title: High Rates of Herpes Simplex Virus Type 2 Infection in Homeless Women: Informing Public Health Strategies.
abstract: Homeless and unstably housed women living in an urban setting are at risk for sexually transmitted diseases, yet the seroprevalence and correlates of herpes simplex virus type 2 (HSV-2) specific to impoverished women are poorly understood.
  
  
  
  Between April and October 2010, we conducted a cross-sectional analysis of sociodemographic, structural, and behavioral factors associated with prevalent HSV-2 infection (recent and historical infections) within a community-recruited cohort of homeless and unstably housed women. Logistic regression modeling was used to identify independent sociobehavioral correlates of HSV-2 infection.
  
  
  
  Among 213 women (114 HIV positive and 99 HIV negative), the median age was 49, 48% were African American, and 63% had completed high school. HSV-2 seroprevalence was 88%, and only 17% of infected women were aware of their infection. In adjusted analysis, odds of HSV-2 infection were significantly higher for those reporting at-risk drinking (adjusted odds ratio [AOR] = 7.04; 95% confidence interval [CI] = 1.59, 67.91), heterosexual orientation (AOR = 4.56; 95% CI = 1.81, 11.69), and for those who were HIV positive (AOR = 3.64; 95% CI = 1.43, 10.30). Odds of HSV-2 infection decreased as current income increased (AOR for each $500 monthly increase = 0.90; 95% CI = 0.78, 0.997).
  
  
  
  There is an extremely high seroprevalence of HSV-2 infection among homeless and unstably housed women, and most are unaware of their HSV-2 status. Screening all unstably housed women for HSV-2 infection, with additional counseling for sexual risk and alcohol use, may lead to the identification of more infections and be a first step in reducing additional disease transmission.
authors.affiliation: 1 Department of Medicine, University of California , San Francisco, San Francisco, California.
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Kelly
authors.affiliation: 1 Department of Medicine, University of California , San Francisco, San Francisco, California.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cohen
authors.affiliation: 2 Department of Epidemiology and Biostatistics, University of California , San Francisco, San Francisco, California.
authors.forename: Barbara
authors.initials: B
authors.lastname: Grimes
authors.affiliation: 3 San Francisco Department of Public Health, University of California , San Francisco, San Francisco, California.
authors.forename: Susan S
authors.initials: SS
authors.lastname: Philip
authors.affiliation: 1 Department of Medicine, University of California , San Francisco, San Francisco, California.
authors.forename: Sheri D
authors.initials: SD
authors.lastname: Weiser
authors.affiliation: 1 Department of Medicine, University of California , San Francisco, San Francisco, California.
authors.forename: Elise D
authors.initials: ED
authors.lastname: Riley
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D055812:Community-Based Participatory Research; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006558:Herpes Genitalis / Q000175:diagnosis / Q000453:epidemiology*; D018258:Herpesvirus 2, Human; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D014505:Urban Population