Human alphaherpesvirus 2 (HSV-2) among female sex workers from Brazil: cross-sectional study using respondent-driven sampling

Sex Transm Infect. 2021 Sep;97(6):461-464. doi: 10.1136/sextrans-2019-054400. Epub 2020 Sep 16.


Objective: Female sex workers (FSWs) are vulnerable to human alphaherpesvirus 2 (HSV-2) infection due to their high numbers of sexual partners. The objective of this study was to evaluate the seroprevalence and risk behaviours associated with HSV-2.

Methods: A cross-sectional study was conducted in Mato Grosso do Sul, Brazil. A total of 376 FSWs were recruited by respondent-driven sampling (RDS) methodology and answered an epidemiological questionnaire. Blood samples were collected to test for HSV-2 antibodies using commercial ELISA and for HSV-2 DNA using real-time PCR.

Results: The seropositivity was 47.3% (178/376) for HSV-2 IgG and 10.1% (38/376) for HSV-2 IgM. HSV-2 viraemia was detected in two infected FSWs with primary infections. In bivariate and multivariate analyses, the OR for HSV-2 IgG increased with age (OR=2.53-7.90, OR=2.66-6.37) and the number of sexual partners (OR=2.30-3.25). On the other hand, daily alcohol consumption (OR=0.10) and the use of condoms during the last intercourse (OR=0.47) were protective factors against HSV-2 acquisition.

Conclusion: Despite the impact of FSWs in public health policies with the dissemination of sexually transmitted infections, there have been few studies performed regarding the prevalence of HSV-2 in Brazil, making it difficult to implement any control or preventative measures. The results produced here using an RDS methodology demonstrated a high prevalence, risk behaviours and primary infection among the FSWs. These results reinforce the need to implement control and preventative measures for HSV-2 infection in this population.

Keywords: herpes; sexual behaviour; virology; women.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Female
  • Herpesvirus 2, Human / genetics
  • Herpesvirus 2, Human / immunology*
  • Herpesvirus 2, Human / isolation & purification
  • Humans
  • Prevalence
  • Risk Factors
  • Risk-Taking
  • Seroepidemiologic Studies
  • Sex Workers / statistics & numerical data*
  • Sexual Behavior / statistics & numerical data
  • Sexually Transmitted Diseases / blood
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / immunology*
  • Sexually Transmitted Diseases / virology
  • Surveys and Questionnaires
  • Young Adult