Online Program

HIV and HSV-2 Infections in Persons Who Use Drugs in the United States

Tuesday, November 3, 2015 : 12:50 p.m. - 1:10 p.m.

Mary Neumann, PhD, Division of HIV/AIDS, CDC, Atlanta, GA
Salaam Semaan, DrPH, National Center for HIV/AIDS, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
background: Reducing sexual transmission of HIV and HSV-2 among persons who use drugs (PWUD) -- heroin, cocaine, “speedball,” crack, methamphetamine, by injection or non-injection -- necessitates relevant strategies, especially because HSV-2 affects HIV acquisition, transmission, and disease progression.

methods: We assessed HSV-2 and HIV sero-prevalence in PWUD and identify clinical and public health strategies. We systematically reviewed U.S.-based studies, 1995 – 2014, on HSV-2 and HSV-2/HIV sero-epidemiology in PWUD and related interventions and services.

results: Eleven studies provided serologic test results. High HSV-2 sero-prevalence for PWUD (range across studies for men and women 38%–75%), higher HSV-2 sero-prevalence in women who use drugs (range across studies 59% -86%), and higher HSV-2 sero-prevalence in HIV-infected women than in women who were not (97% -100% and 68% - 82%, respectively) and in HIV-infected men (61-74%) were reported. HSV-2 strategies and future research for PWUD can include assessing effectiveness of HSV-2 screening or testing; increased awareness of HSV-2 status and importance of partner disclosure; education and counseling; developing and evaluating HSV-2 psychosocial risk-reduction interventions; treating genital herpes; and offering HIV antiretroviral medications for HSV-2/HIV co-infected PWUD.

conclusions: HSV-2 prevalence is high among PWUD, particularly among women who use drugs and those who are HIV-infected. New studies with PWUD on prevention effectiveness and cost-effectiveness of interventions and services for HSV-2 and HSV-2/HIV co-infections can inform program implementation and reduce infection and disparities. Treating PWUD for HSV-2 and HIV infections can build on current scientific knowledge including using effective medications for genital herpes and HIV/AIDS.

Learning Areas:

Clinical medicine applied in public health
Public health or related research

Learning Objectives:
Explain the interactions between HIV and HSV2 that affect infection or co-infection acquisition, transmission, and disease progression to AIDS and genital herpes Analyze the sero-epidemiology of HIV and HSV-2 in persons who use illicit drugs Describe interventions and services to reduce sexual transmission of HIV and HSV-2 and role of prevention and treatment strategies for either and both infections

Keyword(s): HIV/AIDS, Sexual Risk Behavior

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have extensive experience in public health research and presentations
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.