Screening for Asymptomatic Genital Herpes

Is Serologic Testing Worth It?

Leia Raphaelidis, FNP


Journal for Nurse Practitioners. 2014;10(3):194-199. 

In This Article

Coping with Positive Hsv-2 Serology

Because of the stigma that we as a society have attached to herpes and to all STIs, receiving the diagnosis of HSV-2 via positive serology can be emotionally overwhelming. The clinician needs to set aside time to help the individual diagnosed with asymptomatic herpes understand and cope with the result. If in-office rapid testing has been used, then the clinician or other qualified personnel will have to find time at that very same visit to initiate that counseling process. The patient's first reaction may be anger, grief, or disbelief, and a return visit for more patient education may be warranted. Here are some of the key messages to convey at that time.

  • Although the initial diagnosis usually comes a shock, over time people with herpes learn how to live with it and how to talk about it.

  • You may have had this infection for a long time. You did not necessarily acquire this infection from your current or most recent sexual partner.

  • Even if you have no symptoms, it is possible that you could pass this infection to your sexual partner.

  • Using condoms consistently can reduce the transmission of genital herpes.

  • Some people with asymptomatic genital herpes choose to go on suppressive therapy with antiviral medicine. There are no studies to date that tell us to what extent this treatment can reduce transmission to others in people with no symptoms, but experts believe it may help.

  • Much more information is available online (Table 2).

Studies have shown that the negative response to HSV-2 diagnosis, although intense at the time of the initial diagnosis, generally gets better with time, with little lasting psychosocial impact or long-term deterioration in mental health.[22,23] Although there are limited data about how the newly diagnosed adjust, there is ample anecdotal evidence that people learn how to cope with genital herpes, successfully disclose their status to prospective or current partners, and enjoy healthy, satisfying sexual relationships despite their infection.