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Prevalence and Risk Factors for Infection With Herpes Simplex Virus Type-1 and -2 Among Lesbians

Marrazzo, Jeanne M. MD, MPH*; Stine, Kathleen NP*; Wald, Anna MD, MPH*†‡

doi: 10.1097/01.OLQ.0000091151.52656.E5

Background and Objectives Sexual transmission of bacterial and viral sexually transmitted disease has been reported between women. No data are available on seroprevalence of herpes simplex virus type-1 (HSV-1) and type-2 (HSV-2) among lesbians.

Goal The goal was to define prevalence of infection with HSV-1 and HSV-2 among lesbians, and associated risk factors.

Study Design Women who reported sex with another woman in the preceding year were eligible. Medical and sexual histories were obtained. Serum was tested for HSV-1 and HSV-2 antibodies using Western Blot assay.

Results Among 392 subjects, antibodies to HSV-1 were detected in 46% and to HSV-2 in 8%. Increasing age predicted higher seroprevalence to both HSV types, and HSV-2 seropositivity was associated with a history of male partner with genital herpes. Of 78 women reporting no prior sex with men, 3% were HSV-2-seropositive. Most HSV-2-seropositive subjects (71%) reported no history of genital herpes. HSV-1 seroprevalence increased significantly with an increasing number of female sex partners.

Conclusions HSV-2 infection occurs in nearly 1 in 10 lesbians and is not predicted by report of sex with men or sexual identity. Most lesbians infected with HSV-2 are not aware of their infection. Sexual transmission of HSV-1 may occur more frequently among lesbians than among heterosexual women.

A study of lesbians found that herpes simplex virus-2 seroprevalence was 8.2%, with most infected subjects unaware of it. Seroprevalence of herpes simplex virus-1 (46%) increased with increasing number of female partners, suggesting a role for sexual acquisition.

Departments of *Medicine, Epidemiology, and Laboratory Medicine, University of Washington, Seattle, Washington

Supported by NIH grants R29-AI41153-04 (JM) and AI-30731 (AW).

Correspondence: Jeanne M. Marrazzo, MD, MPH, Harborview Medical Center, Division of Infectious Diseases, 325 9th Avenue, Mailbox #359931, Seattle, WA 98104. E-mail:

Received for publication March 24, 2003,

revised July 15, 2003, and accepted July 21, 2003.

© Copyright 2003 American Sexually Transmitted Diseases Association