Online Program

Seroprevalence of Herpes Simplex Virus type 2 (HSV-2) and associated risk factors among females in the USA: National Health and Nutrition Examination Survey (NHANES), 2009-2012

Wednesday, November 4, 2015 : 1:42 p.m. - 2:00 p.m.

Ali Dehghanifirouzabadi, MPH, STD/HIV, Mississippi State Department of Health, Jackson, MS
Mohammad Shahbazi, Dr., Behavioral Sciences, Jackson State University, Jackson, MS
Mina Qobadi, Epidemiology, Jackson State University, Jackson, MS

Background: HSV-2 is one of the most prevalent sexually transmitted infections in the U.S., however, little is known about its associated risk factors among U.S. females.

Research Question: What is seroprevalence of HSV-2 infection among U.S. females? and what are HSV-2 associated risk factors among this population?

Methods: Survey and laboratory data from the 2009-2012 U.S. NHANES data were combined for females 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 females aged 20-49 years old (n=2,826) was 23.6%. Among those with positive HSV-2, 31.1% were African American, 48% more than 39 years old, 57.7% unmarried, 19% had less than high school education and 23.3% had  less than $20,000 annual income. In addition, 99.2% of those women had vaginal sex, 87.6% oral sex, 48.3% anal sex, 12.2% sex with other women, and 51.1% never used condom. After controlling for confounders in multiple regression, women who had less than high school education (OR=1.5, 95% CI: 1.1-2.0, ref=college education), less than $20,000 annual income (OR=1.7, 95% CI: 1.2-2.5, ref=≥$65,000), anal sex (OR=1.6, 95% CI: 1.2-2, ref=no anal sex)  and those who were unmarried (OR=1.4, 95% CI: 1.1-1.9, ref=married), African American (OR=5.7 95% CI: 4.3-7.4, ref=White) and aged 40-49 years old (OR=5.2 95% CI: 3.1-8.7, ref=20-29 years old) were more likely to have HSV-2 infection. Using condom and having sex with women had no significant relationship with HSV-2 infection.

Conclusion: HSV-2 infection is common among U.S. females and associated with low education, low income, older age, having anal sex, being African American and unmarried. Findings from this study suggest the need for prevention among at-risk population. Healthcare providers should be aware of socio-demographic disparity and its potential implications in order to deliver better care for patients with HSV-2 infections.

Learning Areas:

Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Assess the current estimate of HSV-2 prevalence among U.S. females aged 20-49 years old. Identify associated risk factors of HSV-2. Discuss how identifying these risk factors have implications for HSV-2 prevention.

Keyword(s): STDs/STI, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am working as an Epidemiologist at the Mississippi State Department of Health. I have a solid background in public health research methodology and 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.