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This study assesses the psychosocial impact of testing individuals with no prior history of genital herpes for HSV-2. It measures changes in trauma perception, mental health, sexual attitudes, and quality of life. The research concludes that psychosocial morbidity should not deter HSV-2 testing.
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The Psychosocial Impact of Testing Individuals with No Prior History of Genital Herpes for Herpes Simplex Virus Type 2 KR Turner, T Miyai, CK Kent, JD Klausner STD Prevention and Control Services, San Francisco Department of Public Health
Background • CDC Prevention Agenda for Genital Herpes • Assess the psychosocial impact of HSV serologic diagnosis among persons with no history of genital herpes • HSV-2 serologic testing at STD Clinic began in May 2000 • Clinicians initially concerned about psychosocial impact
Study Objectives • To measure changes in perception of trauma associated with genital herpes • To measure changes in general mental health and wellbeing following serologic HSV-2 testing • To measure changes in sexual attitudes following serologic HSV-2 testing • To evaluate the impact a positive HSV-2 result had on quality of life
Study Design • Prospective cohort study • Participants: patients attending STD Clinic between April and August 2001 who expressed interest in HSV-2 testing and had no prior diagnosis of genital herpes Enrollment Week 1 Week 2 Week 13 Participant enrolled; baseline interview conducted; HSV-2 test (In Person) Participant receives HSV-2 results First follow-up interview (Telephone) Final follow-up interview (Telephone)
Measures of psychosocial morbidity: • Genital herpes trauma score (ASHA) • Adjusted Rand Mental Health Inventory 5 item version • Adapted Multidimensional Sexual Self-Concept Questionnaire (Snell) • Herpes Quality of Life (HQoL) questionnaire among HSV-2 infected (Galen)
Data analysis: • Compared the mean scores at baseline to mean scores at follow-up by HSV-2 status. • Quality of Life scores among HSV-2 positives at Follow-Up interviews • Odds ratios, 95% confidence intervals, and Chi Square tests for significance were calculated
Follow-Up 201 enrolled in study, completed baseline questionnaire 196 eligible for 1st f/u interview 41 = HSV2(+) 155 = HSV2(-) 36 (88%) completed 1st f/u interview 144 (93%) completed 1st f/u interview 29 (71%) completed 2nd f/u interview 129 (83%) completed 2nd f/u interview
Good Metal Health Poor Metal Health
Positive Sexual Attitudes Negative Sexual Attitudes
4. Good Quality of Life Among Persons with Asymptomatic HSV-2 Infection at Follow-Up Top Quartile Top Quartile Follow-Up 2 Follow-Up 1
Limitations • Sample size • Follow-up rate • Sensitivity of questionnaires
Conclusions and Recommendations • No significant differences in psychosocial morbidity by HSV-2 status in this population • Psychosocial morbidity should not be a barrier to testing for HSV-2
Acknowledgements San Francisco STD Prevention and Control Services: • Tomio Miyai • SFCC Clinicians • SFCC DCIs and Health Educators Joe Catania, UCSF Galen Research for HQoL ASHA for questions about perception of trauma