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Do Protective Behaviors Follow the Experience of Testing Positive for Herpes Simplex Type 2?

Crosby, Richard A. PhD*; Head, Sara MPH; DiClemente, Ralph J. PhD; Meyerson, Beth PhD; Troutman, Adewale MD§

doi: 10.1097/OLQ.0b013e318177a068

Objective: To test the hypothesis that individuals attending a sexually transmitted disease (STD) clinic would adopt sexual protective behaviors after receiving a positive test for herpes simplex virus 2 (HSV-2).

Methods: Recruitment (N = 360) occurred in a publicly funded STD clinic located in a metropolitan area of the southern United States. Participants were tested for HSV-2 using a rapid test manufactured by Biokit (Lexington, MA) and they completed a self-administered questionnaire before and 3 months after being tested for HSV-2. Follow-up questionnaires were completed by 256 participants (71.1%).

Results: Of those completing follow-up, 43.4% (n = 111) tested positive for HSV-2 at enrollment. Significant differences between participants testing positive and those testing negative (at baseline) for HSV-2 over the follow-up period were not observed for frequency of sex, frequency of condom use, avoiding sex, and number of sex partners. Controlling for statistically identified covariates did not alter the null findings for these between group analyses. When analyzing change (baseline to follow-up) among only those testing positive, significant differences were not found with the exception of reporting greater frequency of condom use with steady (P = 0.037) and nonsteady partners at follow-up (P = 0.017). However, repeated measures analyses yielded only 1 significant group × time interaction; this indicated a greater increase in condom use frequency with steady partners among persons testing negative compared with those testing positive.

Conclusions: Among STD clinic attendees, diagnosis of HSV-2 was unrelated to the adoption of sexual behaviors protective against further acquisition and transmission of STDs. In the absence of education beyond posttest counseling, becoming aware of HSV-2 positive serostatus may not be sufficient to motivate the adoption of safer sex behaviors among this population.

A study of STD clinic attendees found that point-of-care diagnosis of HSV-2 was unrelated to the adoption of sexual behaviors protective against further acquisition and transmission of STDs.

From the *Department of Health Behavior, University of Kentucky College of Public Health, Lexington, Kentucky; †Department of Behavioral Science and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia; ‡Policy Resource Group, LLC Indianapolis, Indiana; and §Louisville Metropolitan Health Department, Louisville, Kentucky

The authors gratefully acknowledge the assistance of the Clinic Director (Deborah Snow) and the clinic staff members.

Supported by Glaxo Smith-Kline (to R.A.C).

Correspondence: Richard Crosby, PhD, College of Public Health, 121 Washington Avenue, Lexington, KY 40506-0003. E-mail:

Received for publication October 10, 2007, and accepted March 16, 2008.

© Copyright 2008 American Sexually Transmitted Diseases Association