title: Socio-demographic and behavioral correlates of herpes simplex virus type 1 and 2 infections and co-infections among adults in the USA.
abstract: OBJECTIVE
  Although herpes simplex virus (HSV)-1 and HSV-2 may co-exist and interact, some epidemiologic features including geographical distribution, secular trends, route of transmission, and established risk factors may distinguish these HSV sub-types. With recent data indicating a link between genital herpes and either strain, a re-evaluation of risk factors for HSV-1/HSV-2 infection and co-infection is needed.
  
  
  METHODS
  We used the 1999-2004 National Health and Nutrition Examination Study (NHANES) data and logistic regression modeling to identify socio-demographic and behavioral risk factors that can independently predict HSV-1/HSV-2 infection and co-infection.
  
  
  RESULTS
  Approximately 48% were positive for HSV-1 alone, 7% were positive for HSV-2 alone and 12% were co-infected with HSV-1 and HSV-2. History of genital herpes was found in individuals infected with either or both HSV sub-types. Whereas age, sex, race, and level of education independently predicted all three outcomes, lifetime sexual activity as well as use of tobacco products and recreational drugs mainly correlated with HSV-2 infection and HSV-1/HSV-2 co-infection. Lifetime use of alcohol was not consistently associated with HSV-1/HSV-2 infection and co-infection.
  
  
  CONCLUSIONS
  Sexual activity played an important role for HSV-2 and was potentially important for HSV-1, with implications for healthcare practice and vaccine development.
authors.affiliation: Graduate Program in Public Health, Eastern Virginia Medical School, 700 W. Olney Road, Norfolk, VA 23501-1980, USA. baydouha@evms.edu
authors.forename: Hind A
authors.initials: HA
authors.lastname: Beydoun
authors.forename: Jessica
authors.initials: J
authors.lastname: Dail
authors.forename: Bethrand
authors.initials: B
authors.lastname: Ugwu
authors.forename: Adel
authors.initials: A
authors.lastname: Boueiz
authors.forename: May A
authors.initials: MA
authors.lastname: Beydoun
mesh_terms: D000293:Adolescent; D000328:Adult; D003710:Demography; D005260:Female; D006558:Herpes Genitalis / Q000150:complications* / Q000453:epidemiology* / Q000209:etiology; D006561:Herpes Simplex / Q000150:complications* / Q000453:epidemiology* / Q000209:etiology; D018259:Herpesvirus 1, Human; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012309:Risk-Taking; D014481:United States / Q000453:epidemiology; D055815:Young Adult