title: Decline in Herpes Simplex Virus Type 2 Among Non-Injecting Heroin and Cocaine Users in New York City, 2005 to 2014: Prospects for Avoiding a Resurgence of Human Immunodeficiency Virus.
abstract: Herpes simplex virus type 2 (HSV-2) infection increases both susceptibility to and transmissibility of human immunodeficiency virus (HIV), and HSV-2 and HIV are often strongly associated in HIV epidemics. We assessed trends in HSV-2 prevalence among non-injecting drug users (NIDUs) when HIV prevalence declined from 16% to 8% among NIDUs in New York City.
  
  
  
  Subjects were current non-injecting users of heroin and/or cocaine and who had never injected illicit drugs. Three thousand one hundred fifty-seven NIDU subjects were recruited between 2005 and 2014 among persons entering Mount Sinai Beth Israel substance use treatment programs. Structured interviews, HIV, and HSV-2 testing were administered. Change over time was assessed by comparing 2005 to 2010 with 2011 to 2014 periods. Herpes simplex virus type 2 incidence was estimated among persons who participated in multiple years.
  
  
  
  Herpes simplex virus type 2 prevalence was strongly associated with HIV prevalence (odds ratio, 3.9; 95% confidence interval, 2.9-5.1) from 2005 to 2014. Herpes simplex virus type 2 prevalence declined from 60% to 56% (P = 0.01). The percentage of NIDUs with neither HSV-2 nor HIV infection increased from 37% to 43%, (P < 0.001); the percentage with HSV-2/HIV coinfection declined from 13% to 6% (P < 0.001). Estimated HSV-2 incidence was 1 to 2/100 person-years at risk.
  
  
  
  There were parallel declines in HIV and HSV-2 among NIDUs in New York City from 2005 to 2014. The increase in the percentage of NIDUs with neither HSV-2 nor HIV infection, the decrease in the percentage with HSV-2/HIV coinfection, and the low to moderate HSV-2 incidence suggest some population-level protection against resurgence of HIV. Prevention efforts should be strengthened to end the combined HIV/HSV-2 epidemic among NIDUs in New York City.
authors.affiliation: From the *Icahn School of Medicine at Mount Sinai; †New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center; ‡College of Nursing, New York University, New York, NY; and §Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: Don C
authors.initials: DC
authors.lastname: Des Jarlais
authors.forename: Kamyar
authors.initials: K
authors.lastname: Arasteh
authors.forename: Jonathan
authors.initials: J
authors.lastname: Feelemyer
authors.forename: Courtney
authors.initials: C
authors.lastname: McKnight
authors.forename: Susan
authors.initials: S
authors.lastname: Tross
authors.forename: David C
authors.initials: DC
authors.lastname: Perlman
authors.forename: Aimee N C
authors.initials: AN
authors.lastname: Campbell
authors.forename: Holly
authors.initials: H
authors.lastname: Hagan
authors.forename: Hannah L F
authors.initials: HL
authors.lastname: Cooper
mesh_terms: D000293:Adolescent; D000328:Adult; D003042:Cocaine; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000453:epidemiology; D060085:Coinfection; D055030:Drug Users; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D003932:Heroin; D006556:Heroin Dependence / Q000150:complications* / Q000453:epidemiology; D006561:Herpes Simplex / Q000453:epidemiology* / Q000635:transmission; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D020010:Heterosexuality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003932:Heroin; D003042:Cocaine