Herpes simplex virus-2 and HIV among noninjecting drug users in New York city.
OBJECTIVE
To examine the relationship between herpes simplex virus 2 (HSV-2) seroprevalence and human immunodeficiency virus (HIV) seroprevalence among noninjecting heroin and cocaine users in New York City.


METHODS
Four hundred sixty-two noninjecting cocaine and heroin users were recruited from a drug detoxification program in New York City. Smoking crack cocaine, intranasal use of heroin, and intranasal use of cocaine were the most common types of drug use. A structured interview was administered and a serum sample was collected for HIV and HSV testing.


RESULTS
HIV prevalence was 19% (95% CI 15%-22%) and HSV-2 seroprevalence was 60% (95% CI 55%-64%). The adjusted risk ratio for the association between HSV-2 and HIV was 1.9 (95% CI 1.21%-2.98%). The relationship between HSV-2 and HIV was particularly strong among females, among whom 86% were HSV-2 seropositive, 23% were HIV seropositive, and all HIV seropositives were also HSV-2 seropositive.


CONCLUSIONS
HSV-2 appears to be an important factor in sexual transmission of HIV among noninjecting cocaine and heroin users in New York City, especially among females. The estimated population attributable risk for HIV infection attributable to HSV-2 infection in this sample was 38%. Programs to manage HSV-2 infection should be developed as part of comprehensive HIV prevention for noninjecting drug users.
Des Jarlais
Don C
DC
Baron Edmond de Rothschild Chemical Dependency Institute, Beth Israel Medical Center, New York, NY 10038, USA. dcdesjarla@aol.com
Hagan
Holly
H
Arasteh
Kamyar
K
McKnight
Courtney
C
Perlman
David
D
Friedman
Samuel R
SR
D000328:Adult; D003042:Cocaine; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D003932:Heroin; D006558:Herpes Genitalis / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D018258:Herpesvirus 2, Human; D006801:Humans; D008297:Male; D009519:New York City / Q000453:epidemiology; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D019966:Substance-Related Disorders
D003932:Heroin; D003042:Cocaine