Background: Most herpes simplex virus type 2 (HSV-2) infections are asymptomatic or unrecognized, so periodic serological surveys are necessary in order to measure the true prevalence of infection, track trends over time, and identify correlates of infection, including coinfection with human immunodeficiency virus (HIV).
Methods: We conducted a community-based, cross-sectional, serological survey among 500 men who have sex with men (MSM) in San Francisco during 2008.
Results: The seroprevalence of HSV-2 infection was 26.1% (95% confidence interval [CI], 18.3-33.9), of HIV infection was 18.6% (95% CI, 13.0-24.4), and of HSV-2/HIV coinfection was 12.0% (95% CI, 7.3-16.8; categories not mutually exclusive). HSV-2 prevalence was 3.7 (95% CI, 2.3-5.9) times as high among HIV-infected MSM as among HIV-uninfected MSM. Strong predictors of HSV-2 infection among both HIV-infected and HIV-uninfected MSM were older age and black race.
Conclusions: The prevalence of HSV-2 infection among MSM in San Francisco is similar to that among MSM nationwide and is higher than that among all men nationwide. Prevalence rates are highly disparate among subpopulations of MSM in San Francisco, with the strongest predictors of infection being HIV-positive serostatus, older age, and black race. Primary prevention of HSV-2, particularly among populations at the highest risk for infection with HSV-2 or HIV, should remain a major public health goal to reduce the substantial morbidity caused by both of these infections.