Barriers to Genital Herpes Testing for People Living with HIV

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Researchers from Johns Hopkins University conducted a cross-sectional survey investigating the frequency of genital herpes testing among those with HIV, utilizing data from the American Social Health Association. Results were published in the Journal of the Association of Nurses in AIDS Care. A total of 110 people living with HIV compromised the study sample; most of the respondents were male, and over half self identified as homosexual, gay or queer; one third identified as heterosexual or straight. The majority of survey respondents (34%) had not been tested for HSV-2. A little under a quarter (22%) preferred not to answer whether they had and close to one third (34%) had been tested.

So what are the reasons associated with decisions not to test for HSV in this group?

Researchers cited several reasons frequently given for not testing. The three reasons given most often were:

Noting healthcare provider recommendation as the factor most frequently cited, it appears healthcare providers play an instrumental role. However, providers’ opinions on whether testing is necessary are mixed. Some healthcare providers suggest that there is only a benefit of knowing one's HSV status if the patient is not on antiretroviral therapy and that the sexual behavior messages patients receive would remain unchanged with or without knowing HSV status. The authors counter this notion, citing a recent study that "noted that the use of ART by patients co-infected with HIV and HSV only partly reduced the frequency of HSV-2 genital shedding, and, therefore, HSV therapy may benefit HIV-infected individuals during ART by further reducing clinical recurrences and the transmissibility of HSV-2 and HIV-1."(Effect of HIV-1 and antiretroviral therapy on herpes simplex virus type 2: a prospective study in African women. Mayaud P, Nagot N, Konaté I, Ouedraogo A, Weiss HA, Foulongne V, Defer MC, Sawadogo A, Segondy M, Van de Perre P; Sex Transm Infect. 2008 Oct;84(5):332-7. Epub 2008 Jul 2. )

The outcome of this study leads the authors to encourage healthcare professionals caring for those HIV positive to encourage HSV testing and counseling.

Reference
Providers' Knowledge, Practices, and Barriers Related to Genital Herpes Testing for Patients With HIV Lisa Gilbert, Joy Nanda, Jason Farley, Hayley Mark Journal of the Association of Nurses in AIDS Care - July 2010 (Vol. 21, Issue 4, Pages 327-334, DOI: 10.1016/j.jana.2009.12.009)