Skip to main content
NCBI home page
Sexually Transmitted Infections logoLink to Sexually Transmitted Infections
. 2003 Aug;79(4):280–285. doi: 10.1136/sti.79.4.280

Psychosocial impact of serological diagnosis of herpes simplex virus type 2: a qualitative assessment

J Melville 1, S Sniffen 1, R Crosby 1, L Salazar 1, W Whittington 1, D Dithmer-Schreck 1, R DiClemente 1, A Wald 1
PMCID: PMC1744709  PMID: 12902574

Abstract

Objectives: To assess the emotional and psychosocial responses to a serological diagnosis of HSV-2 infection in individuals without previous history of genital herpes.

Methods: 24 individuals who had a positive HSV-2 serology by western blot and no clinical history of disease were recruited from four clinics (sexually transmitted disease, maternal and infant care, family medicine, and virology research) over a 10 month period. In-depth qualitative interviews were conducted to elicit an individual's responses to the HSV-2 diagnosis.

Results: Three categories of themes were identified from the interviews. Short term emotional responses included surprise, denial, confusion, distress, sadness, disappointment, and relief to know. Short term psychosocial responses included fear of telling sex partners, anger at the source partner, guilt about acquiring or transmitting, and concern about transmitting to a child. Perceived ongoing responses included fear of telling future partners, concern about transmitting to a sex partner, feeling sexually undesirable, feeling socially stigmatised, feeling like "damaged goods," sex avoidance due to social responsibility, fear of transmitting to a newborn, and relationship concerns relating to the diagnosis.

Conclusions: Individuals exhibit strong emotional and psychosocial responses to a serological diagnosis of HSV-2 infection. Many of the negative responses may be time limited and influenced by factors that are potentially amenable to counselling.

Full Text

The Full Text of this article is available as a PDF (172.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aral S. O., Cates W., Jr, Jenkins W. C. Genital herpes: does knowledge lead to action? Am J Public Health. 1985 Jan;75(1):69–71. doi: 10.2105/ajph.75.1.69. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Ashley R. L., Militoni J., Lee F., Nahmias A., Corey L. Comparison of Western blot (immunoblot) and glycoprotein G-specific immunodot enzyme assay for detecting antibodies to herpes simplex virus types 1 and 2 in human sera. J Clin Microbiol. 1988 Apr;26(4):662–667. doi: 10.1128/jcm.26.4.662-667.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Ashley R. L., Wald A., Eagleton M. Premarket evaluation of the POCkit HSV-2 type-specific serologic test in culture-documented cases of genital herpes simplex virus type 2 [see comment]. Sex Transm Dis. 2000 May;27(5):266–269. doi: 10.1097/00007435-200005000-00005. [DOI] [PubMed] [Google Scholar]
  4. Bailey J. V., Farquhar C., Owen C., Whittaker D. Sexual behaviour of lesbians and bisexual women. Sex Transm Infect. 2003 Apr;79(2):147–150. doi: 10.1136/sti.79.2.147. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bensen C., Stern J., Skinner E., Beutner K., Conant M., Tyring S., Reitano M., Davis G., Wald A. An interactive, computer-based program to educate patients about genital herpes. Sex Transm Dis. 1999 Jul;26(6):364–368. doi: 10.1097/00007435-199907000-00010. [DOI] [PubMed] [Google Scholar]
  6. Brown Z. A., Selke S., Zeh J., Kopelman J., Maslow A., Ashley R. L., Watts D. H., Berry S., Herd M., Corey L. The acquisition of herpes simplex virus during pregnancy. N Engl J Med. 1997 Aug 21;337(8):509–515. doi: 10.1056/NEJM199708213370801. [DOI] [PubMed] [Google Scholar]
  7. Cassell J. A., Brook M. G., Mercer C. H., Murphy S., Johnson A. M. Treating sexually transmitted infections in primary care: a missed opportunity? Sex Transm Infect. 2003 Apr;79(2):134–136. doi: 10.1136/sti.79.2.134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Connor-Greene P. A. The role of counseling in the treatment of genital herpes. J Am Coll Health. 1986 Jun;34(6):286–287. doi: 10.1080/07448481.1986.9938953. [DOI] [PubMed] [Google Scholar]
  9. Desai V. K., Kosambiya J. K., Thakor H. G., Umrigar D. D., Khandwala B. R., Bhuyan K. K. Prevalence of sexually transmitted infections and performance of STI syndromes against aetiological diagnosis, in female sex workers of red light area in Surat, India. Sex Transm Infect. 2003 Apr;79(2):111–115. doi: 10.1136/sti.79.2.111. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Dibble S. L., Swanson J. M. Gender differences for the predictors of depression in young adults with genital herpes. Public Health Nurs. 2000 May-Jun;17(3):187–194. doi: 10.1046/j.1525-1446.2000.00187.x. [DOI] [PubMed] [Google Scholar]
  11. Drob S., Loemer M., Lifshutz H. Genital herpes: the psychological consequences. Br J Med Psychol. 1985 Dec;58(Pt 4):307–315. doi: 10.1111/j.2044-8341.1985.tb02647.x. [DOI] [PubMed] [Google Scholar]
  12. Duncan B., Hart G., Scoular A., Bigrigg A. Qualitative analysis of psychosocial impact of diagnosis of Chlamydia trachomatis: implications for screening. BMJ. 2001 Jan 27;322(7280):195–199. doi: 10.1136/bmj.322.7280.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hoon E. F., Hoon P. W., Rand K. H., Johnson J., Hall N. R., Edwards N. B. A psycho-behavioral model of genital herpes recurrence. J Psychosom Res. 1991;35(1):25–36. doi: 10.1016/0022-3999(91)90004-8. [DOI] [PubMed] [Google Scholar]
  14. Keller M. L., Jadack R. A., Mims L. F. Perceived stressors and coping responses in persons with recurrent genital herpes. Res Nurs Health. 1991 Dec;14(6):421–430. doi: 10.1002/nur.4770140606. [DOI] [PubMed] [Google Scholar]
  15. Lewis K. S. Emotional adjustment to a chronic illness. Lippincotts Prim Care Pract. 1998 Jan-Feb;2(1):38–51. [PubMed] [Google Scholar]
  16. Longo D. J., Clum G. A. Psychosocial factors affecting genital herpes recurrences: linear vs mediating models. J Psychosom Res. 1989;33(2):161–166. doi: 10.1016/0022-3999(89)90043-3. [DOI] [PubMed] [Google Scholar]
  17. Manne S., Sandler I., Zautra A. Coping and adjustment to genital herpes: the effects of time and social support. J Behav Med. 1986 Apr;9(2):163–177. doi: 10.1007/BF00848475. [DOI] [PubMed] [Google Scholar]
  18. Mehta S. D., Erbelding E. J., Zenilman J. M., Rompalo A. M. Gonorrhoea reinfection in heterosexual STD clinic attendees: longitudinal analysis of risks for first reinfection. Sex Transm Infect. 2003 Apr;79(2):124–128. doi: 10.1136/sti.79.2.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Mindel A. Psychological and psychosexual implications of herpes simplex virus infections. Scand J Infect Dis Suppl. 1996;100:27–32. [PubMed] [Google Scholar]
  20. Murdaugh C. Health-related quality of life in HIV disease: achieving a balance. J Assoc Nurses AIDS Care. 1998 Nov-Dec;9(6):59–71. doi: 10.1016/S1055-3290(98)80005-8. [DOI] [PubMed] [Google Scholar]
  21. Orroth K. K., Korenromp E. L., White R. G., Changalucha J., de Vlas S. J., Gray R. H., Hughes P., Kamali A., Ojwiya A., Serwadda D. Comparison of STD prevalences in the Mwanza, Rakai, and Masaka trial populations: the role of selection bias and diagnostic errors. Sex Transm Infect. 2003 Apr;79(2):98–105. doi: 10.1136/sti.79.2.98. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Pope C., Campbell R. Qualitative research in obstetrics and gynaecology. BJOG. 2001 Mar;108(3):233–237. doi: 10.1111/j.1471-0528.2001.00077.x. [DOI] [PubMed] [Google Scholar]
  23. Rein M. Stress and genital herpes recurrences in women. JAMA. 2000 Mar 15;283(11):1394–1394. doi: 10.1001/jama.283.11.1394. [DOI] [PubMed] [Google Scholar]
  24. Ribes J. A., Hayes M., Smith A., Winters J. L., Baker D. J. Comparative performance of herpes simplex virus type 2-specific serologic assays from Meridian Diagnostics and MRL diagnostics. J Clin Microbiol. 2001 Oct;39(10):3740–3742. doi: 10.1128/JCM.39.10.3740-3742.2001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Simms I., Eastick K., Mallinson H., Thomas K., Gokhale R., Hay P., Herring A., Rogers P. A. Associations between Mycoplasma genitalium, Chlamydia trachomatis, and pelvic inflammatory disease. Sex Transm Infect. 2003 Apr;79(2):154–156. doi: 10.1136/sti.79.2.154. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Smith A., Denham I., Keogh L., Jacobs D., McHarg V., Marceglia A., Wood V. Psychosocial impact of type-specific herpes simplex serological testing on asymptomatic sexual health clinic attendees. Int J STD AIDS. 2000 Jan;11(1):15–20. doi: 10.1258/0956462001914841. [DOI] [PubMed] [Google Scholar]
  27. Swanson J. M., Chenitz W. C. Psychosocial aspects of genital herpes: a review of the literature. Public Health Nurs. 1990 Jun;7(2):96–104. doi: 10.1111/j.1525-1446.1990.tb00618.x. [DOI] [PubMed] [Google Scholar]
  28. VanderPlate C., Aral S. O. Psychosocial aspects of genital herpes virus infection. Health Psychol. 1987;6(1):57–72. doi: 10.1037//0278-6133.6.1.57. [DOI] [PubMed] [Google Scholar]
  29. Wald A., Langenberg A. G., Link K., Izu A. E., Ashley R., Warren T., Tyring S., Douglas J. M., Jr, Corey L. Effect of condoms on reducing the transmission of herpes simplex virus type 2 from men to women. JAMA. 2001 Jun 27;285(24):3100–3106. doi: 10.1001/jama.285.24.3100. [DOI] [PubMed] [Google Scholar]
  30. Wald A., Zeh J., Selke S., Warren T., Ryncarz A. J., Ashley R., Krieger J. N., Corey L. Reactivation of genital herpes simplex virus type 2 infection in asymptomatic seropositive persons. N Engl J Med. 2000 Mar 23;342(12):844–850. doi: 10.1056/NEJM200003233421203. [DOI] [PubMed] [Google Scholar]
  31. Wilkinson D., Barton S., Chard S., Meadows J. The psychological consequences in patient undergoing a POCKit HSV-2 test. Int J STD AIDS. 2000 Aug;11(8):551–552. doi: 10.1258/0956462001916317. [DOI] [PubMed] [Google Scholar]

Articles from Sexually Transmitted Infections are provided here courtesy of BMJ Publishing Group

RESOURCES