title: Public health strategies for prevention and control of HSV-2 in persons who use drugs in the United States.
abstract: BACKGROUND
  Herpes simplex virus type 2 (HSV-2) affects HIV acquisition, transmission, and disease progression. Effective medications for genital herpes and for HIV/AIDS exist. Parenteral transmission of HIV among persons who inject drugs is decreasing. Reducing sexual transmission of HIV and HSV-2 among persons who use drugs (PWUD; i.e., heroin, cocaine, "speedball", crack, methamphetamine through injection or non-injection) necessitates relevant services.
  
  
  METHODS
  We reviewed HSV-2 sero-epidemiology and HSV-2/HIV associations in U.S.-based studies with PWUD and the general literature on HSV-2 prevention and treatment published between 1995 and 2012. We used the 6-factor Kass framework to assess relevant HSV-2 public health strategies and services in terms of their goals and effectiveness; identification of, and minimization of burdens and concerns; fair implementation; and fair balancing of benefits, burdens, and concerns.
  
  
  RESULTS
  Eleven studies provided HSV-2 serologic test results. High HSV-2 sero-prevalence (range across studies 38-75%) and higher sero-prevalence in HIV-infected PWUD (97-100% in females; 61-74% in males) were reported. Public health strategies for HSV-2 prevention and control in PWUD can include screening or testing; knowledge of HSV-2 status and partner disclosure; education, counseling, and psychosocial risk-reduction interventions; treatment for genital herpes; and HIV antiretroviral medications for HSV-2/HIV co-infected PWUD.
  
  
  CONCLUSIONS
  HSV-2 sero-prevalence is high among PWUD, necessitating research on development and implementation of science-based public health interventions for HSV-2 infection and HSV-2/HIV co-infections, including research on effectiveness and cost-effectiveness of such interventions, to inform development and implementation of services for PWUD.
authors: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Office of the Director, 1600 Clifton Road, NE, E-07, Atlanta, GA 30333, United States. ssemaan@cdc.gov
authors: Salaam
authors: S
authors: Semaan
authors: Mary
authors: M
authors: Leinhos
authors: Mary Spink
authors: MS
authors: Neumann
mesh_terms: D006558:Herpes Genitalis / Q000453:epidemiology / Q000517:prevention & control; D006561:Herpes Simplex / Q000453:epidemiology / Q000517:prevention & control*; D018258:Herpesvirus 2, Human; D006801:Humans; D011634:Public Health / Q000379:methods*; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000517:prevention & control*; D014481:United States / Q000453:epidemiology
keywords: HIV; HSV-2; Herpes; Persons who use drugs; Public health; Sexually transmitted infections