Ordering Herpes simplex virus serology in asymptomatic, non-pregnant patients: a national survey of Australian General Practitioners’ knowledge, attitudes and practices

Abstract

Introduction Diagnostic serology for Herpes simplex virus is not recommended among asymptomatic, non-pregnant patients. Aim This study aimed to survey knowledge, attitudes and practices regarding herpes serology and management among general practitioners across Australia. Methods Anonymous online surveys were conducted from 1 January 2023 to 31 December 2025. Chi-square tests explored associations with ordering serological tests for Herpes simplex (significance threshold: P = 0.05). Results Of 106 surveys completed, 71% of respondents were female, 63% were aged <50 years, 71% had work-experience <20 years, and 54% were metropolitan Sydney or Melbourne-based. Overall, 57% reported never having ordered serology (most common main reasons: lack of clinically useful information (68%), guideline recommendations (12%) and patient anxiety/distress (10%)). Of the 43% reporting ever ordering serology, 47% had ordered within the past year, and 78% generally ordered serology ‘rarely–less than yearly’. The most common main ordering reasons were patient request (44%), assessing risk to sexual partner (38%) and determining the cause of previous symptoms (7%). Overall, 23% reported colleague(s) ordering serology. With regard to diagnosing and managing genital herpes, 80% felt ‘very confident or confident’; 17%, 3%, and 0% felt ‘somewhat’, ‘slightly’ or ‘not-at-all confident’, respectively. Interpreting serology, 50% felt ‘very confident or confident’; 38%, 4%, and 8% felt ‘somewhat’, ‘slightly’ or ‘not-at-all’ confident, respectively. Additionally, 58% strongly or somewhat disagreed that ‘serology should only be ordered by/in consultation with specialists’; 47% were ‘strongly interested’ or ‘interested’ in herpes education/training. A metropolitan Sydney or Melbourne postcode was associated with ever having ordered serology (72% versus 28%; P = 0.003). Discussion General practitioner self-reported ordering of serology was relatively uncommon. Confidence interpreting serology was modest, despite confidence with genital herpes diagnosis and management. Despite guideline adherence, patient request may be driving ordering, highlighting roles for general practitioner education and training and patient resources in improving care. Future studies using mixed-methods or pathology data would enrich these findings.