195660 Racial-Ethnic Disparities in Undiagnosed Infection with Herpes Simplex Virus Type 2

Tuesday, November 10, 2009

Enrique R. Pouget, PhD , Institute for AIDS Research, National Development and Research Institutes, New York, NY
Linda M. Niccolai, PhD , Department of Epidemiology and Public Health, Yale University, New Haven, CT
Trace S. Kershaw, PhD , School of Public Health, Yale University, New Haven, CT
Kim M. Blankenship, PhD , Duke Global Health Institute and Sociology, Duke University, Durham, NC
Jeannette R. Ickovics, PhD , School of Public Health, Yale University, New Haven, CT
Background: Herpes simplex virus type 2 (HSV-2) is a common sexually transmitted infection (STI) that is associated with considerable morbidity. However, symptoms can be alleviated with antiviral suppressive therapy, and being diagnosed can lead to both treatment and changes in behavior that can reduce transmission. Several studies have found racial-ethnic disparities in HSV-2 prevalence, but there have been few studies of disparities in the likelihood of diagnosis.

Methods: Data from the National Health and Nutrition Examination Survey (NHANES) were used to examine racial-ethnic disparities in the likelihood of diagnosis among participants with HSV-2 infection.

Results: Controlling for other factors, being undiagnosed was significantly associated with non-Hispanic Black race-ethnicity, having less than high school education, having no prior STI diagnosis, having never been tested for HIV infection, and not having current health insurance.

Conclusions: Racial-ethnic disparities in the likelihood of being undiagnosed were not accounted for by other factors. Lack of health insurance coverage may be a barrier to diagnosis. The widespread lack of diagnosis among people with HSV-2 infection may contribute to the incidence and prevalence of HSV-2 infection, and may contribute to the elevated incidence and prevalence of HSV-2 and HIV among non-Hispanic Blacks.

Learning Objectives:
1. Describe racial-ethnic disparities in herpes simplex type 2 (HSV-2) infection. 2. Describe racial-ethnic disparities in the diagnosis of genital herpes among people with HSV-2 infection. 3. Discuss the importance of health care utilization and medical mistrust in genital herpes diagnosis.

Keywords: Epidemiology, Health Care Utilization

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I performed the work in partial fulfillment of requirements for my Ph.D.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.