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Implementation of Routine Access to Herpes Simplex Virus Type 2 Antibody Testing in a Public Health Sexually Transmitted Disease Clinic

Fife, Kenneth H. MD, PHD*†‡; Van Der Pol, Barbara PHD*‡; Roth, Alexis M. MPH*; Brand, Juanita RNC; Arno, Janet N. MD*‡; Madlem, Jyl MS; Juliar, Beth E. MA, MS*; Katz, Barry P. PHD*; Williams, James A. BS*; Zimet, Gregory D. PHD§; Fortenberry, J Dennis MD, MS§

doi: 10.1097/OLQ.0b013e3181bc9a2f
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Background: Testing for herpes simplex virus type 2 (HSV-2) antibody is not common in clinical practice. Client characteristics associated with HSV-2 rapid antibody test uptake and test positivity were analyzed in clients attending an urban sexually transmitted disease clinic.

Methods: This optional test was available for $30. The HerpeSelect Express assay was performed on serum. Demographic and behavioral characteristics were compared between clients who requested testing and those who did not and between those who were HSV-2 antibody positive and negative.

Results: In 4 months, 3498 individuals attended the clinic and 443 (12.7%) opted for HSV-2 testing. Clients who were black, younger, or female were less likely to request testing. Recent sexual behavior and self-reported sexual orientation were not associated with uptake of testing. Of the 442 clients with results available, 109 were positive for HSV-2 antibody (24.7%). Women were significantly (P <0.001) more likely to test positive; 42 of 111 (38.4%) versus only 67 of 331 (20.2%) men. A positive HSV-2 antibody test was also associated with increasing age and black race. There was an association with the number of partners in the last 30 days, but no association with the number of partners in the last year. Of the 109 clients who had a positive HSV-2 antibody test, 71 (64.5%) accepted a prescription for suppressive acyclovir therapy.

Conclusions: Uptake of testing was modest in this population, especially among the highest risk individuals, possibly due to the cost of the test. Improved education regarding HSV-2 and subsidized testing may be needed in the populations that have the highest prevalence in order to encourage testing.

Rapid herpes simplex virus type 2 antibody testing was introduced at an urban sexually transmitted disease clinic for a fee of $30 and clients requesting testing were characterized and compared with other clients.

From the Departments of *Medicine and †Microbiology & Immunology, Indiana University School of Medicine, Indianapolis, IN; ‡Marion County Health Department, Indianapolis, IN; and §Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN

The authors thank the staff of the Bell Flower Clinic for their participation in the implementation process and for their ongoing input into the operation of the program. The authors also thank Virginia Caine for her support in implementing this program.

Correspondence: Kenneth H. Fife, MD, PhD, 545 Barnhill Dr, Room 435, Indianapolis, IN 46202. E-mail: kfife@iupui.edu.

Received for publication February 27, 2009, and accepted May 15, 2009.

© Copyright 2009 American Sexually Transmitted Diseases Association