Background: Herpes simplex virus type 2 (HSV-2) is the most common cause of genital ulcer disease in the United States, and men who have sex with men (MSM) have higher prevalence of HSV-2. HSV-2 is one of the most important biologic predictors of HIV acquisition with infected persons having a 2.1 fold increased risk of HIV. Black MSM are disproportionately affected by HIV, and individual behavioral factors fail to explain this disparity suggesting that further investigation into biologic and network-level risk is warranted. This study aimed to estimate the seroprevalence of HSV-2 and examine associations with infection in a cohort of HIV negative black and white MSM.
Methods: The InvolveMENt study is designed to examine factors that may contribute to disparities in HIV and sexually transmitted infections between black and white MSM aged 18-39 years in Atlanta, Georgia. Participants completed a survey at baseline evaluating demographic, individual, and community level risk factors and provided serum samples for HSV-2 serology. We examined the prevalence of HSV-2 and socio-demographic and behavioral associations with infection among HIV negative MSM using multivariate logistic regression.
Results: Of the 394 men in the cohort, 210 were white and 184 were black. Seventy-seven (19.5%) were seropositive for HSV-2. Being black (OR 2.7; p=0.002), increasing age (OR 1.1; p=0.01), greater number of sexual partners in the past 12 months (OR 1.04; p=0.003), and a history of child abuse (OR 1.8; p=0.047) increased the odds of HSV-2 infection in a multivariate model. There was a significant interaction between race and age with black MSM <25 years of age having the highest odds of HSV-2 infection (OR=4.7; p=0.003).
Conclusion: The odds of black MSM being infected with HSV-2 is 2.7 times more than white MSM. Our examination of socio-demographic and behavioral risk factors did not fully account for the disparity, especially among young black MSM. Further investigation into biologic/genetic and partner level factors in HSV-2 infection among MSM is warranted. As it remains an important risk factor for HIV acquisition, there is also continued need for research in the design and implementation of HSV-2 prevention programs specifically for young, black MSM.
Table of Contents
Table of Contents Introduction/Literature Review...1 Methods...15 Results...20 Discussion...23 References...29
About this Master's Thesis
|Committee Chair / Thesis Advisor|
|HERPES SIMPLEX VIRUS-2 INFECTION IN BLACK AND WHITE HIV-NEGATIVE MEN WHO HAVE SEX WITH MEN ()||2018-08-28||