These recommendations are based on expert opinion [New Zealand Herpes Foundation, 2007; Sen and Barton, 2007] and the British Association for Sexual Health and HIV (BASHH) 2007 national guideline for the management of genital herpes [BASHH, 2007].

• Counselling, follow up, and providing up-to-date information are essential for people with genital herpes, as the condition is chronic, causes considerable distress, and disrupts sexual relationships.
• The cumulative risk of transmission from an infected man to a seronegative woman is about 7% per year. The cumulative risk of transmission from an infected woman to a seronegative man is probably less, at around 3% per year [Mark et al, 2003].
• There is an increased risk of transmission immediately before, and immediately after, a symptomatic episode [Wald, 2004]. However, nearly everyone, both men and women, with HSV type-2 infection sheds viruses at some time without symptoms. Asymptomatic shedding is more frequent with HSV type-2 infection, in the first 12 months after acquiring the infection, and in those with more frequent symptomatic episodes.
• Condoms are probably effective in reducing transmission of HSV from men to women, although there is less evidence that they are effective at reducing transmission from women to men [Casper and Wald, 2002]. Effectiveness may be reduced by lack of acceptance, poor compliance, poor technique, and mechanical failure of the condom [Langenberg, 2004].