Background:
In the U.S., genital herpes (GH) prevalence is 10.6% among 20-29 year olds. About 90% of seropositive persons do not know they are infected.

Objective:
Investigate the individual and institutional characteristics associated with GH screening and diagnosis in sexually active young adults aged 18-24.

Method:
Three data sets were analyzed: the National Longitudinal Study of Adolescent Health (Add Health) Wave III from 2001-2002 (n=11,570), the American College Health Association (ACHA)'s national survey of college students from 2000-2006 (n=222,470), and ACHA's 2006 national survey of college health centers (n=128).

Result:
Among the AddHealth sample of sexually active young adults, aged 18-24, 18.4% of females and 7.1% of males self-reported GH testing in the previous 12 months. Testing was higher for both males and females reporting a history of HIV testing or STI symptoms in the previous 12 months and those with higher numbers of sexual partners. Overall self-reported GH diagnosis in the ACHA student survey was 0.7%; prevalence was higher in women and in African Americans, and increased with age. Among college health centers, 52.3% offered GH screening to asymptomatic students and type-specific serology was available at 67.2% of schools.

Conclusion:
Factors associated with GH testing and diagnosis are similar to those associated with seroprevalence. As evidenced by the difference between self-reported GH diagnosis and seroprevalence data, large numbers of young adults have GH and do not know it. Only a minority of young adults are routinely tested for GH and screening is not universally available. Health messages to increase testing rates could be linked to testing for other STIs, including HIV.

Implications:
Detecting and appropriately educating, counseling, and treating GH infection may prevent further transmission among young adults. Disseminating information and messages to young adults and their providers about testing, even during asymptomatic periods, is essential.