title: Genital herpes serotesting: a study of the epidemiology and patients' knowledge and attitude among STD clinic attenders in Coventry, UK.
abstract: OBJECTIVE
  To examine the seroprevalence and correlates of antibodies to herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2), and to assess patients' knowledge and attitude towards genital herpes infection and its serotesting, before and after counselling.
  
  
  METHODS
  A cross sectional study among genitourinary medicine (GUM) clinic attenders in Coventry, a UK metropolitan city. Participants were asked to complete a self administered questionnaire before and after counselling. Patients were counselled before testing and after receiving the result. A commercially available enzyme immunoassay (EIA) was used to identify HSV-1 and HSV-2 antibodies (Gull/Meridian EIA).
  
  
  RESULTS
  223 patients participated in the study (97% of eligible patients). Overall, prevalence of HSV-2 antibody was 43/216 (20%) (19/103, 18% for males and 24/113 (21%) for females, p=0.61) while prevalence of HSV-1 antibody was 129/215 (60%) (60% for both sexes, p=0.91). In the multivariate analysis HSV-2 seropositivity was higher among black people and those with a history of genital herpes. HSV-1 seropositivity was independently associated with less education, increased years of sexual activity (between 14-25 years), and history of cold sores. The majority of patients wanted this serotesting to be available in the clinic (204/222 (92%) before and 216/218 (99%) after counselling, p=0.0003) and 97% accepted the test when offered. Only three patients regretted having the test and four patients contacted the department within 6 months of receiving the results for more counselling.
  
  
  CONCLUSIONS
  The vast majority of the study population not only wanted to be tested, but accepted the test when offered. HSV-2 infection is common and largely unrecognised among our study population. The psychological impact of introducing type specific HSV serological testing in a clinical setting seems to be minimal. Counselling could improve patients' awareness of the infection and the acceptability of the test and its results.
authors.affiliation: Department of Genitourinary Medicine, Coventry and Warwickshire Hospital, Coventry, UK. noshinarouz@msn.com
authors.forename: N
authors.initials: N
authors.lastname: Narouz
authors.forename: P S
authors.initials: PS
authors.lastname: Allan
authors.forename: A H
authors.initials: AH
authors.lastname: Wade
authors.forename: S
authors.initials: S
authors.lastname: Wagstaffe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000914:Antibodies, Viral / Q000097:blood; D001364:Awareness; D004739:England / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000523:psychology; D018259:Herpesvirus 1, Human / Q000276:immunology; D018258:Herpesvirus 2, Human / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012698:Serologic Tests
chemical_list: D000914:Antibodies, Viral