Psychosocial issues in genital herpes management.

Genital herpes leads to considerable distress in many patients at the time of diagnosis. Most people with recurrences adapt psychologically over time, but some fail to do so, and show continuing psychological morbidity. It is not clear why some people adjust and others do not. Antiviral medication may help to promote adjustment but the evidence is inconclusive. Little is known about the behavioural adjustments that people make, or how they deal with their sexual relationships. Many people fail to disclose to some or all of their sexual partners, particularly casual partners. There are little hard data on the most effective ways to help people adjust to the diagnosis and to help them to reduce the risk of transmission, although what people are told (and the practical advice they are offered) may be important. This article, the first of two papers in this issue to consider the impact of genital herpes, outlines the problems facing people with genital herpes; the second article gives practical guidance for clinicians supporting people with herpes.