Anonymous STD Contact Notification

A new website in LA will allow people to anonymously notify partners that they may have been exposed to an STD. The internet has given us many new opportunities, but this may be one of the most interesting, and controversial. Traditional methods of STD tracking and notification are in place everywhere in the US, but many people infected with an STD are unwilling to comply with these laws, or in the case of herpes, may not be reportable by law.

Perhaps this method is better than none at all. My concern is that this method could be used as a joke or worse, a mean way, of getting back at a previous partner. Already, in our clinic, we have people calling who have been told they were exposed to an STD. Some even get fake letters! That's the downside. The upside is that more people will get tested for STDs, even if the notification is fake.

I suppose on balance, there are more upsides than down, but it can still be pretty frightening or alarming. What do you think?

- Terri


Related Topics: Sex Ed for Guys, Confidential Sexual Healthcare for Teens

Tags: STD,inSPOTLA

Herpes Transmission Facts

Lots of people ask me how likely it is that they will either contract or transmit a genital herpes (HSV 2) infection to a sexual partner, so I thought I would address that in today's blog.

The first tool in reducing transmission rates is knowing whether herpes is even in a relationship! If two people have no idea that one of them is infected, they can't begin to reduce the risk of transmitting the infection because they don't know there is anything to be concerned about! So testing for genital herpes is the first step - finding out who is infected and who is not.

Let's say you have an infected male and an uninfected female. If they avoid sex during outbreaks, don't use condoms regularly, and don't take antiviral therapy every day, the risk of tranmission is about 10% per year. But if you add condoms, it reduces transmission about about 50%, if he takes Valtrex 500 mg once a day, he can reduce transmission also by about 50%. So you can see that the numbers get very low!

If it is a woman infected with HSV 2 having sex with an uninfected male, given the circumstances listed above again, then the transmission rate is about 4% prior to the interventions of condoms and Valtrex.

Which interventions are appropriate and desirable are decisions that individual couples makes, based on concerns about infection.

I hope this is helpful for those of you wondering about how likely it is that you might infect someone else or get infected yourself.

Terri

Related Topics: Dating and Herpes, Understanding STDs

Seattle Planned Parenthood Genital Herpes Lecture

This week I was in Seattle, lecturing to the Planned Parenthood providers. There were probably 50 clinicians attending, and it was so great to see how much they already knew, and also, how excited they were to learn all the latest details about genital herpes tests, treatment and counseling.

One of the most frequent questions to come up is "What do we do about people who test positive by blood test, but have no symptoms?" As I have said many times, people who have positive blood tests but no symptoms are both infectious and infected. Anna Wald and I have a study in the New England Journal of Medicine in 2000 describing this research. If someone has a positive blood test, they can also become more aware of subtle symptoms that they previous did not notice or thought were due to something else.

They were also so happy to have access to the patient counseling video as talking about the "softer" issues of self esteem, sexuality and how to tell partners can be both difficult and time consuming.

Stay warm out, our winds in Portland today are taking the perceived temps down to 14 degrees!

Related Topics: Could I Have Caught Herpes From Him?, Shattering the Genital Herpes Myth

Progress on Herpes Testing during Pregnancy

Hello from snowy Michigan. As many of you know, I travel around the country, lecturing on genital herpes infection for about 10 days a month. This week I am in Michigan for the entire week, driving across the state from Kalamazoo to Jackson to Monroe to Detroit to Saginaw. I've had several lunches, breakfasts and dinners with physicians and nurse practitioners and nurse midwives and physician assistants, and here, have focused mostly on OB/GYN providers.

It has been gratifying to find many of these clinicians open to testing for herpes during pregnancy. You see, herpes testing is not a part of routine OB care in many parts of the country. The usual practice is to ASK patients, as they begin their OB care, "do you have herpes or does your partner have herpes?" But as those of you who read my posts know, 25% of the US population is infected with HSV 2 and 90% of those infected don't know. So ASKING misses 90% of those infected!

If we don't know who is infected with HSV 2, we cannot put them on suppressive therapy at 36 weeks, we cannot avoid the use of fetal scalp electrodes for monitoring fetal health (which disturbs intake skin and may allow virus to enter the baby's body), we might prematurely rupture membranes to speed labor (which also puts babies more at risk of HSV acquisition). All of these things could be avoided if we only knew the woman was infected!

In addition, if we did herpes testing on all pregnant women, we would know who was NOT infected and still vulnerable to infection. If we knew that, then we could advise an HSV negative woman to proceed in one of two ways: 1) she could have her sexual partner tested. If they are also negative for HSV, then sex could proceed normally. If her partner was positive for HSV 2 or had HSV 1 orally, then we could advise the couple, prior to the third trimester, about sexual behavior that is safe or not safe. or 2) she could simply avoid sexual contact during the third trimester, thus protecting her baby in that way. The WAY COOL thing is that I identified one OB doc who already tests all of his patients, another who is offering testing to all patients (I personally think it should not be optional but mandatory, as is gonorrhea and chlamydia testing), and another group of OB providers who was eager to hear about the testing protocol and was eager to implement it. Very exciting week in terms of openness to pregnancy testing!

Perhaps I will write you blogs from the backroads of America, taking the "herpes temperature" of US providers.

Stay warm, everybody, it's cold out there!
Terri

Related Topics: Herpes and Pregnancy, STD's and Pregnancy