In search of optimal genital herpes management and standard of care (INSIGHTS): doctors' and patients' perceptions of genital herpes.

OBJECTIVE To compare and contrast attitudes and behaviours of family doctors and patients with regard to genital herpes and its management. METHODS Family doctors and infected patients were surveyed online to explore disease importance/seriousness, emotional impact, transmission and treatment. The study received ethics approval. RESULTS 400 patients and 200 doctors participated. Doctors estimated the emotional impact of genital herpes to be higher than did patients. Patient distress increased with recurrences and more recent diagnosis. Doctors and patients underestimated the risk of transmission during periods of asymptomatic viral shedding, 45% and 51%, respectively. Doctors reported that 74% of their patients were taking medication, whereas only 29% of patients reported use of antivirals. Doctors reported discussing suppressive therapy with 59% of patients, whereas only 25% of patients recalled such a discussion. Only 40% of patients were aware that daily anti-viral therapy was available to reduce the risk of transmission. The most compelling reason for high interest in suppressive therapy was to reduce the frequency or severity of outbreaks (62%). CONCLUSIONS Although doctor and patient attitudes and behaviours coincide in a number of areas, there are many areas of misalignment. This presents opportunities for education and improvement in the management of genital herpes.