Demographic rather than behavioral risk factors predict herpes simplex virus type 2 infection in sexually active adolescents.
BACKGROUND
Despite the high prevalence of herpes simplex virus type 2 (HSV-2) infection in adults and data indicating that many HSV-2 infections are acquired in late adolescence, the demographic and sexual behavior correlates of HSV-2 infection in high risk adolescents have not been extensively studied.


METHODS
Using a cross-sectional design we evaluated serologic evidence of HSV-2 infection in 381 adolescents age 14 to 19 years at an urban sexually transmitted disease clinic and a community clinic. Study enrollment was offered to all patients participating in a project offering free hepatitis B vaccine. Participants were interviewed and blood was drawn for HSV Western blot.


RESULTS
Twelve percent [95% confidence interval (CI), 8.6 to 15.1] of 379 adolescents in this study had antibodies to HSV-2. Only 22% of HSV-2-seropositive youth reported a history of herpes. Seropositivity for HSV-2 was significantly associated with African-American race (odds ratio, 2.3; 95% CI 1.1 to 4.8) and female gender (odds ratio, 6.0; 95% CI 2.3 to 15.9); 25% of the African-American girls were HSV-2-seropositive. Self-reported condom use, number of sexual partners in the prior 2 months and history of a sexually transmitted disease did not predict HSV-2 antibody status.


CONCLUSIONS
HSV-2 infection among adolescents was prevalent, particularly among African-American girls, and correlated with demographic rather than behavioral variables. As in adults most HSV-2 infections were unrecognized. These data suggest that type-specific serologic testing for HSV-2 infection should be considered in sexually active adolescents. Prevention efforts should target children before initiation of sexual activity.
Sucato
G
G
Department of Pediatrics, Robert Wood Johnson Clinical Scholars Program, University of Washington, Seattle, USA.
Celum
C
C
Dithmer
D
D
Ashley
R
R
Wald
A
A
D000293:Adolescent; D015153:Blotting, Western; D003430:Cross-Sectional Studies; D005260:Female; D006558:Herpes Genitalis / Q000175:diagnosis / Q000453:epidemiology*; D018258:Herpesvirus 2, Human / Q000276:immunology; D006801:Humans; D008297:Male; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D014861:Washington