Risk factors for infection with herpes simplex virus type 2: role of smoking, douching, uncircumcised males, and vaginal flora

Sex Transm Dis. 2003 May;30(5):405-10. doi: 10.1097/00007435-200305000-00006.


Background: Herpes simplex virus type 2 (HSV-2), the primary cause of genital herpes, is one of the most prevalent sexually transmitted diseases worldwide. Epidemiologic serosurveys suggest that infections occur more frequently in women than in men.

Goal: The goal of the study was to identify unique correlates of HSV-2 infection in women that might contribute to their increased susceptibility of infection or suggest opportunities for decreasing the incidence of disease.

Study design: We enrolled 1207 women aged 18 to 30 years from three Pittsburgh health clinics in a cross-sectional study. Each woman provided demographic and behavioral information, vaginal swab specimens for bacterial culture, a vaginal smear for Gram stain diagnosis of bacterial vaginosis, and blood for HSV-1 and HSV-2 serology.

Results: Black race, older age, cigarette smoking, douching, a greater number of lifetime sex partners, a history of intercourse with an uncircumcised partner, the presence of vaginal group B Streptococcus, and abnormal vaginal flora were among the independent predictors of HSV-2 infection.

Conclusion: HSV-2 infection may be occur more often in women who douche, smoke, have sex with uncircumcised partners, or have bacterial vaginosis; these represent alterable risk factors.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Circumcision, Male
  • Cross-Sectional Studies
  • Female
  • Herpes Genitalis / blood
  • Herpes Genitalis / epidemiology*
  • Herpes Genitalis / etiology
  • Herpesvirus 2, Human* / immunology
  • Humans
  • Logistic Models
  • Pennsylvania / epidemiology
  • Risk Factors
  • Seroepidemiologic Studies
  • Sexual Behavior
  • Smoking
  • Streptococcus
  • Surveys and Questionnaires
  • Therapeutic Irrigation
  • Vagina / microbiology