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有症状的新发性生殖器疱疹患者的就医行为和性行为

Healthcare seeking and sexual behavior among patients with symptomatic newly acquired genital herpes.

作者信息

Richards Julie, Krantz Elizabeth, Selke Stacy, Wald Anna

机构信息

Department of Medicine, University of Washington, Seattle, Washington 98122, USA.

出版信息

Sex Transm Dis. 2008 Dec;35(12):1015-21. doi: 10.1097/OLQ.0b013e318182a596.

Abstract

BACKGROUND

Symptoms among patients with first episode herpes simplex virus (HSV) likely influence health seeking and sexual behavior. An improved understanding of this relationship provides insight into the experience of having genital herpes and has implications for counseling.

OBJECTIVE

To describe the healthcare seeking and sexual behavior in patients with symptomatic laboratory confirmed first episode HSV infection.

METHODS

Two hundred thirty-six patients (94 men and 142 women) with newly acquired genital herpes were asked to complete a demographic and sexual history questionnaire. To confirm initial HSV diagnosis, swabs of lesions were collected for viral culture and HSV DNA polymerase chain reaction and blood was drawn for confirmation of HSV serostatus using the Western blot.

RESULTS

Women reported pain and men reported lesions as the most frequent and bothersome symptom or sign causing each to seek healthcare. Forty-three percent of all participants missed some work or school because of their symptoms; women missed more school or work, sought care sooner, and saw more providers than men. Before diagnosis, most respondents (67%) suspected genital herpes was the etiology of the symptoms. Twenty-seven percent reported having sex after noticing their symptoms, though those who missed more school or work were less likely to engage in sexual intercourse.

CONCLUSIONS

Men and women have different experiences with first episode HSV, but morbidity is substantial, especially among women. Both men and women may continue to engage in sexual activity after onset of genital herpes, emphasizing the need for providers to counsel their patients to avoid exposing partners to the infection.

摘要

背景

初发性单纯疱疹病毒(HSV)感染患者的症状可能会影响其就医行为和性行为。更好地理解这种关系有助于深入了解生殖器疱疹患者的经历,并对咨询工作具有指导意义。

目的

描述有症状且经实验室确诊的初发性HSV感染患者的就医行为和性行为。

方法

236例新感染生殖器疱疹的患者(94例男性和142例女性)被要求完成一份人口统计学和性病史调查问卷。为确诊最初的HSV感染,采集病变部位的拭子进行病毒培养和HSV DNA聚合酶链反应,并采集血液,采用免疫印迹法确认HSV血清状态。

结果

女性报告疼痛,男性报告皮损,是导致他们各自寻求医疗保健的最常见且令人困扰的症状或体征。所有参与者中有43%因症状而误工或误学;女性误工或误学更多,就医更早,看诊的医疗服务提供者也比男性更多。在确诊之前,大多数受访者(67%)怀疑生殖器疱疹是症状的病因。27%的人报告在注意到症状后有过性行为,不过误工或误学更多的人进行性交的可能性较小。

结论

男性和女性在初发性HSV感染方面有不同的经历,但发病率很高,尤其是在女性中。男性和女性在生殖器疱疹发病后可能仍会进行性活动,这强调了医疗服务提供者需要建议患者避免将感染传播给性伴侣。

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