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Seroprevalence of Herpes Simplex Virus Type 2 and Characteristics Associated With Undiagnosed Infection: New York City, 2004

Schillinger, Julia A. MD, MSc*†; McKinney, Christy M. PhD, MPH‡; Garg, Renu MPH*; Gwynn, R Charon PhD§; White, Kellee MPH∥; Lee, Francis MD, MSc¶; Blank, Susan MD*†; Thorpe, Lorna PhD*; Frieden, Thomas MD*

Sexually Transmitted Diseases: June 2008 - Volume 35 - Issue 6 - pp 599-606
doi: 10.1097/OLQ.0b013e3181666fb1

Background: Herpes simplex virus type 2 (HSV-2) infection is associated with substantial morbidity and increased risk for human immunodeficiency virus acquisition. We describe HSV-2 seroprevalence in adult New Yorkers, and examine the relationship between select characteristics, infection, and diagnosis.

Methods: HSV-2 seroprevalence and risk factors were measured using the 2004 New York City Health and Nutrition Examination Survey, a population-based cross-sectional survey of adults. HSV-2 seroprevalence and corresponding 95% confidence intervals were computed for select characteristics. Associations between proposed risk factors and HSV-2 infection and diagnosis were estimated using unadjusted and adjusted odds ratios.

Results: Nearly 28% of adults were infected with HSV-2; 88.4% of HSV-2 positive persons were undiagnosed. Black women had the highest seroprevalence (59.7%) of any sex or race/ethnicity group. Women, non-Hispanic blacks, and Hispanics (vs. non-Hispanic whites), and men who have sex with men were at greater odds of HSV-2 infection. Among HSV-2 infected individuals, non-Hispanic blacks (vs. non-Hispanic whites), uncircumcised men, and those with no routine place of care were less likely to be diagnosed.

Conclusions: HSV-2 is highly prevalent and largely undiagnosed in New York City; seroprevalence varies by subgroup. Targeted HSV-2 screening, counseling and treatment may help reduce transmission of HSV-2 and human immunodeficiency virus.

We found that among New York City adults herpes simplex virus type 2 is highly prevalent and largely undiagnosed in New York City and that seroprevalence varies considerably across subgroups.

From the *New York City Department of Health and Mental Hygiene, New York, New York; †Centers for Disease Control and Prevention, Atlanta, Georgia; ‡Dallas Regional Campus, University of Texas Houston School of Public Health, Dallas, Texas; §International Center for AIDS Care and Treatment Programs, Columbia University; ∥Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, New York; and ¶Pediatric Infectious Diseases Division, Emory University, Atlanta, Georgia

Support was received from the City of New York.

Correspondence: Julia A. Schillinger, MD, MSc, (CAPT USPHS), Director of Surveillance, Epidemiology and Research Bureau of STD Control, New York City Department of Health and Mental Hygiene, 125 Worth Street, Room 207, CN#73, New York, NY 10013. E-mail:

Received for publication November 14, 2007, and accepted December 20, 2007.

© Copyright 2008 American Sexually Transmitted Diseases Association