Implementation of routine access to herpes simplex virus type 2 antibody testing in a public health sexually transmitted disease clinic.
BACKGROUND
Testing for herpes simplex virus type 2 (HSV-2) antibody is not common in clinical practice. Client characteristics associated with HSV-2 rapid antibody test uptake and test positivity were analyzed in clients attending an urban sexually transmitted disease clinic.


METHODS
This optional test was available for $30. The HerpeSelect Express assay was performed on serum. Demographic and behavioral characteristics were compared between clients who requested testing and those who did not and between those who were HSV-2 antibody positive and negative.


RESULTS
In 4 months, 3498 individuals attended the clinic and 443 (12.7%) opted for HSV-2 testing. Clients who were black, younger, or female were less likely to request testing. Recent sexual behavior and self-reported sexual orientation were not associated with uptake of testing. Of the 442 clients with results available, 109 were positive for HSV-2 antibody (24.7%). Women were significantly (P <0.001) more likely to test positive; 42 of 111 (38.4%) versus only 67 of 331 (20.2%) men. A positive HSV-2 antibody test was also associated with increasing age and black race. There was an association with the number of partners in the last 30 days, but no association with the number of partners in the last year. Of the 109 clients who had a positive HSV-2 antibody test, 71 (64.5%) accepted a prescription for suppressive acyclovir therapy.


CONCLUSIONS
Uptake of testing was modest in this population, especially among the highest risk individuals, possibly due to the cost of the test. Improved education regarding HSV-2 and subsidized testing may be needed in the populations that have the highest prevalence in order to encourage testing.
Fife
Kenneth H
KH
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA. kfife@iupui.edu
Van Der Pol
Barbara
B
Roth
Alexis M
AM
Brand
Juanita
J
Arno
Janet N
JN
Madlem
Jyl
J
Juliar
Beth E
BE
Katz
Barry P
BP
Williams
James A
JA
Zimet
Gregory D
GD
Fortenberry
J Dennis
JD
D000212:Acyclovir / Q000627:therapeutic use; D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D000914:Antibodies, Viral / Q000097:blood*; D000998:Antiviral Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006284:Health Plan Implementation / Q000379:methods* / Q000706:statistics & numerical data; D006297:Health Services Accessibility; D006561:Herpes Simplex / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D007196:Indiana; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011933:Reagent Kits, Diagnostic / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data
D000914:Antibodies, Viral; D000998:Antiviral Agents; D011933:Reagent Kits, Diagnostic; D000212:Acyclovir