Doctors need educating about how to treat genital herpes. Nina Hall reports
Curtis Phinney is a successful 40-year-old American - dapper, with a ready, open smile and the confidence that goes with a job in Washington as a government scientist. But four years ago he was knocked sideways, literally, when he visited his doctor with what he thought was a minor skin complaint on his genitals. The doctor diagnosed genital herpes - an incurable, sexually transmitted disease, usually caused by the HSV- 2 virus. "I had my pants around my ankles when the doctor told me," he recalls. "I had no idea. The blood rushed from my face and I had trouble keeping balance, but I couldn't move my feet because my pants were round my ankles. Luckily, there was a chair close by."

Curtis' reaction was due to fear of the stigma associated with the affliction and the effect it would have on his social and sex life. He had been unsuccessfully looking for a "committed, monogamous relationship" following a divorce. That now seemed impossible. "What went through my head at that moment was that no-one was going to want me, I was never going to be hugged again. I was going to spend the rest of my life lonely and miserable."

But Curtis was lucky in one respect. He had a sympathetic and enlightened doctor who recognised the infection immediately and prescribed anti-viral treatment. And he found a local support group who offered help.

Most sufferers are not so fortunate. A study in Europe last year revealed that many doctors are ignorant about genital herpes. Half of GPs thought that it was a self-limiting disease not requiring treatment, while a further fifth did not realise it was sexually transmitted. Few doctors referred patients to specialist clinics, let alone offered counselling. As a result, the International Herpes Management Forum, a group of doctors and patients who want to improve awareness of herpes viruses, recently met in London to develop guidelines for doctors on diagnosing and managing genital herpes.

In the past 10 years, genital herpes, like HIV, has become a pandemic. More than a 100 million people worldwide are now infected with herpes simplex virus type 2 (HSV-2). In the UK, a staggering one in eight women are infected and one in 30 men (the number has grown by nearly a quarter in the 10 years). Although sufferers may have several outbreaks a year, the fact that the disease isn't fatal means it does not attract the same attention as HIV.

According to Dr Simon Barton, clinical director in HIV/genitourinary medicine at the Chelsea and Westminster Hospital in London and a member of the workshop, more than 60 per cent of infected people don't even know that they have the condition, possibly because they don't have symptoms, but often because the lesions are internal (inside the urinary tract or vagina) or on the buttocks and thighs rather than on the genitals. Doctors, too, are unaware of possible symptoms - vaginal discharge or pain when urinating - so may not know what to look for.

Sufferers are often very angry or depressed. Curtis says he came close to killing himself after he was diagnosed. But he has now come to terms with the virus, and believes it has had some positive effects on his sexual self-image. "It changed my sexual behaviour," he says. "I started to shoot only for people with whom it was worth sustaining a successful relationship." He now has a partner whom he confided in long before they had sex. "She made a choice and we are getting married next April."

For more information, contact the International Herpes Management Forum on 01903 288188.