title: Cunnilingus and vaginal intercourse are risk factors for herpes simplex virus type 1 acquisition in women.
abstract: OBJECTIVE
  Although numerous cross-sectional studies have identified herpes simplex virus type 1 (HSV-1) as an important genital pathogen, the specific sexual activities associated with HSV-1 infection are not well delineated. Our objective was to identify demographic and behavioral variables in women associated with the prevalence and acquisition of HSV-1.
  
  
  METHODS
  From 1998 through 2000, we enrolled 1207 nonpregnant 18- to 30-year-old women from 3 Pittsburgh, Pennsylvania, area health clinics in a prospective cohort study. Serum from the women was tested each visit for the presence of type-specific HSV-1 antibodies.
  
  
  RESULTS
  At enrollment, HSV-1 serum antibodies were detected in only 38% of women < or =20 years of age. Black race, < or =12 years education, older age, and a history of at least 5 lifetime male sex partners were independently associated with the prevalence of HSV-1. In longitudinal analyses, women who had vaginal intercourse were more likely than sexually inactive women to acquire HSV-1 (6.8 vs. 1.2 cases per 100 woman-years of follow up; P=0.05). Similarly, women who only had receptive oral sex, without vaginal intercourse, were also more likely than sexually inactive women to acquire HSV-1 (9.8 vs. 1.2 cases per 100 woman-years of follow up; P=0.04).
  
  
  CONCLUSIONS
  Receiving cunnilingus and vaginal intercourse are important risk factors for the acquisition of HSV-1 among young women. Genital herpes prevention strategies will need to consider both the increased susceptibility for HSV-1 acquisition that young adults now have at sexual debut and the important contributions of HSV-1 to the burgeoning genital herpes epidemic.
authors.affiliation: Department of Medicine, Division of Infectious Disease, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. rsitc@mwri.magee.edu
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Cherpes
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Meyn
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Hillier
mesh_terms: D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006561:Herpes Simplex / Q000453:epidemiology* / Q000209:etiology*; D018259:Herpesvirus 1, Human / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D010414:Pennsylvania / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D016387:Women's Health
chemical_list: D000914:Antibodies, Viral