"Do not underestimate the impact of this diagnosis on your patients. They will require extensive, thoughtful counseling [because] the physical impact of genital herpes is nothing compared to the psychological one," Ms. Mulcahy said.
Such counseling should include information about the natural history of disease, the ability to bear children, the transmission risk to sexual partners, and the variations in severity of primary vs. recurrent episodes. It also is important to dispel cancer myths, reiterate the fact that the virus can be transmitted in the absence of symptoms or lesions, remind patients of their obligation to inform current and future partners, and recommend counseling and testing for sexual partners, she said.
Risk-reduction strategies also should be discussed, including avoiding sexual contact when symptoms or lesions are present and using latex barrier protection and suppressive therapy. There are three oral antiviral drugsacyclovir, valacyclovir, and famciclovirapproved for the treatment of genital herpes. Topical treatments, she stressed, "absolutely do not work and have no role in the treatment of genital herpes."