Correlates to seroprevalent herpes simplex virus type 2 among rural Appalachian drug users.
Herpes simplex virus type 2 (HSV-2) is the most common cause of genital ulcer disease and, along with substance abuse, an important HIV risk factor. Therefore, the purpose of this study was to examine HSV-2 seroprevalence in a sample of drug users in rural Appalachia. Rural Appalachian individuals age 18 or older reporting non-medical use of prescription opioids, heroin, crack/cocaine, or methamphetamine in the past 6 months (n = 499) were included. Behavioral, demographic, and sexual network data were collected using interviewer-administered questionnaires. Participants' serum was tested for HSV-2 antibodies using the Biokit rapid test (Lexington, MA). The estimated population seroprevalence of HSV-2 was 14.4% (95%CI: 9.6-19.4%). Only 8.8% were aware of being HSV-2+, and unprotected sex was reported in 80% of serodiscordant sexual relationships. In a multivariate model, female gender, age, older age at first oral sex, and frequency of unprotected sex in the sexual network were independently associated with HSV-2 seropositivity. Despite lower seroprevalence than that reported in similar studies of substance abusers, targeted interventions to reduce sexual risk behavior are warranted in this underserved population. Network-informed approaches with particular focus on women, older individuals, and those engaging in frequent unprotected sex are recommended.
Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, Kentucky.|Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, Kentucky.
Dustin B
DB
Stephens
Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, Kentucky.|Department of Epidemiology, University of Kentucky College of Public Health, Lexington, Kentucky.
April M
AM
Young
Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, Kentucky.
Ursula L
UL
Mullins
Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, Kentucky.|Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, Kentucky.
Jennifer R
JR
Havens
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D001061:Appalachian Region / Q000453:epidemiology; D055030:Drug Users; D005260:Female; D006558:Herpes Genitalis / Q000453:epidemiology; D006561:Herpes Simplex / Q000453:epidemiology*; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012309:Risk-Taking; D012424:Rural Population; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D055815:Young Adult
D000914:Antibodies, Viral
HIV risk; HSV-2; drug use; genital herpes