Incidence of herpes simplex virus type 2 infection in 5 sexually transmitted disease (STD) clinics and the effect of HIV/STD risk-reduction counseling.
The seroincidence of herpes simplex virus type 2 (HSV-2) infection was determined among 1766 patients attending sexually transmitted disease (STD) clinics and enrolled in a randomized, controlled trial of human immunodeficiency virus (HIV)/STD risk-reduction counseling (RRC). Arm 1 received enhanced RRC (4 sessions); arm 2, brief RRC (2 sessions); and arm 3, the control arm, brief informational messages. The overall incidence rate was 11.7 cases/100 person-years (py). Independent predictors of incidence of HSV-2 infection included female sex; black race; residence in Newark, New Jersey; <50% condom use with an occasional partner; and, in females, incident trichomoniasis and bacterial vaginosis. Only 10.8% of new HSV-2 infections were diagnosed clinically. Incidence rates were 12.9 cases/100 py in the control arm, 11.8 cases/100 py in arm 2, and 10.3 cases/100 py in arm 1 (hazard ratio, 0.8 [95% confidence interval, 0.6-1.1], vs. controls). The possible benefit of RRC in preventing acquisition of HSV-2 infection offers encouragement that interventions more specifically tailored to genital herpes may be useful and should be an important focus of future studies.
Department of Medicine, University of Colorado Health Sciences Center, Denver, Colorado, USA. stg8@cdc.gov
Sami L
SL
Gottlieb
John M
JM
Douglas
Mark
M
Foster
D Scott
DS
Schmid
Daniel R
DR
Newman
Anna E
AE
Baron
Gail
G
Bolan
Michael
M
Iatesta
C Kevin
CK
Malotte
Jonathan
J
Zenilman
Martin
M
Fishbein
Thomas A
TA
Peterman
Mary L
ML
Kamb
D000293:Adolescent; D000328:Adult; D000368:Aged; D017280:Condoms; D003376:Counseling / Q000379:methods*; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission / Q000821:virology; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012111:Residence Characteristics; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016036:Seroepidemiologic Studies; D012737:Sex Factors; D014245:Trichomonas Infections / Q000150:complications; D016585:Vaginosis, Bacterial / Q000150:complications