Educational interventions and the prevention of herpes simplex virus transmission.

Herpes simplex virus (HSV) is a common sexually transmitted infection (STI) worldwide, and the prevalence of this infection has increased significantly over the last two decades in many developed countries. The objective of educational interventions is to limit HSV transmission. There are few data on the effectiveness of such interventions but much of the published data, from the UK and the USA, suggest that they may be beneficial. In the USA, Project RESPECT demonstrated that counselling those at risk may reduce HSV acquisition, a conclusion supported by data from candidate HSV vaccine trials and educational initiatives for other STIs. Patients should be counselled on the natural history of genital HSV infection, variability in recurrence and strategies to limit transmission risk, using measures such as promoting condom use and limiting the number of sexual partners. Healthcare providers should give consistent, relevant information and know where patients can access further information. Serological testing may allow an opportunity to counsel patients about genital herpes. A significant barrier to effective implementation of educational interventions is the low level of accurate knowledge among the general public regarding genital herpes, especially about asymptomatic shedding, transmission, risk reduction strategies and therapeutic options. Often there is no link between knowledge and behaviour, with success potentially depending on the character of the patients. Due to the lack of knowledge, mass education campaigns may be required, although targeted campaigns may provide a more cost-effective solution. These campaigns should target young adults who have the highest rate of HSV acquisition. Education should also be available to pregnant women, who are likely to be highly motivated to avoid acquisition from infected partners due to the possibility of neonatal herpes.