Objective: To compare and contrast physician and patient attitudes and behaviours regarding genital herpes (GH) and its’ management.

Methods: A 15 minute on-line questionnaire exploring GH knowledge, attitudes and perceptions was developed. The study was approved by the Research Ethics Board, University of Alberta.

Results: Two hundred family physicians and 400 individuals with GH completed the questionnaire. Physicians and patients underestimate the incidence of GH and the proportion of transmission attributable to asymptomatic shedding. Physicians tend to overestimate the emotional impact of GH relative to subjects.

While physicians estimate that 75% of their patients are using pharmacotherapy for GH, only 28% of patients report taking medication. Number of recurrences is the key factor related to the use of medication. While physicians cite cost as the main reason for not offering therapy, patients cite lack of severity and/or few recurrences. Only 40% of patients were aware that suppressive anti-viral therapy can reduce the risk of disease transmission. The main determinant for physicians to prescribe suppressive therapy is number of recurrences rather than risk of transmission. Patients who had discussed suppressive therapy with their physician, but were not taking it, cited infrequent outbreaks, cost, “physician didn’t think it was warranted” and potential side effects as reasons for not taking anti-viral medications.

Conclusions: While physician and patient attitudes and behaviours regarding GH 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.