Family doctors and patients with herpes are poorly informed about the viral infection, indicate the results of an online survey, published ahead of print in the journal Sexually Transmitted Infections. And there seem to be diverging opinions about how the infection is perceived and treated, the responses suggest.
Survey participants included 400 Canadian patients who had been diagnosed with herpes infection and 200 family doctors. The average age at diagnosis was 31, and the average length of time patients had had their infection was 13 years. Almost two thirds of the doctors were male and had been in practice for an average of almost 15 years.
The results showed that doctors overestimated the ongoing emotional impact of herpes infection. Patient distress was linked to the frequency of recurrent bouts of infection and a recent diagnosis.
Doctors were also much less likely to recognize that patients worry more about passing on the infection to someone else than about the outbreaks themselves.
Doctors believed that three out of four of their patients took antiviral treatment for their infection, but in reality fewer than one in three (29 percent) patients said they were doing this.
The doctors also said that they had discussed the use of treatment to suppress infection with over half (59 percent) of their patients. But only one in four patients remembered having had such a discussion with their doctor. More worryingly, both doctors and patients underestimated the risks of passing on the infection during periods when there are no obvious outward symptoms, but when the skin sheds infectious viral particles (viral shedding).
Doctors estimated that 45 percent of infections are passed on when there are no symptoms, while patients thought this happened in 51 percent of cases. The actual figure is 70 percent, say the authors.
Patients were also ignorant about how the virus is passed on. Although virtually all of them recognized that herpes is contracted through sex, only two thirds said that this was the sole source. Almost one in five thought that herpes could be caught from toilet seats or blood transfusions. And almost one in 10 thought shaking hands could pass it on. One in 20 thought swimming pools and baths were also potential sources of infection.
Source: British Medical Journal
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