Figure. Screening for Genital Herpes: Analytic Framework and Key Questions (Text Description)

This figure describes the analytic framework and key questions guiding the literature searches. The figure starts at the top of the page with the two-part key question (KQ) 1. KQ 1-a is, "Does screening for herpes simplex virus (HSV) in asymptomatic adolescents and adults reduce symptomatic recurrences and transmission of disease?" KQ 1-b is, "Does screening for HSV in pregnant women reduce neonatal HSV and complications?"

From KQ 1, a line goes to the left to "Screening" and a line/arrow proceeds to the right to the end outcomes: "Adults/adolescents: reduced recurrences, reduced transmission" and "Pregnant women: reduced neonatal HSV." An asterisk following HSV refers to the comment, "Includes disseminated disease, encephalitis, neurological impairment, and death."

On the left, under screening, is "Risk Factor Assessment." Risk factor assessment encompasses 2 categories: "asymptomatic adolescents and adults" and "pregnant women." An arrow proceeds to the right from these 2 groups to KQ 2, "Can risk factors identify groups at higher risk for HSV infection?" The arrow continues right and splits into "low risk" and "high risk."

The arrow continues from there, becoming one line again, and proceeds to the three-part KQ 3 which falls under "HSV testing." KQ 3-a is, "What are the HSV screening tests and their performance characteristics?" KQ 3-b is, "What is the optimal time to screen during pregnancy?" and KQ 3-c is, "What is the role of screening partners?"

KQ 4 branches below KQ 3 to "Harms," where it stops. KQ 4 is "What are the harms of screening?"

Proceeding right from KQ 3, the arrows split again, pointing to "HSV positive" and "HSV negative." "HSV negative" is an end point.

The arrow continues right from "HSV positive" to the two-part KQ-5, which falls under "Interventions." KQ 5-a is, "How effective are interventions in reducing symptomatic recurrences and transmission in adolescents and adults?" KQ 5-b is, "How effective are interventions in reducing neonatal infection and complications?"

The arrow proceeds from KQ 5 to the end outcomes at which KQ 1 stops.

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