title: Herpes simplex virus seroprevalence and seroconversion among active duty US air force members with HIV infection.
abstract: BACKGROUND
  Herpes simplex virus (HSV) infection is associated with an increased risk of both HIV transmission and acquisition. We evaluated longitudinal HSV serology and sexually transmitted infections (STIs) among active duty US Air Force (USAF) members with HIV infection.
  
  
  METHODS
  USAF members diagnosed with HIV between 1996 and 2012 were included and divided into 2 groups: 1996-2004 (n=131) and 2005-2012 (n=266). HSV-1 and -2 serology was evaluated at HIV diagnosis. Longitudinal HSV-1 and -2 serology and ICD-9 codes for HSV and non-HSV STIs were also examined for those with ≥ 1 year of follow-up.
  
  
  RESULTS
  Patients were most commonly Caucasian (44.2%) or African American (43.4%) men with a median age of 28 years at HIV diagnosis. HSV-2 seroprevalence at HIV diagnosis decreased from the period of 1996-2004 (48.8%) to 2005-2012 (30.1%; P<0.01). Odds of HSV-2 seropositivity was significantly greater for non-Caucasians (OR 2.19, 95% CI 1.33-3.60) and for HIV diagnosis between 1996 and 2004 (OR 2.06, 95% CI 1.29-3.27), with a trend observed for those age >30 years at HIV diagnosis (OR 1.73, 95% CI 0.94-3.18). A total of 81 (20.4%) patients developed STIs by ICD-9 codes, including 24 (6.1%) new genital herpes diagnoses, during a median follow-up of 4.6 years. HSV-2 seroconversion occurred in 33 of 253 (13.0%) with an incidence rate of 5.07 per 100 person-years (95% CI 4.76-5.37).
  
  
  CONCLUSIONS
  Although HSV-2 seroprevalence at HIV diagnosis decreased over time, high-risk sexual behaviors were ongoing as evidenced by the high proportion of new STI diagnoses and HSV-2 seroconversions. Continued education to reduce risk behaviors is warranted to prevent acquisition and transmission of STIs in HIV-infected persons.
authors.affiliation: San Antonio Military Medical Center, Department of Internal Medicine, JBSA Fort Sam Houston, TX, United States.
authors.forename: Jared A
authors.initials: JA
authors.lastname: Cohen
authors.affiliation: Institute for Health Disparities Research, University of Texas at San Antonio, San Antonio, TX, United States.
authors.forename: Amanda
authors.initials: A
authors.lastname: Sellers
authors.affiliation: Institute for Health Disparities Research, University of Texas at San Antonio, San Antonio, TX, United States.
authors.forename: T S
authors.initials: TS
authors.lastname: Sunil
authors.affiliation: Mike O'Callaghan Federal Medical Center, Infectious Disease Service, Nellis AFB, NV, United States.
authors.forename: Peter E
authors.initials: PE
authors.lastname: Matthews
authors.affiliation: San Antonio Military Medical Center, Infectious Disease Service, JBSA Fort Sam Houston, TX, United States. Electronic address: jason.f.okulicz.mil@mail.mil.
authors.forename: Jason F
authors.initials: JF
authors.lastname: Okulicz
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006561:Herpes Simplex / Q000453:epidemiology*; D018259:Herpesvirus 1, Human / Q000276:immunology; D018258:Herpesvirus 2, Human / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D014481:United States; D055815:Young Adult
keywords: Genital herpes; Herpes simplex virus; Human immunodeficiency virus; Sexually transmitted infections