Racial/ethnic disparities in undiagnosed infection with herpes simplex virus type 2.
BACKGROUND
Herpes simplex virus type 2 (HSV-2) is a common sexually transmitted infection (STI) that is the main cause of genital herpes. Studies have found racial/ethnic disparities in HSV-2 prevalence, but there have been few studies of racial/ethnic differences in the proportion of infections that go without a genital herpes diagnosis.


METHODS
Data from 1396 HSV-2-seropositive participants of the National Health and Nutrition Examination Survey 1999-2004 were used to examine racial/ethnic differences in the odds of reporting being diagnosed previously with genital herpes.


RESULTS
The proportion of participants who reported not being diagnosed previously with genital herpes was 85.5%. In adjusted analysis, non-Hispanic blacks had twice the odds of reporting being undiagnosed as non-Hispanic whites (adjusted odds ratio = 2.0, 95% CI = 1.37, 2.87). Being undiagnosed was also significantly associated with less than high school education, no prior STI history or HIV test, no current health insurance, and residence in the Midwest and South.


CONCLUSIONS
The low proportion of genital herpes diagnosis among non-Hispanic blacks with HSV-2 is not accounted for by other sociodemographic factors or health insurance. Combined with the high prevalence of HSV-2, the low proportion of diagnosis in this population is more likely to contribute to ongoing HSV-2 transmission than among non-Hispanic whites or Mexican Americans. More research is needed to assess the role that lack of diagnosis plays in ongoing HSV-2 transmission, and whether targeted HSV-2 screening, counseling and treatment could be part of a more effective prevention strategy for non-Hispanic blacks.
Pouget
Enrique R
ER
National Development and Research Institutes Inc., 71 West 23rd Street, New York, NY 10010, USA. pouget@ndri.org
Kershaw
Trace S
TS
Blankenship
Kim M
KM
Ickovics
Jeannette R
JR
Niccolai
Linda M
LM
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D044383:Black People / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology*; D006558:Herpes Genitalis / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology*; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
D000914:Antibodies, Viral