title: Risk factors for infection with herpes simplex virus type 2: role of smoking, douching, uncircumcised males, and vaginal flora.
abstract: BACKGROUND
  Herpes simplex virus type 2 (HSV-2), the primary cause of genital herpes, is one of the most prevalent sexually transmitted diseases worldwide. Epidemiologic serosurveys suggest that infections occur more frequently in women than in men.
  
  
  OBJECTIVE
  The goal of the study was to identify unique correlates of HSV-2 infection in women that might contribute to their increased susceptibility of infection or suggest opportunities for decreasing the incidence of disease.
  
  
  METHODS
  We enrolled 1207 women aged 18 to 30 years from three Pittsburgh health clinics in a cross-sectional study. Each woman provided demographic and behavioral information, vaginal swab specimens for bacterial culture, a vaginal smear for Gram stain diagnosis of bacterial vaginosis, and blood for HSV-1 and HSV-2 serology.
  
  
  RESULTS
  Black race, older age, cigarette smoking, douching, a greater number of lifetime sex partners, a history of intercourse with an uncircumcised partner, the presence of vaginal group B Streptococcus, and abnormal vaginal flora were among the independent predictors of HSV-2 infection.
  
  
  CONCLUSIONS
  HSV-2 infection may be occur more often in women who douche, smoke, have sex with uncircumcised partners, or have bacterial vaginosis; these represent alterable risk factors.
authors.affiliation: Department of Medicine, Division of Infectious Disease, Magee-Womens Research Institute, 204 Craft Avenue, Pittsburgh, PA 15213, USA. rsitc@mail.magee.edu
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Cherpes
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Meyn
authors.forename: Marijane A
authors.initials: MA
authors.lastname: Krohn
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Hillier
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002944:Circumcision, Male; D003430:Cross-Sectional Studies; D005260:Female; D006558:Herpes Genitalis / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D018258:Herpesvirus 2, Human / Q000276:immunology; D006801:Humans; D016015:Logistic Models; D010414:Pennsylvania / Q000453:epidemiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D012907:Smoking; D013291:Streptococcus; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation; D014621:Vagina / Q000382:microbiology