HERPES SIMPLEX VIRUS-2 INFECTION IN BLACK AND WHITE HIV-NEGATIVE MEN WHO HAVE SEX WITH MEN Public

Abstract

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

Tables...41

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, General Health Sciences, Medicine and Surgery
Mot-clé	HSV-2 herpes infectious disease HIV Herpes simplex virus type 2
Committee Chair / Thesis Advisor	Kelley, Colleen, Emory University
Committee Members	Del Rio, Carlos, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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