Background: Herpes simplex virus 2 (HSV-2) infection biologically facilitates acquisition and transmission of HIV.
Objectives: To examine prevalence of and associations between herpes simplex virus type 2 (HSV-2) and HIV among never-injecting heroin and cocaine users in New York
Methods: Subjects were recruited from patients entering the Beth Israel drug detoxification program. Informed consent was obtained, a structured questionnaire including demographics, drug use history and sexual risk behavior, was administered and a blood sample was collected for HIV and HSV-2 antibody testing. Only persons who reported that they had never injected illicit drugs were included in the analyses.
Results: 1418 subjects who had never (lifetime) injected drugs (NIDUs) were recruited from 2005 through 2009. Subjects were primarily male (76%) and African-American (67%) or Hispanic (25%), reported recent crack cocaine use (74%), and had a mean age of 42 years. The prevalence of both viruses was high: for HSV-2, 61% among the total sample, 53% among non-MSM male NIDUs, 85% among female NIDUs, and 72% among MSM NIDUs; for HIV, 16% among the total sample, 15% among non-MSM males, 20% among females and 46% among MSM. HSV-2 was associated with HIV, (OR = 3.2, 95% CI 2.3 to 4.5), and the strength of the association increased with increasing age of the subjects. The association was particularly strong among females (OR = 7.1, 95% CI 1.7 to 30.0).
Conclusions: Rates of HIV and HSV-2 infection and the association between the two viruses among non-injecting drug users in New York City are comparable to rates in sub-Saharan Africa.
Implications for Programs, Policy, and/or Research: Additional interventions to reduce HIV transmission among NIDUs are urgently needed, as well as platforms for providing services to NIDUs and better methods for tracking HIV infection among NIDUs.