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

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.