High prevalence of antibodies to herpes simplex virus type 2 among middle-aged women in Mexico city, Mexico - A population-based study

Background: Herpes simplex virus type 2 (HSV-2) is among the most prevalent sexually transmitted diseases worldwide. In Mexico there is a lack of popu lation-based HSV-2 surveys. Goals: To determine population-based HSV-2 seroprevalence and risk factors among women in Mexico City, Study Design: A random sample of 730 women was identified among the residen ts of Mexico City. Women ages 25 to 85 years were selected from 3694 househ olds, Western blot serology testing was conducted on serum samples to deter mine HSV-2 type-specific serostatus, A structured questionnaire was adminis tered, and multivariate analyses were performed to identify risk factors fo r HSV-2 seropositivity, which were stratified into two age categories: youn ger than 50 years of age and 50 years of age or older, Results: The HSV-2 seroprevalence among female participants was 29.8%, with a significant trend of increasing HSV-2 prevalence for each higher level o f age (P < 0.001), Female participants had a median age of 46 years and wer e predominantly monogamous (82.6%). The overall population-based seropreval ence estimated in Mexico City among women was 35.8%, The independent risk f actors for HSV-2 seropositivity included a history of two or more sexual pa rtners (odds ratio [OR], 2.2; 95% CI, 1.4-3.4), two or more sexual partner before first pregnancy (OR, 2.3; 95% CI, 1,4-3,7), cohabitation with partne r (OR, 2.5; 95% CI, 1,3-4,7), and current vaginal douching (OR, 1.7; 95% CI , 1.2-2.6), Conclusions: Population-based HSV-2 seroprevalence is endemically high amon g middle-age women in Mexico City, and clearly is correlated with higher-ri sk sexual behavior. This elevated HSV-2 seroprevalence may reflect unrecogn ized HSV-2 transmission throughout life.