“People come to the ASHA hoping to find not only up-to-date information, but also validation and acceptance.”
-Veteran ASHA Health Communication Specialist Danna Bower reflects on over 14 years on the job
For nearly a decade and a half, Danna Bower has worked in ASHA’s various contact centers, providing information and support to callers with questions about herpes and other STIs. A veteran of virtually every sexual health information service ASHA has offered since the early 1990s, Ms. Bower currently staffs the STI Resource Center hotline and serves as one of the administrators on ASHA’s web-based STI Message Boards, where she can frequently be found responding to inquiries in the herpes forums. Recently The Helper asked her to reflect on her career and share insights gained from responding to thousands of calls, emails, and website questions about herpes.
What are the most common HSV questions you deal with through the hotline and HSV message board?
On the hotline, I get many calls from people testing positive for HSV-2 yet who have never noticed any symptoms. There are couples who have been married for many years yet one partner suddenly has an outbreak or tests positive, and both the caller and their partner are certain each has been faithful. Callers are often surprised to know that the vast majority of people who have herpes aren’t aware of it as they've never experienced an outbreak, and that it's entirely possible that one partner was infected long before the current relationship began. A number of other calls are from those recently diagnosed, and have a wide spectrum of questions – most have an emotional component, as you would expect. The majority of those calls address stigma issues; who’s to blame, how to tell their partner, risk reduction and sometimes questions about pregnancy and fertility.
On our message boards, the topics or ‘threads’ with the most traffic are those that address antibody testing, infection rates, pregnancy, the law and herpes, and insurance coverage. One advantage we have with the message boards is that anybody can read them at any hour of the day. Also, there may be several responses to the same question, offering broad support and even links to more information.
We know the topic of stigma is one of the biggest issues that comes up with newly diagnosed HSV patients. How do you respond to callers and users of the message board who have difficulty coping? We start by empathizing with each caller or poster. When someone is newly diagnosed, it can be difficult on many levels. People come to the ASHA hoping to find up-to-date information, validation, and acceptance.
Another component is helping the caller to understand that he or she isn’t marked by herpes. The truth is that 1 in 4 sexually active adults have herpes—so if we don’t have it ourselves the chances are we know somebody who does. Sometimes I ask the caller if he or she knows someone with herpes. If they do, I ask them if they think that person is “dirty” (or whatever word they used to describe themselves). People really do have a choice in perpetuating the stigma or realizing that having herpes doesn’t take away from their value. It’s merely a virus. That’s it.
What advice do you offer when people ask about talking with partners?
These conversations are my most challenging, as we don’t really know the caller or the caller’s partner. Therefore, I keep a copy of Managing Herpes close by for tips on how to shape the message and the response. Most people with HSV agree that it’s wise to let the relationship flourish a bit before broaching the subject with a partner. It’s also helpful to rehearse what you’re going to say to your partner and be prepared for all kinds of questions and reactions. Try to have a good attitude and be upbeat about the message. A positive presentation is more likely to yield a positive response. Work on being calm, confident and sincere. Carefully plan the time and place for the conversation. Partner communication works best when individuals are relaxed and can devote their full attention to the conversation. So, choose a place that’s quiet and free of interruptions.
How do calls to the hotline differ from message board posts?
It seems to me the hotline callers have more of a sense of urgency. Many have just been diagnosed and are still in an emotional state. Oftentimes, when people are diagnosed, they hear the word "herpes" and are unable to process anything else the doctor tells them. Luckily, some clinicians understand what's happening and hand their patients our number as they walk out the door. This is when we can attempt to fill in the blanks.
The posts to the HSV message board generally don’t have the same immediacy. Here, people post their questions and are content to check back later for an answer. The questions themselves are usually more technical in nature. It seems our posters are Internet-savvy and are often well-researched on the subject before they post. Mostly, people want to know more about treatment options, available diagnostic tests, or clarification about conflicting HSV information.
How have you been able to sustain your energy and enthusiasm over so many years?
People are contacting ASHA, sometimes, because they can't seem to find the information and empathy they need from other sources. When I leave work each evening, knowing I made a difference for a few people really sustains me.
ASHA’s Message Boards are free, anonymous, and available 24 hours a day. ASHA’s STI Resource Center is available weekdays from 9 a.m. until 6 p.m. at 919.361.8488.