Counseling Recommendations

The Centers for Disease Control and Prevention (CDC) advises counseling of infected persons and their sex partners, stating that counseling "is critical to the management of genital herpes."1

The goals of counseling include1:

– Helping patients cope with the infection

– Reducing the risk of sexual transmission

 

CDC Counseling Recommendations
2006 CDC STD Treatment Guidelines recommendations for counseling include*1:

  • Persons with genital herpes should be educated on the potential for recurrent episodes, asymptomatic viral shedding, and the risk of sexual transmission
  • Sexual transmission of HSV can occur during asymptomatic periods
  • The risk of HSV-2 sexual transmission can be decreased by the daily use of valacyclovir by the infected person†
  • Asymptomatic persons diagnosed with HSV-2 infection should receive the same counseling messages as persons with symptomatic infection
  • Discordant couples should be encouraged to consider suppressive antiviral therapy as part of a strategy to reduce risk of transmission, in addition to consistent condom use and avoidance of sexual activity during recurrences

ACOG Counseling Recommendations
Counseling recommendations outlined in the November 2004 Practice Bulletin from the American College of Obstetricians and Gynecologists on gynecological care for HSV infections include:*2

  • Women should be told that they are likely to have recurrences
  • Women should be told they may have viral shedding with or without symptoms and that they are infectious at that time
  • Telling a partner about the infection should be encouraged
  • Discordant couples should be counseled that consistent use of condoms decreases but does not eliminate the risk of transmission
  • Many women may require a separate visit for counseling
*These are not complete summaries of the CDC Treatment Guidelines and the 2004 ACOG Practice Bulletin.  Please see the current CDC Guidelines and the complete ACOG Bulletin for more detailed information.

†In immunocompetent heterosexual adults. Safer sex practices should be used with daily therapy with VALTREX.

  1. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2006. MMWR. 2006;55 (RR-11):1-92.
  2. American College of Obstetricians and Gynecologists. Gynecological Herpes Simplex Virus Infections. ACOG Practice Bulletin No. 57.
    November 2004;104:1111-1117.
    3.