Genital Herpes Simplex Monogamous Couples
Monogamous Couples
Test results can be used to counsel couples in monogamous relationships in which one partner has clinical or serologic evidence of herpes. Serologic testing can identify partners at risk. Many people are unaware of their infection. Explain the risks when one partner has antibodies and the other does not. Educate patients about the frequency of transmission, asymptomatic shedding, condoms, and suppressive therapy. The annual rate of acquisition is 32% in susceptible female partners who lack antibodies to either HSV type 1 or 2 and 9% in females with HSV type 1 antibodies. The annual rate of acquisition is less than 6% in male susceptible partners, regardless of previous HSV type 1 infection. Most infections are acquired from people who are unaware that they are shedding the virus but have no symptoms. Condoms are more effective for protecting women. Vaginal secretions can spread beyond a condom barrier to the pubis and thighs. Herpes is often seen in these areas in men. Suppressive therapy can substantially reduce viral shedding and the risk of transmission.
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