While many people may be under the false impression that herpes testing is included as a routine part of a standard STD screening, HSV antibody screening is far from commonplace. The fact that most transmission is the result of individuals who were unaware of their infection would seem a fair argument for more widespread testing. Yet concerns about the effectiveness and benefits of testing asymptomatic individuals make the subject controversial. However, researchers have explored the question of more widespread testing in a specific population—patients at STD clinics.

Researchers in Indiana recently undertook a study to implement routine HSV-2 testing in a public health sexually transmitted disease clinic. Researchers cite three factors prompting the study: “(1) requests by clients of the clinic for access to this test; (2) a desire to provide more comprehensive STD services; and (3) recognition of HSV-2 as an important cofactor for HIV transmission and the impact on the minority populations served by the clinic.” Results of their study appeared recently in Sexually Transmitted Diseases.

People visiting the Bell Flower Clinic, an STD clinic run by the Marion County Health Department in Indianapolis, Indiana, had the option to test for HSV-2 during their visit for an additional fee of thirty dollars. For four months after implementing the HSV-2 testing program, researchers collected data. Clients who opted to test were given an HSV-2 rapid test.

During the four months of the study, 3,498 people attended the clinic and 443 of those opted to test. Twenty-four percent (106) of evaluable subjects were positive for HSV-2. While whites or Hispanics were more likely to request testing, blacks were less likely. Men were more likely than women to request testing as well as older adults requested more often than younger adults. Forty-two of 112 women tested were positive and 67 of 331 men tested positive. Upon further analysis, researchers found an association with positive results and increasing age. Also, black clients were more likely to test positive for HSV-2.   

Disturbingly, the study also revealed the group within the study with the highest number of cases–black women–were the group least likely to opt for testing. Researchers believe cost may have factored in the low uptake.

This led to the conclusion that having the option to test for HSV-2 is not enough. Education must be improved and assistance with cost may need to be implemented to compel those in groups with the highest prevalence of HSV-2 to test.