The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Wednesday, May 10, 2006
319

Characteristics of persons with undiagnosed herpes simplex virus type 2 infection; findings from the New York City Health and Nutrition Examination Survey

Julia A. Schillinger1, Renu Garg2, Charon Gwynn2, Kellee White2, Francis Lee3, Susan Blank1, Lorna Thorpe2, and Thomas Frieden2. (1) Bureau of Sexually Transmitted Disease Control, NYC DOHMH / Division of STD Prevention, CDC, 125 Worth St., Room 207, CN-73, New York, NY, USA, (2) New York City Department of Health and Mental Hygiene, New York, NY, USA, (3) Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA


Background:
Unrecognized herpes simplex virus type 2 (HSV-2) infection contributes to the ongoing transmission of genital herpes and HIV.

Objective:
To estimate the proportion of HSV-2 infected persons with undiagnosed HSV-2 infection, and predictors for undiagnosed infection.

Method:
The NYC Health and Nutrition Examination Survey (HANES) was a complex sampling survey modeled closely on the National HANES. An immunodot assay was used to test sera for antibodies to gG-2 (HSV-2) and gG-1 of herpes simplex virus type 1 (HSV-1). Eligible, consenting NYC residents aged >= 20 were interviewed face-to-face, and by audio-computer assisted self-interview (ACASI). Sexually active participants were asked: ‘has a health care provider ever told you that you had genital herpes?' HSV-2 seropositive participants answering ‘no' were considered ‘undiagnosed.' Analyses took into account the complex sampling design and were limited to persons with HSV results and ACASI data (n=1622). Prevalence estimates age standardized to 2000 US Census. Logistic regression used to assess independent risk factors for undiagnosed HSV-2 infection.

Result:
HSV-2 seroprevalence was 28.3%; HSV-1, 71.1%. Among HSV-2 seropositive persons, only 10.6% reported they had been told they had genital herpes. In bivariate analyses older persons, persons with fewer lifetime sex partners, or with HSV-1 antibody, were more likely to be undiagnosed (p<0.05); race/ethnicity was marginally significant (p=0.08). Prevalence of undiagnosed infection did not differ by sex, education, health insurance status, or having a routine place of medical care. In a multivariate model, persons of older age and lacking a routine place of medical care had increased odds of being undiagnosed.

Conclusion:
One in four New Yorkers is HSV-2 infected; the great majority are unaware of their infection. Having a routine place of care may improve the likelihood of being diagnosed.

Implications:
All persons seeking STD testing should be offered, or advised to obtain, type-specific herpes serologic testing.

See more of Viral STDs: Herpes
See more of Oral and Poster

See more of The 2006 National STD Prevention Conference