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Univariate and Multivariate Risk Factors for Per-act Probability of HSV-2 Transmission

Univariate and Multivariate Risk Factors for Per-act Probability of HSV-2 Transmission

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Background: The efficacy of condoms for protection against transmission of herpes simplex virus type 2 (HSV-2) has been examined in a variety of populations with different effect measures. Often the efficacy has been assessed as change in hazard of transmission with consistent vs inconsistent use, independent of the number of acts. Condom efficacy...

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... men to women, the rate was 28.5 transmissions per 1000 unprotected acts (95% CI, 10.8 to 74.1) and 1.3 per 1000 protected acts (95% CI, .4 to 4.5) for an estimated condom efficacy of 96% (95% CI, 84% to 99%, P < .001) (Figure 1 and Table 1). ...

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... The HSV-2 prevalence among Indigenous individuals who self-reported condom use (52.9%) (sexually active) was higher than in those who did not use condoms (47% OR 0.75 (0.60-0.93)). The use of condoms is a protective factor, as condom use is directly linked to the prevention of HSV-2 and other STIs [60][61][62][63][64][65]. The risk of unprotected sex (occasionally or never using condoms) among sexual partners of the same ethnicity, concurrent partners, and partners using illegal drugs is associated with low frequency of consistent condom use and, in turn, vulnerability to the transmission of STIs other than HSV-2 in indigenous migrant agricultural workers [64,66]. ...
... The use of condoms is a protective factor, as condom use is directly linked to the prevention of HSV-2 and other STIs [60][61][62][63][64][65]. The risk of unprotected sex (occasionally or never using condoms) among sexual partners of the same ethnicity, concurrent partners, and partners using illegal drugs is associated with low frequency of consistent condom use and, in turn, vulnerability to the transmission of STIs other than HSV-2 in indigenous migrant agricultural workers [64,66]. Behaviors that generate risk directly facilitated the acquisition of HSV-2; the HSV-2 prevalence was high with respect to the use of illicit drugs, alcoholism, the use of sharp objects, and having a tattoo, amounting to 44.4%, 54.3%, 57.4%, and 56%, respectively. ...
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Sexually transmitted Human alphaherpesvirus 2 (HSV-2) causes genital ulcers, especially among sexually active adolescents and adults. We estimated the exact prevalence of anti-HSV-2 antibodies and correlated it with the demographic and behavioral aspects of the Indigenous population of the Jaguapirú and Bororó villages (Dourados, Mato Grosso do Sul (MS), Brazil). In total, 1360 individuals (>18 years old) were administered serologic tests. The prevalence of anti-HSV-2 IgM was 12.9%, that of anti-HSV-2 IgG was 57.2%, and 8.5% cases tested positive for both HSV-2 IgM and IgG. The prevalence of anti-HSV-2 antibodies was higher in females (59.5%) compared to males (49%), with an OR of 0.64 (0.49–0.83). Anti-HSV-2 antibodies were found in 14.2%, 12.3%, 15.4%, and 14.5% of participants with urinary problems, genital wounds, genital warts, and urethral discharge, respectively. In summary, the seroprevalence of HSV-2 in the Indigenous population was five times higher than that reported in the general adult Brazilian population. Educational level, income level, smoking, condom use, incarceration, illicit drug abuse, the sharing of used needles and syringes without adequate disinfection, homosexual relationships, prostitution, the sexual practices among drug users, and avoidance of contraceptive methods could contribute to the facilitation of HSV-2 transmission in the Indigenous population. Our results may help develop culturally appropriate intervention programs that eliminate health-access barriers and improve the implementation of public health policies aimed at promoting information regarding and preventing, treating, and controlling HSV-2 infection in Brazilian Indigenous populations.
... In a recent study, the authors found that the condom reduced the transmission of HSV-2 by 65% from men to women. and by 96% from women to men [28]. Although condoms are available in some areas, HSV-2 can continue to spread through the mucocutaneous route. ...
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... HSV-2 among women has been widely studied and well documented (Bernstein et al., 2013;Daniels et al., 2016;A. Davis et al., 2016;Fleming et al., 1997;Korr et al., 2017;Lehavot et al., 2014;Magaret et al., 2015;Masese et al., 2014;McQuillan et al., 2018;Nowotny et al., 2018;Pratt et al., 2012;Ramchandani et al., 2017;Rollenhagen et al., 2014;Smith et al., 2002;Van der Pol, 2014;Xu et al., 2006;Xu, Sternberg, Gottlieb, et al., 2010). However, few researchers have examined HSV-2 risk or prevalence specifically among WSW and have found that HSV-2 is more prevalent among WSW than among WSM (Gorgos & Marrazzo, 2017;Operario et al., 2015;Xu, Sternberg, & Markowitz, 2010a). ...
... HSV-2 infection among women overall has been widely studied and well documented (Anzivino et al., 2009;Bernstein et al., 2013;Beydoun et al., 2010;Cunningham et al., 2006;Daniels et al., 2016;A. Davis et al., 2016;Esber et al., 2015;Fleming et al., 1997;Hsu et al., 2016;Kalu et al., 2015;Kelly et al., 2016;Korr et al., 2017;Lehavot et al., 2014;Li & Wen, 2017;Magaret et al., 2015;Masese et al., 2014;McGee et al., 2017;McQuillan et al., 2018;Nakubulwa et al., 2016;Nowotny et al., 2018;Posavad et al., 2015;Pratt et al., 2012;Ramchandani et al., 2017;Rollenhagen et al., 2014;Satterwhite et al., 2013;Smith et al., 2002;Spicknall et al., 2021;Stephens et al., 2016;Sudenga et al., 2012;Van der Pol, 2014;Xu et al., 2006;Xu, Sternberg, & Markowitz, 2010a). However, analyzing data on women without considering their sexual behavior may mask important differences in the factors related to HSV-2 infection in women who have sex with women (WSW) versus women who have sex exclusively with men (WSM; Conron et al., 2010). ...
... In the United States, an estimated 18.6 million individuals were living with an HSV-2 infection in 2018 and 572,000 new HSV-2 infections occurred that year . As shown in table 3, the prevalence of HSV-2 among individuals of reproductive age (14-49 years) is 12.1%, and is more prevalent among women and high number of sexual partners, prior history of an STI, and condomless sex (Garland & Steben, 2014;Gupta et al., 2007;Magaret et al., 2015;Stanaway et al., 2012;Stephens et al., 2016). Because HSV-2 is mainly transmitted during sex, the risk of infection reflects an individual's amount of sexual activity, the number of sexual partners, as well as the prevalence of HSV-2 in the community (Wald & Corey, 2007). ...
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Herpes simplex virus type 2 (HSV-2), the main cause of genital herpes, is an incurable sexually transmitted infection responsible in 2018 for 18.6 million infections in the United States. HSV-2 is twice as frequent in women than in men. Women who have sex with women (WSW) have a higher prevalence of depression and drug use than women who have sex exclusively with men (WSM), which are each related to HSV-2 as they increase the likelihood of engaging in risky sexual behaviors. The purpose of this study was to assess the predictive relationship between depression status, nonprescription drug use status, and HSV-2 status in WSW while controlling for age, race, educational level, income, and total number of sex partners. The research design was a quantitative, correlational study of a cross-sectional nature using secondary data from the National Health and Nutrition Examination Survey (NHANES). The theoretical framework for this study was the escape theory, which describes why individuals engage in certain activities (e.g., drug use and risky sexual behaviors) to avoid negative thoughts about themselves. Data were analyzed using chi-square and multiple logistic regression tests to assess the relationships between variables. Results did not indicate statistically significant (p < 0.05) predictive relationships between depression status, nonprescription drug use status, and HSV-2 status in WSW, but age, race, educational level, income, and total number of sex partners were all predictively related to HSV-2 status at statistically significant levels. The results of this study may motivate researchers to further investigate these relationships. STI prevention planners could use this information to ensure that these risk factors are considered when designing HSV-2 interventions for sexual minority women.
... Mask efficacy is inferior to that of other, less permeable barrier methods to prevent infections such as condoms 1,3,4 . The most commonly used cloth and hospital masks do not provide a perfect facial seal and mask fabric does not block emission or inhalation of all aerosolized viral particles 5,6 . ...
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... Meanwhile, type 2 (HSV-2) is more severe than HSV-1 and is considered a sexually transmitted disease. HSV-2 infection in a healthy and non-infected person occurs through sexual contact and direct contact with bodily fluids with an infected person [23] . The present study is focused on HSV-2 and attempts to understand the impact of alternative treatment policy on its transmission dynamics. ...
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Infection of Herpes Simplex Virus type 2 (HSV–2) is a lifelong sexually transmitted disease. According to the Center for Disease Control and Prevention (CDC), 11.9% of the United States (U.S.) population was infected with HSV–2 in 2015-2016. The HSV–2 pathogen establishes latent infections in neural cells and can reactivate causing lesions later in life, a strategy that increases pathogenicity and allows the virus to evade the immune system. HSV–2 infections are currently treated by Acyclovir only in the non-constitutional stage, marked by genital skin lesions and ulcers. However, patients in the constitutional stage expressing mild and common (with other diseases) symptoms, such as fever, itching and painful urination, remain difficult to detect and are untreated. In this study, we develop and analyze a mathematical model to study the transmission and control of HSV–2 among the U.S. population between the ages of 15-49 when there are options to treat individuals in different stages of their pathogenicity. In particular, the goals of this work are to study the effect on HSV–2 transmission dynamics and to evaluate and compare the cost effectiveness of treating HSV–2 infections in both constitutional and non-constitutional stages (new strategy) against the current conventional treatment protocol for treating patients in the non-constitutional stage (current strategy). Our results distinguish model parameter regimes where each of the two treatment strategies can optimize the available resources and consequently gives the long-term reduced cost associated with each treatment and incidence. Moreover, we estimated that the public health cost of HSV–2 with the proposed most cost-effective treatment strategy would increase by approximately 1.63% in 4 years of implementation. However, in the same duration, early treatment via the new strategy will reduce HSV–2 incidence by 42.76% yearly and the reproduction number will decrease to 0.84 from its current estimate of 2.5. Thus, the proposed new strategy will be significantly cost-effective in controlling the transmission of HSV–2 if the strategy is properly implemented.
... The first step to protection is to encourage condom use. It has been shown to have quite high effectiveness in regular use and higher effectiveness in transmission from man to woman [73]. Sexual intercourse should be avoided during active attack periods. ...
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... However, due to the high prevalence of HIV/STI's and multiple and concurrent partnerships, condom use among married partners may continue to be recommended, particularly for serodiscordant couples. [14] However, negotiating condom use in a marriage is more difficult due to trust issues and the implication that a partner is being unfaithful. [15][16][17][18] Gender inequality also plays a major role; men are often considered the sexual decision-makers regarding condom use and women may not be able or willing to consistently impose strategies for protection. ...
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Background Zambia experiences high unmet need for family planning and high rates of HIV, particularly among youth. While male condoms are widely available and 95% of adults have heard of them, self-reported use in the past 12 months is low among young adults (45%). This study describes factors associated with non-use of male condoms among urban young adults in Zambia. Methods A household cross-sectional survey in four urban districts was conducted from November 2015 to January 2016 among sexually active young adults ages 18–24 years. A random walk strategy was implemented in urban areas; eligible, enrolled participants were administered a survey on household characteristics, health access, and knowledge, attitudes and practices related to contraception. Relative risk regression models were built to determine factors associated with the decision to not use a male condom (non-use) at most recent sexual intercourse. Results A total of 2,388 individuals were interviewed; 69% were female, 35% were married, and average lifetime sex partners was 3.45 (SD±6.15). Non-use of male condoms was 59% at most recent sexual intercourse. In a multivariate model, women were more likely to report non-use of a male condom compared with men (aRR = 1.24 [95% CI: 1.11, 1.38]), married individuals were more likely to report non-use compared with unmarried individuals (aRR = 1.59 [1.46, 1.73]), and those residing in the highest poverty wards were more likely to report non-use compared with those in the lowest poverty wards (aRR = 1.31 [1.16, 1.48]). Those with more negative perceptions of male condom use were 6% more likely to report non-use (aRR = 1.06 [1.03, 1.09]). Discussion regarding contraception with a partner decreased non-use 13% (aRR = 0.87 [0.80, 0.95]) and agreement regarding male condom use with a partner decreased non-use 16% (aRR = 0.84 [0.77, 0.91)]). Discussion Non-use of male condoms is high among young, married adults, particularly women, who may be interested in contraception for family planning but remain at risk of STI infection. Effective marketing strategy of dual protection methods to this population is critical.
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The guideline provides recommendations on the management of adults with anogenital herpes in the UK. Recommendations include diagnostic tests, management of the primary or first episode of anogenital herpes and recurrences, effectiveness of therapy, prophylaxis, and prevention of transmission between partners, as well as patient centred counselling.