How did I get herpes? Is there a cure? What causes an outbreak-- and what can I do to prevent another one? My friend got herpes and had to stay in the hospital; will that happen to me? Can I still have children?
Teenagers with newly diagnosed sexually transmitted infection have many questions for their physician. In the case of herpes simplex virus (HSV) infection--the focus of this month's clinical update on 
sexually transmitted diseases--approximately 50 million Americans are infected with type 2 virus, and 6% of all 12- to 19-year-olds carry the HSV-2 antibodies that indicate either active or latent infection.1 HSV-2 infection crosses all socioeconomic and racial classes. Its prevalence is growing fastest among Caucasian adolescent boys.
The adolescent who contracts a genital HSV infection is at risk for "outbreaks" or "reactivations" throughout his or her teenage and adult life. Thus, the infection can have substantial effects on the adolescent's self- esteem and sense of security about sexual health.
Teenagers with newly diagnosed HSV infection need accurate, timely answers to their questions. The questions in this month's feature (page 238) reflect those that my patients have asked me when I told them they had a herpes infection. The list of questions--and answers--is not exhaustive, but it does cover most topics that adolescents ask. A handout on HSV infection that you can give to your patients follows (page 244).
A wealth of data suggest that teenagers of all races, locales, and socioeconomic backgrounds have experience with various types of sexual contact. It is therefore not surprising that sexually transmitted infections tend to travel in groups. If your patient has newly diagnosed HSV-2 infection, it is prudent to screen for chlamydial and HIV infection, as well as for gonorrhea and syphilis. If pain or swelling precludes a pelvic examination, these screens can be performed at a follow-up visit.
In the next issue of Consultant for Pediatricians, I will review human papilloma virus--a leading cause of genital warts and of cervical cancer in young women. The following (and final) installment in this series will review some of the more atypical sexually transmitted diseases that you may see when treating teenagers.