High Rates of Herpes Simplex Virus Type 2 Infection in Homeless Women: Informing Public Health Strategies

J Womens Health (Larchmt). 2016 Aug;25(8):840-5. doi: 10.1089/jwh.2015.5579. Epub 2016 May 31.

Abstract

Background: Homeless and unstably housed women living in an urban setting are at risk for sexually transmitted diseases, yet the seroprevalence and correlates of herpes simplex virus type 2 (HSV-2) specific to impoverished women are poorly understood.

Materials and methods: Between April and October 2010, we conducted a cross-sectional analysis of sociodemographic, structural, and behavioral factors associated with prevalent HSV-2 infection (recent and historical infections) within a community-recruited cohort of homeless and unstably housed women. Logistic regression modeling was used to identify independent sociobehavioral correlates of HSV-2 infection.

Results: Among 213 women (114 HIV positive and 99 HIV negative), the median age was 49, 48% were African American, and 63% had completed high school. HSV-2 seroprevalence was 88%, and only 17% of infected women were aware of their infection. In adjusted analysis, odds of HSV-2 infection were significantly higher for those reporting at-risk drinking (adjusted odds ratio [AOR] = 7.04; 95% confidence interval [CI] = 1.59, 67.91), heterosexual orientation (AOR = 4.56; 95% CI = 1.81, 11.69), and for those who were HIV positive (AOR = 3.64; 95% CI = 1.43, 10.30). Odds of HSV-2 infection decreased as current income increased (AOR for each $500 monthly increase = 0.90; 95% CI = 0.78, 0.997).

Conclusions: There is an extremely high seroprevalence of HSV-2 infection among homeless and unstably housed women, and most are unaware of their HSV-2 status. Screening all unstably housed women for HSV-2 infection, with additional counseling for sexual risk and alcohol use, may lead to the identification of more infections and be a first step in reducing additional disease transmission.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Community-Based Participatory Research
  • Cross-Sectional Studies
  • Female
  • HIV Infections / epidemiology*
  • Herpes Genitalis / diagnosis
  • Herpes Genitalis / epidemiology*
  • Herpesvirus 2, Human*
  • Homeless Persons / statistics & numerical data*
  • Humans
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Seroepidemiologic Studies
  • Sexual Behavior
  • Socioeconomic Factors
  • Urban Population