Gender-specific association between Herpes Simplex Virus type 2 (HSV-2) and cocaine use among U.S. adults: Findings from National Health and Nutrition Examination Survey (NHANES), 2009-2012
Background: HSV-2 is one of the most prevalent sexually transmitted infections in the U.S. Despite the evident relationship between sexually transmitted infections and substance abuse, little is known about the gender specific association between HSV-2 and cocaine use.
Research Question: What is the prevalence of HSV-2 among U.S. adults? Is there any gender-specific relationship between HSV-2 and cocaine use?
Methods: Survey and laboratory data from the 2009-2012 U.S. NHANES data were combined for adults aged 20-49 years old. Data were weighted to reflect the NHANES complex survey design. Descriptive statistics, binary and multiple logistic regressions were done using SAS 9.3 PROC SURVEY procedure.
Results: The overall HSV-2 seroprevalence among adults aged 20-49 years old (n=5,452) was 18.0%. Among those with positive HSV-2, 29.8% were African American, 50.9% more than 39 years old, 55.3% unmarried, 20.6% had less than high school education and 20.9% had less than $20,000 annual income. In addition, 99.3% had sex, 50.7% never used condom and 97.4% used some forms of cocaine. After controlling for confounders in multiple regression, those who ever used cocaine were more likely to have HSV-2 infection (OR=3.3, 95% CI: 1.3-8.2, ref= never used cocaine). Additionally, using any forms of cocaine was significantly associated with HSV-2 infection among women (n=2,831, p=0.002) while this relationship was not significant among men (n=2621, p=0.38). Women who had ever used any forms of cocaine were more likely to have HSV-2 infection (OR=5.7, 95% CI: 1.2-17.3, ref= never used cocaine), while using cocaine did not significantly predict HSV-2 infection among men.
Conclusion: HSV-2 infection is common in U.S. and associated with cocaine use, particularly in women. Women who ever used cocaine were more likely to get HSV-2 infection indicating the need for prevention among high risk population and increased efforts in public health policy and practice to control substance abuse.
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related education
Public health or related public policy
Assess the current estimate of HSV-2 prevalence among U.S. adults aged 20-49 years old. Evaluate gender-specific association between HSV-2 and cocaine use. Discuss how identifying high-risk population has implications for HSV-2 prevention.
Keyword(s): STDs/STI, Drug Abuse
Qualified on the content I am responsible for because: I am MPH student working as an Epidemiologist at the Mississippi State Department of Health. I have a solid background in Epidemiology and public health research methodology and I have worked with underserved populations nationally and internationally for more than 5 years. My experiences include project design, data collection and analysis, preparing abstracts and writing manuscripts.
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.