Herpes simplex virus type 2 (HSV-2) is the most common cause of genital ulcer disease and, along with substance abuse, an important HIV risk factor. Therefore, the purpose of this study was to examine HSV-2 seroprevalence in a sample of drug users in rural Appalachia.
Rural Appalachian individuals age 18 or older reporting non-medical use of prescription opioids, heroin, crack/cocaine, or methamphetamine in the past 6 months (n = 499) were included. Behavioral, demographic, and sexual network data were collected using interviewer-administered questionnaires.
Participants' serum was tested for HSV-2 antibodies using the Biokit rapid test (Lexington, MA). The estimated population seroprevalence of HSV-2 was 14.4% (95%CI: 9.6-19.4%). Only 8.8% were aware of being HSV-2+, and unprotected sex was reported in 80% of serodiscordant sexual relationships.
In a multivariate model, female gender, age, older age at first oral sex, and frequency of unprotected sex in the sexual network were independently associated with HSV-2 seropositivity. Despite lower seroprevalence than that reported in similar studies of substance abusers, targeted interventions to reduce sexual risk behavior are warranted in this underserved population.
Network-informed approaches with particular focus on women, older individuals, and those engaging in frequent unprotected sex are recommended.
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- 1Department of Behavioral Science (https://behavioralscience.med.uky.edu/), University of Kentucky College of Medicine, Lexington, Kentucky.
- 2Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, Kentucky.
- 3Department of Epidemiology, University of Kentucky College of Public Health, Lexington, Kentucky.
- J Med Virol. 2016 Mar;88(3):512-20. doi: 10.1002/jmv.24358. Epub 2015 Aug 27.
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