ABSTRACT
BACKGROUND There are two separate story lines that describe genital herpes (HSV-1 and HSV-2) infections in women. The first is the focus upon the symptomatic patient that was the vogue of medical attention in the 1970s and early 1980s. This was the pre-heterosexual human immunodeficiency virus (HIV)-era, where oral contraceptives prevented an unwanted pregnancy and pre-marital sexual activity with more than one partner was the rule, not the exception. The great fear was the acquisition of genital herpes, and physicians’ knowledge of this infection was too sharply focused. Over time, it has been discovered that this narrow emphasis overlooked the largest portion of women with genital herpes. The medical dogma of the early 1980s was that women with this condition became very ill with their first outbreak, with perineal pain, fever, and voiding difficulties so severe in some instances that they had to be catheterized. The first infection was a sentinel event, easily recognized by the patient and the physician. Afterwards, these patients were instructed to be alert to the perineal tingling that occurred prior to the visible outbreak of perineal vesicles. These women were instructed that this was a time frame in which they could transmit the virus to a sexual partner and they should avoid intimate contact. At the onset of labor, these patients could inform their doctor of the possibility of a herpes eruption.
