Sexual and demographic risk factors for herpes simplex type 1 and 2 in women attending an antenatal clinic

Abstract

Objective: To establish risk factors for the presence of HSV-2 and HSV-1 infections in pregnant women. Design, population, and setting: A prospective study of 3306 women attending the antenatal department Westmead Hospital, Sydney, between June 1995 and April 1998. Methods: Women completed a self administered questionnaire to establish risk factors for the presence of HSV-2 and HSV-1. Sera were tested for antibodies to HSV-2 and HSV-1. Data were analysed using SPSS and SAS. Main outcome measures: Seroprevalence of and risk factors for HSV-2 and HSV-1. Results: 375 (11.3% (95% CI 10.3-12.5)) women were HSV-2 antibody positive. Increasing age, Asian country of birth, lower education level, public hospital status, confirmed genital herpes, a partner with genital herpes, early age of first sex, more than one lifetime sexual partner, and previous chlamydia infection were independently associated with HSV-2 seropositivity. Of 408 women tested for HSV-1 antibodies, 323 (79.2% (95% CI 74.9-83.0)) were positive. Oral herpes, oral blisters or sores, and being HSV-2 seropositive were independently associated with HSV-1 seropositive status. When the logistic regression model was rerun without HSV-2 status, parity of two or more and one or more sexual partners in the past 3 months were significant predictors of HSV-1 seropositivity. Conclusions:The presence of antibodies to HSV-2 and HSV-1 is related to a number of sexual and demographic risk factors. Public health campaigns directed at encouraging young people to delay the onset of sexual activity and reduce the number of sexual partners need to be evaluated. However, the possible availability of an HSV-2 vaccine that is able to protect over 70% of women oVers the best hope for control of genital herpes. (Sex Transm Inf 2001;77:413-415)

Sexual behavioral correlates with HSV-2 seroprevalence among pregnant women in Nigeria

“…Although this seroprevalence result falls within the range of 30%-80% found among women of reproductive age in sub-Saharan Africa [11], it is higher than HSV-2 seroprevalences found in several studies among populations of pregnant women in the sub-Saharan Africa region: 20.7% and 33.6% from different locations in Tanzania [12,13]; and 26% in Senegal [14]. This figure is still remarkably higher than findings from studies on pregnant populations outside Africa: 7.5% in India [15], 11.5% in Australia [16], 14.5% in Mexico [17], and 22% in USA [18]. The implication of this finding is that HSV-2 transmission in Benin, Nigeria is efficient; and it indicates that there could be underlying peculiar factors in the environment that enable the sustenance of such a high level of transmission efficiency.…”

Community-based study on seroprevalence of herpes simplex virus type 2 infection in New Delhi

“…Such studies have found a wide range of seroprevalence of HSV-2, which varies according to the populations studied, from 11.3% in women attending antenatal clinics to over 70% in commercial sex workers. [6][7][8] Various population-based studies conducted in developed and developing countries have reported HSV-2 seroprevalence in the range of 5.6-42.2%. [9][10][11][12] However, very few populationbased studies on the seroprevalence of HSV-2 have been carried out in India.…”

Sexual behavioural correlates of herpes simplex virus type 2 infections among pregnant women in South-western Nigeria

“…This is in agreement with other studies, which show that HSV-2 sero-positivity is associated with a greater number of lifetime sexual partners and multiple sexual partners within six months to the time of the study. 3,7,12,[22][23][24][25][26][27][28][29] In the present study, women with more than one lifetime sexual partners were 2.4 times more likely to have HSV-2 infection than those with one lifetime sexual partner. This is similar to some other studies which observed that women with more than one lifetime sexual partners were twice as likely to have HSV-2 antibodies, than those with one partner.…”

“…7 Sexually transmitted infections were also strongly associated with acquisition of HSV-2 infection and similar findings have been reported by some authors. 23,[25][26][27] The results of the index study re-emphasize the primary role of multiple sexual partners in the acquisition of HSV-2 infection. This is in agreement with other studies, which show that HSV-2 sero-positivity is associated with a greater number of lifetime sexual partners and multiple sexual partners within six months to the time of the study.…”

“…3,11,22 The inconsistent use of condom with their sexual partners prevailed (57.8%) among the HSV-2 sero-positive women and this was observed in similar studies on pregnant women. 7,[21][22][23][24] This is of great concern as HSV-2 transmission can occur in long-standing monogamous relationships, and the virus may be transmitted to a susceptible partner after a long time of unprotected sexual contact with an asymptomatic but infected partner. 7 There is need for consistent use of condom as nearly everyone, with genital HSV-2 infection sheds virus intermittently without symptoms.…”