title: High prevalence of antibodies to herpes simplex virus type 2 among middle-aged women in Mexico City, Mexico: a population-based study.
abstract: BACKGROUND
  Herpes simplex virus type 2 (HSV-2) is among the most prevalent sexually transmitted diseases worldwide. In Mexico there is a lack of population-based HSV-2 surveys.
  
  
  OBJECTIVE
  To determine population-based HSV-2 seroprevalence and risk factors among women in Mexico City.
  
  
  METHODS
  A random sample of 730 women was identified among the residents of Mexico City. Women ages 25 to 85 years were selected from 3,694 households. Western blot serology testing was conducted on serum samples to determine HSV-2 type-specific serostatus. A structured questionnaire was administered, and multivariate analyses were performed to identify risk factors for HSV-2 seropositivity, which were stratified into two age categories: younger than 50 years of age and 50 years of age or older.
  
  
  RESULTS
  The HSV-2 seroprevalence among female participants was 29.8%, with a significant trend of increasing HSV-2 prevalence for each higher level of age (P < 0.001). Female participants had a median age of 46 years and were predominantly monogamous (82.6%). The overall population-based seroprevalence estimated in Mexico City among women was 35.8%. The independent risk factors for HSV-2 seropositivity included a history of two or more sexual partners (odds ratio [OR], 2.2; 95% CI, 1.4-3.4), two or more sexual partners before first pregnancy (OR, 2.3; 95% CI, 1.4-3.7), cohabitation with partner (OR, 2.5; 95% CI, 1.3-4.7), and current vaginal douching (OR, 1.7; 95% CI, 1.2-2.6).
  
  
  CONCLUSIONS
  Population-based HSV-2 seroprevalence is endemically high among middle-age women in Mexico City, and clearly is correlated with higher-risk sexual behavior. This elevated HSV-2 seroprevalence may reflect unrecognized HSV-2 transmission throughout life.
authors.affiliation: National Institute of Public Health of Cuernavaca, Morelos, Mexico. elazcano@insp3.insp.mx
authors.forename: E
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.forename: J S
authors.initials: JS
authors.lastname: Smith
authors.forename: N
authors.initials: N
authors.lastname: Muñoz
authors.forename: C J
authors.initials: CJ
authors.lastname: Conde-Glez
authors.forename: L
authors.initials: L
authors.lastname: Juárez-Figueroa
authors.forename: A
authors.initials: A
authors.lastname: Cruz
authors.forename: M
authors.initials: M
authors.lastname: Hernández
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000097:blood*; D015153:Blotting, Western; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000276:immunology; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D016015:Logistic Models; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012747:Sexual Partners
chemical_list: D000914:Antibodies, Viral