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Herpes Simplex Virus-2 and HIV Among Noninjecting Drug Users in New York City

Des Jarlais, Don C. PhD*; Hagan, Holly PhD; Arasteh, Kamyar PhD*; McKnight, Courtney MPH*; Perlman, David MD; Friedman, Samuel R. PhD

doi: 10.1097/OLQ.0b013e3180ca9647
Article

Objective: To examine the relationship between herpes simplex virus 2 (HSV-2) seroprevalence and human immunodeficiency virus (HIV) seroprevalence among noninjecting heroin and cocaine users in New York City.

Methods: Four hundred sixty-two noninjecting cocaine and heroin users were recruited from a drug detoxification program in New York City. Smoking crack cocaine, intranasal use of heroin, and intranasal use of cocaine were the most common types of drug use. A structured interview was administered and a serum sample was collected for HIV and HSV testing.

Results: HIV prevalence was 19% (95% CI 15%–22%) and HSV-2 seroprevalence was 60% (95% CI 55%–64%). The adjusted risk ratio for the association between HSV-2 and HIV was 1.9 (95% CI 1.21%–2.98%). The relationship between HSV-2 and HIV was particularly strong among females, among whom 86% were HSV-2 seropositive, 23% were HIV seropositive, and all HIV seropositives were also HSV-2 seropositive.

Conclusions: HSV-2 appears to be an important factor in sexual transmission of HIV among noninjecting cocaine and heroin users in New York City, especially among females. The estimated population attributable risk for HIV infection attributable to HSV-2 infection in this sample was 38%. Programs to manage HSV-2 infection should be developed as part of comprehensive HIV prevention for noninjecting drug users.

We examined HIV and HSV-2 prevalence among 462 noninjecting drug users. HIV prevalence was 19%, HSV-2 60%. The estimated population attributable risk for HIV attributable to HSV-2 was 36%.

From the *Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, New York; †National Development and Research Institutes, New York, New York; and ‡Department of Medicine, Beth Israel Medical Center, New York, New York

This study was supported by NIH grants DA R01 03574 and P30 DA P30 1104.

Correspondence: Don C. Des Jarlais, PhD, Beth Israel Medical Center, 160 Water St., 24th Floor, New York, NY 10038. E-mail: dcdesjarla@aol.com.

Received for publication February 1, 2007, and accepted April 29, 2007.

© Copyright 2007 American Sexually Transmitted Diseases Association