The Psychosocial Impact of Testing Individuals with No Prior History of Genital Herpes for Herpes Simplex Virus Type 2 KR Turner, T Miyai, CK Kent, JD Klausner STD Prevention and Control Services, San Francisco Department of Public Health

Background CDC Prevention Agenda for Genital Herpes Assess the psychosocial impact of HSV serologic diagnosis among persons with no history of genital herpes HSV-2 serologic testing at STD Clinic began in May 2000 Clinicians initially concerned about psychosocial impact

Study Objectives 1.To measure changes in perception of trauma associated with genital herpes 2.To measure changes in general mental health and wellbeing following serologic HSV-2 testing 3.To measure changes in sexual attitudes following serologic HSV-2 testing 4.To evaluate the impact a positive HSV-2 result had on quality of life

Study Design Prospective cohort study Participants: patients attending STD Clinic between April and August 2001 who expressed interest in HSV-2 testing and had no prior diagnosis of genital herpes Participant enrolled; baseline interview conducted; HSV-2 test (In Person) Enrollment Participant receives HSV-2 results Week 1 First follow-up interview (Telephone) Week 2 Final follow-up interview (Telephone) Week 13

Measures of psychosocial morbidity: 1.Genital herpes trauma score (ASHA) 2.Adjusted Rand Mental Health Inventory 5 item version 3.Adapted Multidimensional Sexual Self- Concept Questionnaire (Snell) 4.Herpes Quality of Life (HQoL) questionnaire among HSV-2 infected (Galen)

Data analysis: Compared the mean scores at baseline to mean scores at follow-up by HSV-2 status. Quality of Life scores among HSV-2 positives at Follow-Up interviews Odds ratios, 95% confidence intervals, and Chi Square tests for significance were calculated

201 enrolled in study, completed baseline questionnaire 196 eligible for 1 st f/u interview 41 = HSV2(+)155 = HSV2(-) 36 (88%) completed 1 st f/u interview 144 (93%) completed 1 st f/u interview 29 (71%) completed 2 nd f/u interview 129 (83%) completed 2 nd f/u interview Follow-Up

Good Metal Health Poor Metal Health

Positive Sexual Attitudes Negative Sexual Attitudes

4. Good Quality of Life Among Persons with Asymptomatic HSV-2 Infection at Follow-Up Follow-Up 1 Follow-Up 2 Top Quartile

Limitations Sample size Follow-up rate Sensitivity of questionnaires

Conclusions and Recommendations No significant differences in psychosocial morbidity by HSV-2 status in this population Psychosocial morbidity should not be a barrier to testing for HSV-2

Acknowledgements San Francisco STD Prevention and Control Services: Tomio Miyai SFCC Clinicians SFCC DCIs and Health Educators Joe Catania, UCSF Galen Research for HQoL ASHA for questions about perception of trauma