription needed for anti-viral medication
- HSV1 – may have few, if any recurrences
- HSV2 – may have 2-6 recurrences per year
- Recurrences usually mild and are over in a few days
- Most people don't use regular medication after 1st episode
What next? Relationships
- Talk to your partner - share information
- Partner may have HSV – once contracted the virus doesn't pass back and forth
- Reduce transmission by avoiding genital contact with partner when symptoms present
- Condoms reduce transmission of HSV
- If partner does contract virus, most likely to have few if any symptoms
What's next? Future plans
People with genital herpes can:
- Have normal lives
- Have normal fertility
- Have healthy babies and vaginal deliveries
- Donate blood
- Work in any occupation
- Use spa and swimming pools
- Cuddle with their kids in bed, share a bath
- Make choices with their partners about sexual practices and the use of condoms
- Have the same overall health, immune system and lifespan as others and no additional cancer risk
What next? Talking is good
- Tell trusted friend/family member
- Return to your GP, Sexual Wellbeing Clinic or sexual health clinic for follow-up
- Counselling available at sexual health clinics
- For information and phone counselling contact: Phone toll free 0508 11 12 13 or from a mobile 09 433 6526 or email info@stief.org.nz
- Check out information on: www.herpes.org.nz
NZ Herpes Foundation: Helping people to live ordinary lives
Toll free 0508 11 12 13
Or from a mobile 09 433 6526
For Clinicians